Watch Your Head!

Watch Your Head!
By Dr. Randy Borum

(Article First appears in Black Belt Magazine, June, 2009)

Sport-related concussions once again have hit the headlines. It is estimated that at least 300,000 of them occur every year. Martial artists who do full-contact sparring are certainly at some risk for these injuries. But are concussions really such a big deal?

Medically, a concussion is considered to be a mild traumatic brain injury. It is caused either by some type of blunt trauma – such as a punch or kick- or by forces accelerating or decelerating the brain within the skull. Typically, there is no discernible damage to the structure of the brain, but concussions do temporarily disrupt brain functions. As a result, concussions are diagnosed and graded based on their symptoms rather than by neuroimaging. Basically, the severity of concussive injury depends on the nature, duration and extent of disrupted brain functions, not on the shape, size or color of what shows up on a brain scan.

Just because there are no signs of physical damage, doesn't mean that no harm was done or that the injury isn't serious. Medical researchers don't know for sure what happens to the brain during a concussion and what causes the brain functions to be impaired, but it seems to be linked to damage that occurs at a cellular level. When the concussion is caused by abrupt rotational forces, risk increases for damaging areas of axons within the brain. This is known as “diffuse axonal injury.” Axons are the pathways that allow neurons to communicate with each other. Disrupt the pathways, and you disrupt the function.

The cumulative effect of repeated concussions is a subject of ongoing medical inquiry. For many years, the medical literature has reported cases of “pugilistic dementia”, sometimes called “punch drunk syndrome” due to its effect impairing speech, coordination, and cognitive functions. These cases have mostly been reported among professional boxers after about 15 years of competing. The more contemporary term used to describe the phenomenon is “chronic traumatic encephalopathy” (CTE).

CTE has recently been in the news because of claims that it is linked to deaths of several retired professional athletes, primarily football players. Researchers at Boston University's School of Medicine have established the Center for the Study of Traumatic Encephalopathy to better understand the problem by examining the brains of affected individuals after their death. Studying the brains directly after death, neurologists can see damage that does not appear on traditional scans. The youngest case they have studied is that of 18-year-old high school football player who had suffered multiple concussions.

In these brains studies, researchers have found deep structural abnormalities called neurofibrillary tangles caused by the build-up of “tau”, an abnormal and toxic protein. Interestingly, neurofibrillary tangles have also been implicated in Alzheimer's dementia. Signs of CTE may start with memory problems or disturbances in mood or behavior, such as depression, mood swings or erratic/impulsive actions. Incidentally, in a survey I conducted of more than 400 combat sport athletes, those who had a history of multiple concussions were much more likely to be seriously depressed than those with no concussive history.

Researchers believe that problems associated with CTE get worse over time. As the protein accumulates, the effects get progressively worse, eventually killing brain cells; in some case, ultimately leading to a full-blown dementia. Once the build up occurs, the cell damage may progress and the brain functions may continue to deteriorate even years after the repeated concussions have stopped.

Of course, most people who get concussions – even more than one – do not seem to develop this severe and progressively worsening condition. There seems to be no reliable way right now, though, to distinguish in advance those who will from those who won't. The risk of concussions is not unique to martial arts and combative sports – in fact there are a larger number that occur from football-related injuries. But those who train or compete in full-contact martial arts should be aware that sustaining repeated concussions – at least in some cases - can have serious consequences. Any single impact may seem like an insignificant “ding”, but the cumulative effects, particularly over years, can be quite troubling.

If you train or compete in full-contact sports, there are a few things you can do to educate yourself and mitigate your risk. First, learn to recognize the signs of concussive injury. Sometimes people think if there's no loss of consciousness or memory, there's no problem. That's not necessarily true. While loss of consciousness and amnesia (memory loss) are often related to the severity of the injury, neither is a necessary condition to diagnose concussion, and neither is a good isolated marker of its effects. Experts suggest that symptoms – and possibly cognitive and postural testing - be assessed and monitored at the time of the event and afterwards. Common signs at the time include confusion, feeling “foggy”, clumsy or uncoordinated movement, dizziness, balance problems, headache, nausea, and vision problems. If you are with someone who may have had a concussive injury, you can ask a couple of simple questions. Check whether they know where they are and what day it is, whether they remember the hit and what preceded it, whether they can remember new words you give to them and repeat a series of two or three numbers backwards. These questions don't provide a diagnosis. That's not what you're trying to accomplish. But failing these basic tasks could suggest the person has sustained some injury – however minor – and at least should sit out the day and perhaps consult his or her healthcare professional.

Second, after sustaining a concussion, give your brain plenty of time to recover. It is tempting for some fighters to try to tough it out and go immediately back to trading blows, but getting a second concussion while the brain is still recovering from the first can seriously compound the severity and damage. Studies have shown that, on average, it takes approximately seven days for athletes to fully recover from symptoms of a concussion. At a minimum, the National Athletic Trainers’ Association recommends that athletes who experience a head injury resulting in loss of consciousness or amnesia should refrain from participating on the day of the injury, and that management should be more conservative for athletes who have a history of prior concussions.

You can find additional information about sport-related concussions from the Centers for Disease Control and Prevention (www.cdc.gov/ncipc/tbi/) or the University of Pittsburgh Medical Center (sportsmedicine.upmc.com/ConcussionProgram.htm).

Why I love Transworld Sport...

Many of my first year undergraduate students are baffled by the time dedicated to considering the concept of 'sport' and its relationship to 'games', 'leisure', 'play', 'recreation' and other concepts. "Of course we know what sport is, we don't need to spend weeks thinking about it" they often lament, as I discuss the notion of conceptual analysis, ostensive definitions, and necessary and sufficient conditions. And unfortunately that's often the response from even the most engaged of students. The others simply shrug their shoulders as if to say, "Why would I care whether something is sport or not?"

There are two prongs of response to such apathy: one, it is an attempt to give some indication of philosophic methods - methods which I fear are severely neglected in many courses on research methods. Definition of terms is crucial in any exegesis of a problem or issue in order to ensure that what you are trying to study is really what you are studying, as well as to ensure that others are clear as to what you are talking about and mean when you use particular concepts.
Two, from a more practical and pragmatic point of view, there are people (who may, in the future, be my former students) who are tasked with the responsibility of deciding whether a particular activity fulfils particular criteria to be allocated funding or a place in an event (such as the Olympic games). Decisions have to be rationalised and justified to other parties (i.e. the public, Governments, the media) and it would simply not be acceptable for such judgements to be made on a whimsical subjective preference.

So where does Transworld Sport come in to all of this? For those of you that are not familiar with the television programme, it is the broadest and most global sports broadcast that exists. For instance, the programme I was watching today highlighted the sport of sheep shearing in New Zealand and the Columbian target sport of Tejo (where a lead weight is thrown twenty meters into a box of clay in an attempt to explode a small paper triangle filled with gunpowder). That such obscure activities are showcased indicates that the concept of sport has an ethereal and ambiguous quality. How can sheep shearing possibly be a sport when it is simply a means to an end in gathering wool to provide warmth and comfort? When it is regulated, timed and primarily done to discover who is the fastest, fittest, and most skilled in displacing one object (wool) from an other (sheep). When is a recreational game that was labelled 'the devil's game' and banned due to its association with an alcoholic drink, a sport? When those involved practice for hours every day, embed gym sessions into their routines, wear a team uniform in a formal event that is officiated by a governing body.



Transworld Sport is a wonderfully democratic and inclusive sports programme that doesn't pander to the hegemonic Westernised, male and affluent business conception of sport with which we are bombarded on a daily basis in the similarly hegemonic media. Rather, it reveals a conception of sport that is as broad and as deep as human imagination allows a physically skilful activity that is bounded by rules but done for its own sake, to be.

Are video games a sport?

Organized competitions, teams, regular salaries, cash prizes, fans - welcome to the Cyberathlete Professional League (CPL). Are video games a sport? That is the question raised by Gloria Goodale in an article published in The Christian Science Monitor (link below). The competitors regard themselves as athletes and as being engaged in sport. There are no sticks, no balls, and the competitors might not even break a sweat (or if they do, it may be more likely that it is due to being in poor physical health).

Chess, poker, hot dog eating, skateboarding, golf, baseball, figure skating, swimming, soccer/football, video games - which of these are sports? What do you think?

http://www.csmonitor.com/2003/0808/p13s01-alsp.html

Taking steroids is only natural...

...according to Alva Noe in this Salon article. One of the central points undergirding the view Noe expresses is as follows:

Human beings are and always have been a technological animal. Ours is a history of shared technological innovation. Sharpened stones and cave paintings show up 80,000 years ago in the archaeological record. We are natural by design; we are designed by nature and culture. Once this basic fact about ourselves is clearly in focus, we are forced to acknowledge that using of steroids or other performance-enhancing drugs does not cross a bright line when it comes to personal responsibility. The athlete's reliance on steroids is no different in principle from a reliance on training techniques, newly designed footwear, sunglasses, mitts, nutrition or the computer-graphic analysis of plays. We are what we do and are never entirely self-sufficient in determining the scope of what we can do.

Noe also makes the argument at the end of the article that steroids are not sufficient for the skill required to hit a homerun in MLB, or have the kind of career that high-profile players accused of doping have had. Their talent is not dependent on the performance-enhancing substances.

I am a purist, I suppose, and think the bans on steroids and other similar substances are justified. I think that steroids are different in principle from sunglasses, mitts, and good nutrition.

Philosophy of Sport on Twitter

In a further attempt to embrace web2.0 and not to be left behind (though perhaps it's really an indication of our sheep like tendency), both the International Association for the Philosophy of Sport and the British Philosophy of Sport Association are now on Twitter.

When the Going Gets Tough, The Tough Get Mindful

When the Going Gets Tough,
The Tough Get Mindful

How do you persist on a demanding and difficult task? Conventional wisdom often says to suck it up and tough it out, but new research from psychologists at University of Kentucky could argue for a very different approach.

Daniel Evans and colleagues wanted to understand what effects a practice called mindfulness might have on persistence. Mindfulness has become a popularly studied intervention within the past decade, and has shown significant success in reducing stress and psychological distress. The concept is simple, but it usually takes some practice to master.

The essence of mindfulness is learning to be quietly focused in the present moment- the “here and now” - while non-judgmentally observing – and not reacting to - your perceptions, sensations, thoughts and emotions.

Researchers got 142 psychology students to work on a series of word puzzles within certain time limits, but the first of the puzzles did not have any real solution. This created a situation where they were supposed to persist on a task, even after finding the first attempt to be impossible.

Learning not to judge or evaluate (nonjudging) and not to react (nonreactivity) to what’s going on inside you is the tricky part of mindfulness, but they are vital ingredients, according to the study. The better the subjects were in not judging or reacting, the more persistent they were. Researchers found the subjects were aware of what they were experiencing – positive and negative – but their mindful stance allowed them not to be self conscious about it.

Some researchers believe that people need to be self critical to motivate them to persist toward a goal. This research suggests otherwise. Those who were internally aware but self-conscious – focusing on the discrepancy between how they are doing and what they want to achieve – were less persistent. The researchers conclude the mindfulness may be a promising strategy for self-regulating behaviors, thoughts and emotions.

Evans, D., Baer, R., & Segerstrom, S. (2009). The effects of mindfulness and self-consciousness on persistence Personality and Individual Differences DOI: 10.1016/j.paid.2009.03.026

Beating the Jitters

Beating the Jitters

By Dr. Randy Borum

(Article First appears in Black Belt Magazine, May, 2009)

“How do I get rid of the jitters before a fight (or match)?” – That is probably the single most common question that martial artists ask me. I sense that many are looking for a dose of magic or a quick fix – particularly because they raise the question within 24 hours of their scheduled competition. Sometimes there are stopgap measures that will help you get over a particular psychological hurdle, but with just a little advance planning you can make a big long term difference.

Let me begin by trying to clear up a few misconceptions about pre-competition jitters. First, all marital arts competitors – including mixed martial artists – should know that feeling nervous is completely normal and it does not necessarily mean that you will perform badly. In the world of MMA, the fighter probably best known for calmness in the cage is Russia’s Fedor Emelianenko. Consistently ranked as one of the World’s top heavyweights, Fedor saunters into the cage like it’s just another day at the office. During interviews, he is often asked about his stoic demeanor and he freely admits that he gets nervous before fights (as he believes all fighters do), but he has refined a strategy that works for him to control it.

This leads me to address a second misconception – that there is one ideal state of pre-competition calmness that works for everyone and that everyone can get there in the same way. Sometimes we are led to believe that buying the right program, listening to the right motivational CD, or reading the right book will allow anyone to achieve their optimal performance state. My experience suggests that different competitors experience jitters in different ways, for different reasons, and have to find a management strategy that works with their specific needs and style. Their optimal states of arousal or intensity also vary quite a bit. So Fedor’s state of mellow composure works very well for him, but it could be disastrous from someone else.

So, here’s the starting point for our discussion: if you get nervous jitters before a fight, “good for you” – you’re in very good company. There probably is not a “one size fits all solution”, but there are some fairly straightforward, battle-tested strategies and approaches you can use to find what works best for you. Here’s how you might begin:

First, try to understand how your jitters work. Typically, pre-competition anxiety can appear in your physical sensations (e.g., rapid breathing and heartbeat, sweating, muscle tension, butterflies), your emotional state (e.g. “feeling” nervous or fearful) and your thoughts (e.g., things you are saying to your self, negative thoughts, self-doubt). Write down what kinds of jittery experiences you have in each of those three areas before a competition. Then – as best you can determine – make a note about when they occur, how severe they are, and how much you think each interferes with your performance. Part of the task here is to figure out what “triggers” and patterns you can identify. Try to discern your earliest indictors or warning signs, then run through the progression. Ask yourself: “What comes first?”, “Then what happens?” until you understand the usual sequence.

Second, be proactive by preventing the jitters before they start, and deterring them at the earliest stages. Part of anxiety’s potency comes from its ability to sneak up on you and to build momentum. Because the human brain tends to default to a negative state (see Psyched column in the December, 2008 issue), unless you are being proactive, then you are increasingly vulnerable to the jitters’ destructive effects. You don’t realize you have been overcome by anxiety until it’s too late.

Being proactive here means intentionally orienting your thoughts, feelings and body in a positive direction. To do this with your thoughts, you might try writing down a few first person statements about your strengths, skills and preparation (e.g., “I can take down my opponent at will”). Read them to yourself at different intervals at least four times a day. These are the positive thoughts that can be occupying your mind. To orient your mood or emotions, you might try mental imagery or visualization. Observing yourself and experiencing the feeling of being successful in executing moves and techniques against an opponent. Reflect on past successes in training or competition to re-connect with that feeling of confidence and mastery.

Proactively creating a positive physical state involves two different tasks – first knowing your optimal state of intensity for competition and then being able to regulate your body’s response accordingly. A Zen-like state of tranquility may or may not work for you. Some competitors prefer to go in at a fairly high state of intensity, which is fine as long as it is controlled and energy is not being unnecessarily wasted. But know what has worked best for you in the past (or, if you are just beginning, what is most likely to work for you) and try to keep yourself within an optimal zone. That’s where self-regulation comes in: Learning to ramp up or down as needed. For most people, firing up is not the main challenge, but rather it is handling the “adrenaline dump” that happens at show time. Using deep breathing and progressive muscle relaxation – particularly after a bit of practice – can help you transition from a state of anxiety to a state of readiness.

If you do this successfully, does this mean that you will never again feel nervous? No, and that’s not the objective. The point is keep the jitters from hindering your performance and to facilitate a state of optimal performance. As you become more aware of your early warning signs, you can take a few minutes and re-center yourself before the nerves spin out of control. One useful tip is to remember that the thoughts, feelings, and physical reactions are all connected to each other. If you are getting jittery in one area – like getting negative thoughts - you can respond not only by invoking your positive thoughts, but also by calming your body. It might then be easier for your mind to focus on the positive thoughts and it will take some of the sting out of those doubts. A number of elite-level fighters I know feel jittery before a match, but in their minds, they interpret or label it as “energy”, “excitement”, or a signal that they are “ready to go.” Sometimes the jitters just need to be put in their proper place.