Wednesday, February 16, 2011

Get the Facts on Concussions

Why do we umpire? Mostly, I suspect, because we love the game, we enjoy helping youth and adults experience the sport fairly and safely, and we welcome the comradeship of our partners. At the same time we love it, we also know that there is a small but ever present danger of injury. Beyond the aching knees, bad bruises, and turned ankles, the most serious dangers come from lightning, heat exhaustion, and concussion. The first two of these are, fortunately, rare events and largely avoidable. The last, concussion, is, unfortunately, a risk on every pitch when we are behind the plate.

According to the Mayo Clinic, concussions are caused by a blow to the head that temporarily interferes with the way your brain works. When concussed, your brain actually moves suddenly and violently within your head causing stretching and damage. As they point out, most people who have concussions never black out. Nevertheless, concussions are serious and science is still learning about them. Recent publicity about concussions in football has brought new attention to the issue. However, baseball, especially for catchers and umpires, has many of the same issues.
Cal Drummond was an American League umpire from 1960 to 1969. In 1969 he was struck by a foul ball. He had brain surgery but recovered and began to work his way back through the minors. On May 3, 1970, he took himself out of game because of dizziness. He died soon after. While this is the most horrific of umpire concussions, researchers now know that multiple concussions, mostly untreated, can increase a person's risk of getting epilepsy and suffering permanent impairment of brain function.
Because many of us work more games behind the plate each year than major league umpires, we need to take precautions to ensure that we minimize the risk of concussion and know what to do if we suffer one. There is no absolute protection. A mask or helmet is very important but, according to scientists, the cause of a concussion is not the impact of the ball but the sudden movement of your brain inside your head. As one prominent brain injury physician once told me, we need a tougher neck, not a tougher mask.
Having said that, research shows that a good mask or helmet is an essential part of protecting yourself. The mask or helmet and, most importantly, the padding between them and your head, does absorb and deflect some of the force of the impact of a ball. While there are many strongly held views on whether a traditional mask or hockey-style helmet is better for protecting your head from concussion, the research that I have reviewed shows that there is really no evidence either way. A helmet is better for protecting against a blow from the side -- from a swing for example. Some also believe that the flatter, so-called, low-profile traditional masks are poorer at deflecting a pitch or foul ball and, therefore, may be less protective. However, there is no research on the matter. One thing that does appear to be clear is that the padding in the mask or helmet is very important. It may be worth checking and replacing the padding if you have a less expensive or older mask.
An obvious way to avoid concussion is to not get hit. But how do you do that? One way is to use good positioning. Make sure that your head level is low, just above the catcher's head. Also, make sure that you are setting up deeper in the slot. By deeper, I mean further from the plate and more behind the batter. Besides increasing the chances that a missed inside pitch will hit the batter, rather than you, it will also increase the chances that a foul ball will miss you.
Of course, we're not always going to be so skilled or lucky to avoid a hit. What do you do if it happens? First, recognize the signs and symptoms. Remember, most concussions occur when you don't black out. According to the Mayo Clinic, symptoms "can be subtle and may not be immediately apparent." They include confusion, amnesia, headache, dizziness, ringing in the ears, nausea or vomiting, slurred speech, fatigue, memory or concentration problems, sensitivity to light and noise, sleep disturbances, irritability, and depression.

Mayo Clinic recommends that, if any of these symptoms last 15 minutes or longer or include loss of consciousness or amnesia, it's not safe to put yourself at risk for at least one week. It is important to rest, both physically and mentally. That's because doctors believe that repeated concussions make matters much worse and increase the risk of long-term permanent problems. What this means is that you have to honest with yourself and your assigners. We may have to take a break from working the plate. We'll have to understand when a partner asks us to work the plate because of a recent hit to the head.

Umpiring is fun and rewarding. Through the right equipment and technique, we can do a lot to protect ourselves. However, we cannot eliminate the risks completely. It's time we all paid more attention to concussion risk and do the right things to take care of ourselves and our partners. To learn more, I recommend a free course offered by the NFHS. You can find it at www.nfhslearn.com.

Note: The author is not a medical professional. This article is not providing medical advice but, instead, is reporting on the medical advice given by other cited sources. You should never substitute the information you read for the advice of your physician.

Ian Spatz is a baseball umpire living in the Maryland suburbs of Washington, DC. This article was written for the Metropolitan Baseball Umpires Association and appears with the author's permission. Thanks Ian!

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