Monday, October 22, 2012

What's NASCAR Waiting For?


If NASCAR doesn't act, team
owners including Joe Gibbs need to act

The National Football League has required it since 2006.  Major League Baseball requires it, the National Hockey League requires it and so does Major League Soccer. 
 
IndyCar requires it.
 
In fact, virtually every major professional sporting organization in the U.S. (and many amateur groups, from the NCAA to little league) requires some sort of testing baseline be established for its athletes to help check for concussions and guard against athletes returning to action too soon.
 
So what’s NASCAR waiting for?
 
"We will continue to work closely and review our policies with the medical experts that advise NASCAR on baseline testing and other medical issues” NASCAR said.  “While not mandatory, baseline testing can and has been used and is just one of the many tools a neurologist or neurosurgeon may use as part of a neurological assessment.''
 
Time to make a test mandatory.
 
Last week at Kansas, Denny Hamlin hit the wall hard in practice.  Although Hamlin drove his car back to the garage, avoiding a mandatory trip to the infield medical center, he said he felt “slightly dizzy” and that he “got his bell rung.”
 
At the urging of a NASCAR official, Hamlin eventually made his way to the med center where he was checked and asked to come back in a hour.  After the second visit he was cleared to return to the track.  The following morning he said he felt “100 percent.”
 
Compared to what?
 
That Hamlin was cleared to drive about an hour after saying he got his bell rung and was a little dizzy, is amazing enough.  If he had been a pro quarterback, he would not have been allowed to go back in the game without an ImPact review.  Hamlin’s was a worst case scenario, one which he openly addressed.    
 
"No doubt about it," Hamlin said. "You would do whatever it took to stay in the car in a championship battle. But the one thing you can't hide is the signs you're not right.
 
The trouble is, those signs aren’t always readily apparent. 
 
You probably remember the story of Natasha Richardson, the actress and wife of actor Liam Neeson.  She hit her head while skiing.  At first she seemed fine and refused medical attention.  But three hours later she was complaining of a headache and taken to a hospital, eventually dying three days later from an epidural hemorrhage due to a “blunt impact to the head.”
 
Contrast that with a similar story with a different ending of Brandon McCarthy.  The Oakland A’s pitcher was hit by a line drive during a game this year, got up, briefly tried to stay in the game and then walked off the field.  The team insisted on a CT scan, which disclosed the epidural hemorrhage.  He was rushed to a hospital for surgery and he is expected to make a full recovery and play again next season.
 
"If you are not treated for this, you could die, but if you're treated rapidly, you usually have a very, very good recovery," said Dr. Geoffrey Manley, the vice chairman of neurological surgery at the University of California San Francisco.  "That is why people need to be evaluated promptly.”
 
The real concern here isn’t that a driver walks away from a crash where his “bell was rung” and races the following the weekend, although that’s obviously a concern.  But the real concern should be that a driver says he’s fine, gets on his plane and then suffers the same sort of trauma as Richardson or McCarthy.  A baseline test may help prevent something like that from happening.
 
Most professional organizations use ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) to establish a baseline to compare a post-event test against.  When Dale Earnhardt, Jr., went to see the experts on concussions he went to see the doctors behind ImPACT.  Most organizations conduct the computer-based tests as part of its pre-season physical regime.  It only takes about 20 minutes and sets a baseline for such skills as reaction time, information processing, etc. 
 
ImPACT, a commercially sold product and one of several available, is designed to “assists doctors in making return-to-play decisions and should never be used as a stand-alone tool or as a diagnostic instrument,” according to its website.  It is far from perfect and there is a wide-ranging debate in the scientific community as to the value of such tests.  That may be one reason NASCAR hasn’t acted.  Studies on ImPACT indicate a fairly high level of false positives, about 30 percent.  But better false positives than false negatives.  Danica Patrick, who took the test when she was driving Indy cars, said it can be “gamed,” purposely recording lower scores so a post-accident assessment won’t look so bad.  Several NFL players have admitted to doing just that.
 
Still, virtually every professional sporting organization in America – except NASCAR – considers establishing a baseline as important.
 
NASCAR doesn’t need to mandate ImPACT.  Leave it up to the teams or individual driver to decide how they want to establish their baseline.  But mandate that a baseline be set as a first line of defense. 
 
If NASCAR doesn’t act, the team owners should.  Some team owners, including Richard Childress, already have.  Come on Joe Gibbs, with your football experience, you should be a leader here.  Make sure each of your drivers gets a baseline test.  And don’t wait until next year.  Think about Hamlin.  And if NASCAR won’t do it, get together with the other big buck owners and make sure someone on the team is trained to conduct the test and is at every race and every test session. 
 
There's no reason to wait.

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