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Tuesday, June 6, 2023

Can training stop the rise in traumatic brain and spinal cord injuries?

Brent Brookbush

Brent Brookbush


Panel Discussion: Can training stop the rise in traumatic brain and spinal cord injuries?

Will new training methods and technologies be able to stop the rise in traumatic brain and spinal cord injuries? Or, are sports like football, boxing and hockey doomed?

Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS

This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on February 3rd, 2013

Ryan Crandall

F=MA….doubt it, unfortunately. Take off the pads and helmet…that is a likely problem solver for lowering collision speeds.

February 3 at 10:33am

Brent Brookbush

That is an interesting point. Although, I doubt that would reduce the number of traumatic injuries. It would be interesting to compare the traumatic brain and spinal cord injury stats of football players against rugby players.

February 3 at 10:35am

Christopher DeSouza

I think a big issue is that due to athletes focusing more on nutrition and better training, the games are only getting faster and the players are getting stronger. This leads to games that are more fun to watch, but it also leads to an increase of powerful high speed collisions. I don't know if there will be things to change that except for teaching kids how to protect themselves properly. It won't really be able to prevent it, but it would hopefully lower the risk in most sports.

February 3 at 12:20pm

Brent Brookbush

Hey Christopher DeSouza, I appreciate where you are coming from and I talk about "protecting your face" in Basketball when I catch someone in the chin with an unintentional shoulder… but the truth is, I have been nearly knocked out on a basketball court, playing with great players and I know how to protect my face (My point, stuff happens). Basketball isn't half as violent as football. I don't think that teaching people to protect themselves is enough. I even heard from a school teacher in one community who reported they had canceled the "football season" because kids were not interested in playing anymore. It may be 1 in 1,000,000 that suffer from a traumatic brain injury or spinal cord lesion, but when the risk is a life as a quadriplegic or worse… less individuals are going to literally risk their necks to participate in these sports. I have to admit… knowing what I know now… if I had children, football, hockey, gymnastics, and diving would not be options.

February 3 at 12:30pm

Ryan Crandall

I still feel that effects twenty years after I played…I rammed my self into players and I was small. My poor neck.

February 3 at 1:01pm

Barbara Kay

I actually have a couple of opinions about this. I know from personal experience that proper training in movement and mechanics can prevent injury in certain ways. I pitched fastpitch softball for twelve years, throwing 200-300 pitches per day when practicing, and sometimes throwing two or three games in a row and never had a shoulder or back problem (which a lot of girls had due to improper mechanics and lack of strength training and stretching). If you are performing the motion correctly, chances are you will prevent any self-inflicted injuries. However, in sports like football, the guys are taught how to tackle correctly (meaning safely to avoid injury), but we still see it happen. I do think that we are making strides in technologies in terms of enhancing the helmets to give more support/protection. However, I also think back to the times when players had minimal protection and there weren't nearly as many injuries as there are now. Take baseball players - back in the 30s and 40s they used to cut a hole in the palm of their gloves so they could feel the ball hit it - now someone breaks a nail and he is on the DL for two weeks. Could it be that there is a mental toughness component to all of this as well? I think so. However, we can't ignore that the more muscle building, steroid usage, etc. that occurs, the less likely it is that athletes are focusing on flexibility - which means increased risk of injury when performing movements. A friend of mine was a Div. I basketball player and trained extensively - focusing on strength and flexibility - particularly in her upper body. She was in a car accident and broke her neck - the doctors said that she should have been paralyzed but the fact that she had such strong muscular development in her back saved her - they actually performed a research study on her. So, the benefits of strength training are obvious - but performing the movements and training the muscles to function effectively and efficiently through proper range of motion is key.

February 3 at 1:27pm

Brent Brookbush

Great points Barbara Kay, I do think some training programs have fallen way behind, still focused on olympic lifts and max strength as opposed to an integrated approach that considers postural dysfunction, ideal human movement, and neuromuscular efficiency. However, the better our athletes perform the harder the hits are going to be in the sports I mentioned above. Before there was extensive padding there were few if any guys who were more than 220lbs and could run a 40 meter dash around or below a 4.4sec. That is a ridiculous amount of force. And more padding may or may not stop the rattling that happens with in the skull and the cumulative effect these hits have on the spine and nervous system as a whole. I know this is a focus of new research, but I think we may end up looking back at football and boxing in particular and consider how many lives were actually ruined in the pursuit of professional careers.

February 3 at 5:26pm

Kinesiology Cscs

Are you oppposed to the Olympic Lifts and max strength?

February 3 at 6:27pm

Brent Brookbush

No Kinesiology Cscs, well… for the most part. Olympic lifts are highly over recommended for the athletic population, for example snatches pose a ton of risk to the shoulder complex with no real benefit to the field athlete. Many exercises could serve the purpose of developing overhead power with less risk and more transferable gains. Max Strength is essential part of athletic development, but it should be one piece of a periodisized program. I think many strength training programs still spend the majority of time in a high intensity max strength phase with a focus on olympic lifts, and this increases the risk of injury for athletes. Everything in moderation

February 3 at 7:00pm

Kinesiology Cscs

Ok thanks. I ask because I notice NASM seems to suggest "progressing" by decreasing load and increasing instability and "proprioceptively enriched environment," which is great for progression in neuromuscular control, but obviously not strength or mechanical power. I'm only slightly familiar with NASM curriculums; am aware they endorse a periodized routine; but can't recall seeing them endorse heavy squats, deads, and Olympic Lifts as part of a comprehensive strength and conditioning program.

February 3 at 7:17pm

Brent Brookbush That's only during phase 1 and phase 2 of the NASM model. I think it gets the most attention because it is the most under-utilized part of programming in most performance programs, and is the most useful for the personal training client (most personal training clients are not going to spend much if anytime working on a max strength or power phase). You should look into the NASM PES program for more sports specific training… we are big fans of PAP training, and I even heard they may make a workshop that focuses on max strength and olympic lifts. They have already created kettle bell and sand bag workshops. The NASM model is simple an evidence-based, progressive system for optimal performance. Almost any modality you can think of fits somewhere.

February 3 at 7:26pm

Kinesiology Cscs

Ok thanks. I do have the PES book, have read some parts and browsed through others, just haven't taken the time to get the cert yet. Thanks for your answer.

February 3 at 7:28pm

Mark Jamantoc

I am certainly not the best person to answer this but one thing is certain: ACCIDENTS HAPPEN. No amount of training can prevent any accident. They can be decreased in terms of incidence but it will still happen at times. I deal mostly with musculoskeletal pain. When patients usually see me in the clinic, the damage has been done. For training athletes, I usually just refer them to certain trainers who do specific training for them. One big advantage of being a Physical Therapist is knowing what to tell these players: whether they are about to go to surgery or post-op care. I listened to a lecture given by Dr Michael Colgan of the Colgan Institute and he, having worked with many many elite olympic athletes for the past 40 years, he has seen how we have improved so much in nutrition, training, and most of all prevention. He used to be the doctor of the boxer Evander Holyfield. He is currently studying the human brain and developing some high level supplementation for athletes with brain / memory issues. He released a book last year called the ANTI-INFLAMMATORY ATHLETE FOR ANY AGE http://colganinstitute.com/online-courses/online-courses/index.php?main_page=product_info&cPath=1&products_id=199 and it's a superb book for prevention of inflammation for athletes especially when they are training for an event or a sport.

The Anti-Inflammatory Athlete - PDF Download - $6.99 : The Colgan Institute,

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February 3 at 11:42pm

Joel Crandall

Women's Soccer is the #2 Sport for Concussions! Must take Heading the ball out of the Game

February 6 at 12:47am

© 2014 Brent Brookbush

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