The Institute for Preventative Sports Medicine, led by members of our Board of Directors and Advisory Council, have continued to work on the forefront of injury prevention and healthcare cost containment related issues.

Our most recent publication: The Comparison of Standard vs. Break –Away Bases: An Analysis of a Preventative Intervention for Softball and Baseball Foot and Ankle Injuries, was recently published in the International Journal of Foot and Ankle. The co-authors of the study, Dave Janda, Cynthia Bir, and Beth Kedroske, confirm in this laboratory study the beneficial effect of break-away bases. The purpose of this study was to identify the injury reduction capabilities of break-away bases in a laboratory setting. In addition, the study revealed that not all types of break-away are equally effective in reducing injuries. In fact, the Rogers Break-Away Base was found to be the most effective at reducing injuries at all levels of the lower extremity. This is in contra-distinction to marketing by the sports equipment industry, that all types of bases are in fact the same.

Our study entitled: The Evaluation of the Cumulative Concussive Effects of Soccer Heading in the Youth Population, is scheduled for publication in April 2002 in The International Journal of Injury Control. As many of you are aware, The Institute has taken the leading role in the issue of heading within the sport of soccer. In this field study, we at The Institute, found that there was a relationship between heading and information processing and memory ability. We found that, as the amount of heading increased there was a deleterious effect on information processing and memory ability of the student athletes. Our recommendations as it relates to heading in soccer are: 1) Modify how children are trying to head the ball in practice. It has been our experience that the vast majority in heading events is occurring at these practice sessions. We suggest a lighter mass ball be utilized, such as a beach ball, which is the same size as a soccer ball. By utilizing this type of ball, it is our contention that we can virtually eliminate the information processing and memory deficits that are occurring. 2.) It is our firm belief that student athletes complaining of headache, nausea, vomiting, blurred vision, or double vision immediately be removed from play. Unfortunately, this is not occurring on the vast majority of fields in our country. In addition, it is of importance that the student athlete not be returned to play until their symptoms have completely dissipated. If their symptoms continue, they should be evaluated by a trained medical professional immediately. If a student athlete is sent back into competition with ongoing symptoms, this can only lead to further and to a more significant injury.

As a follow up to our heading study, Ms. Beth Kedroske, Mr. Rajkumar Israel, and Dr. Janda are currently investigating a number of different type of headbands that have been recommended by manufacturers as reducing the impact of a soccer ball. This study is anticipated to be concluded in late spring of 2002.

The New South Wales Sporting Injuries Committee, which is based in Sydney, Australia and is linked with the Sydney Olympic Organizing Committee, chose The Institute to be the home US base for the winner of the F.E. Johnson Memorial Fellowship. We were honored to have Dr. Andrew McIntosh, who is a leader in head impact research, join us in our laboratory this past summer. Andrew, along with Rajkumar Israel, Beth Kedroske, and Dr. Janda entered into a study of evaluating, comparing and contrasting different types of headgear from various types of sports. We anticipate completion of the final write up of this study by early spring.

As we have outlined in the past, the most common scenario for a student athlete sustaining a fatal event in the sports of baseball, hockey, and lacrosse is an impact to the chest with a ball or puck. In this scenario, the ball or puck impacts the chest at the precise phase of the heart cycle and leads the heart to develop such a rapid rhythm that the heart cannot pump blood effectively to the vital organs and the student athlete dies. As you are well aware, The Institute has been on the leading edge of this scenario, for the past ten years. In fact, we have had a series of studies published first showing that softer, heavier baseballs and the original type of chest protectors were not effective in reducing fatality. Our next series of studies then showed that lighter mass, as well as, modified chest protectors in the baseball industry, could lead to a reduction in the risk of fatality, however, not complete resolution of the problem. As you are also aware, The Institute has recommended that every community athletic field and gymnasium have immediate access to automatic external defibrillators. It has been shown that defibrillators can drastically reduce fatalities that are secondary to an impact event. Rajkumar Israel, Beth Kedroske, Cindy Bir, and Dave Janda are now investigating various types of hockey chest. We anticipate conclusion of this study in the summer of 2002.

Dr. Tom Pashby who has been on The Board of Directors of The Institute since it’s inception, is the leading investigator and prevention spokesperson for the sport of hockey in the world. Tom is responsible for the near complete elimination of blinding eye injuries in the sport of hockey, as well as racquet sports. Tom has now gone on the offensive in trying to eliminate the escalating issue of concussions in the sport of hockey. As Tom has so eloquently outlined, concussions initially averaged 4% of reported injuries in hockey in 1996 and that figure has drastically increased to 17% in 2001. Tom has been on the offensive on both the professional and amateur ranks of instituting a NO HEAD CHECK RULE IN ALL OF HOCKEY AT ALL LEVELS. It is our recommendation at The Institute for Preventative Sports Medicine, that the no head check rule, based on Tom’s analysis and recommendations, be implemented nationally, as well as internationally.

Dr. Janda recently was asked to be the author of an article to be published in Clinical Orthopedics and Related Research. The subject matter was a comprehensive review of softball and baseball injuries as well as prevention methods. It was an honor that The Institute was selected as the most pre-eminent organization involved in injury prevention as it relates to the sports of softball and baseball on an international basis. This article is scheduled for publication in early spring of 2002. In the article many of The Institute’s prevention studies are highlighted.