Is It Really this Simple?

[Ken Jakalski]

I was telling my son about SomaSimple and the latest thinking on the origins of pain. After listening to some of the basics, he said So pain is "100% produced by the brain in response to a threat." I get that. When I broke my leg in football, they gave me a morphine drip. Where was that morphine going? It was activating opiate receptors in the brain. It's tricking the brain, telling it everything is OK, even though the damage is still there."

Why does this make sense to him, while others struggle mightily with this notion of pain as the brain's reponse to a threat?

[venerek]

People don't like having their beliefs challenged. For the same reason why a lot of AV Hill's outdated ideas on fatigue are still rampant, the cartesian pain model has been engrained in people's minds. If they already have an idea of what pain is (i.e. the cartesian model), hearing that it is an output of the brain probably results in some cognitive dissonance.

[DDH]

Cognitive dissonance is a truly powerful force. I think children are often much quicker about seeing things clearly because they haven't absorbed so much bad information. This is why I think it is so important to teach more critical thinking skills. I grew up in a very dogmatic environment that discouraged critical thinking. Our culture in many ways punishes people for being different and thinking independently.

There is also the dunning-kruger effect where sometimes the less you know the more confident you are that you are right. I think that comes in to play quite often.

[Barrett Dorko]

Check out this thread.

[DDH]

Barrett,

What an interesting thread! Thank you for the link. I read it all and plan to go back and check out many of the links within the thread.

[Greg Lehman]

Hi Ken,

Your son still heard

When I broke my leg in football, they gave me a morphine drip. Where was that morphine going? It was activating opiate receptors in the brain. It's tricking the brain, telling it everything is OK, even though the damage is still there."

He still heard that broke your leg and thus there was nociception. He learned that some drug introduced from the outside might still be able to modify this even if damage is still there. Did he learn how to modify the pain induced "from that damage" without any drugs?

I think this is tough to do. If he blows an ACL will he deny painkillers?

Thanks Ken, What are your kids racing now?

Greg

My little kids feel pain everyday...I refuse to recognise it (initially)...when it really hurts then I know that it really hurts. I'm that dad that looks like an A hole because I don't respond immediately when they fall.

[bernard]

Originally Posted by Ken Jakalski

Why does this make sense to him, while others struggle mightily with this notion of pain as the brain's reponse to a threat?

Originally Posted by Groucho Marx

Why, a four year old child could understand this report! Run out and find me a four year old child.

[keithp]

Originally Posted by Greg Lehman

I think this is tough to do. If he blows an ACL will he deny painkillers?

And even if he did deny painkillers, why would he do so? Because of the pain education, or some other "principle" all together?

For example, this unfortunate young woman will make for an interesting case study of one, looking to see if she develops chronic pain after her ordeal.

A woman fighting necrotizing fasciitis is refusing to take pain medications during some procedures, partly because of her personal convictions, her father said.

AC despises the use of morphine in her treatment, despite its effectiveness at blocking her pain, her father said in a Friday online update on his daughter's condition. Her graduate-school study of holistic pain management techniques leads her to feel she's a "traitor to her convictions" when she uses drugs to manage her pain ..."The nurse who completed AC's dressing change was astonished at AC's insistence to avoid morphine during the procedure, as was her mother and I," he wrote. "I know the pain was significant, but AC's courage is greater."

Respectfully,
Keith

[Barrett Dorko]

My own sense is that this young woman has conflated ignorance with courage.

On the other hand, I've probably done the same in other realms.

[Ken Jakalski]

Hi Greg!

My little kids feel pain everyday...I refuse to recognise it (initially)...when it really hurts then I know that it really hurts. I'm that dad that looks like an A hole because I don't respond immediately when they fall.

One of the expressions I like to tell my high school kids was something my mom used to say to me when I was a kid, and said to my kids when they were little. Come into the house crying, and mom would say, "Oh, you'll be fine by the time you get married."

I use that line to this day.

My son was a fullback/linebacker in high school. He had a petty tough career. He broke his arm as a freshman, fractured his leg a sophomore, and his wrist as a senior. The leg was really the worst. It was "J" fracture of the tibia. He had issues with compartment syndrome after that. In his last two years, he was no longer a two way player.

He's twenty nine now, and still gives me crap about the leg. I was the athletic director at the time, and the coaches called me out to the practice field after he went down. When I got out to the field, he was sitting on the sidelines in obvious distress. I told him it was most likely a level two ankle sprain and that he'd be back by the end of the season.

He doesn't much trust my medical advice any more

[Ken Jakalski]

I enjoy watching football, and certainly enjoyed watching my son play, but I really wonder about the future of the game. We hear the cliche about high level football like being in a car wreck every week, but that, at least from my perspective as the father of a player, is kind of true. My wife would just shake her head when my son would come in the door after a game, and that was just the visible and often superficial marks and his hands and neck. It certainly made me feel good to see my son starting on the varsity as a sophomore, but I now wonder about the cumulation of collisions on a younger athlete, considering that his growth plates still hadn't closed.

Many of the skilled athletes in our district play soccer. They are involved in club play early on, and maybe that's a good thing.

I recall the scene from Saving Private Ryan when Mike Horvath (Tom Sizemore) is shot. Hanks asks how he's doing, and Mike says, "I just got the wind knocked out of me." He dies shortly after.

We often see that in football, but I wonderi if the collisions leading to a downed players involve more than just getting the wind knocked out them.

The wonder doesn't last long, though, because we'll keep cheering when they're helped to their feet and walk or trot to the sidelines, and wait anxiously to see their number back in the game.

[byronselorme]

Originally Posted by keithp

And even if he did deny painkillers, why would he do so? Because of the pain education, or some other "principle" all together?

For example, this unfortunate young woman will make for an interesting case study of one, looking to see if she develops chronic pain after her ordeal.


Respectfully,
Keith

I saw this this morning Keith and I knew someone here would catch it. .

Could she be calming her cns in a way she doesn't realize but explains using her background?

[byronselorme]

Originally Posted by Ken Jakalski

I enjoy watching football, and certainly enjoyed watching my son play, but I really wonder about the future of the game. We hear the cliche about high level football like being in a car wreck every week, but that, at least from my perspective as the father of a player, is kind of true. My wife would just shake her head when my son would come in the door after a game, and that was just the visible and often superficial marks and his hands and neck. It certainly made me feel good to see my son starting on the varsity as a sophomore, but I now wonder about the cumulation of collisions on a younger athlete, considering that his growth plates still hadn't closed.

Boy Ken I sure wonder about this too. concerns have mounted in the hockey world too since the invention of pads that use a tough. Plastic withan inner foam liner. Now a check can be sent at much faster speeds. Unfortunately it is still the same soft brain inside it all. The old school hockey players may have actually been better off.

[Ken Jakalski]

Hi Byron!

Now a check can be sent at much faster speeds. Unfortunately it is still the same soft brain inside it all. The old school hockey players may have actually been better off.

I believe that's accurate. Several years ago I remember efforts to market a one piece helmet/shoulder pad system that allowed the head to move freely inside an "exoskeleton like" structure.

Two things emerged. Coach worried about limited visibility. They also were concerned about players who could really use their bodies as "missiles" without any concern for head and neck trauma.

Most parents are in the stands (or at least should be) during games. Were they actually to stand on the sidelines, just the sounds of players getting hit or being tackled would surprise them in terms of just how violent those body-to-body and ground-to-body encounters can be.

And with each level of the game the speed and inpact increases. My son would often attend the larger school games in our area. In those games, the players are larger, there are more skilled players on the field, and the speed of the game changes dramatically.

He used to laugh and say, 'in Class 8A I'd be a bag holder."

Progress to college and then pro where all these factors intensify, and we realize this is a game that will eventually take its toll on those who play it.

[advantage1]

In Canada hockey would be equivalent to football in terms of popularity. Hockey has become a very violent sport and we are seeing a rise in head injuries. There are lots of theories as to why this is happening including the equipment, increased size of players, increased speed etc.

Many NHL atheletes suffer consussions and don't report them. There is still that mentaility that you have to 'suck it up' and be a man. One of my favorite players was Paul Kariya. A gifted player with amazing skating and puck handling skills. Unfortunately, his career was cut short by head injuries. The following is a clip that I think illustrates how a player will sacrifice their health and even life for the game:

http://www.youtube.com/watch?v=-ebTSeDGsds

[John W]

I read some stuff about that hit on Kariya, and the investigation ruled that it was a "clean hockey hit" because Stevens hit him within a second of dishing the puck, and supposedly he hit Kariya with his shoulder. I've looked at that video several times, and there's no way that was a shoulder hit. Stevens clearly threw his forearm and elbow directly into Kariya's chin.

It'll probably take a lawsuit like the one against the NFL being brought by former players, who are now dealing with the effects of multiple head injuries, for the NHL to get serious about head shots.

[amacs]

Yes, I get to look after this at the higher schools regional level. The crack (not slap) of flesh on flesh leaves me constantly surprised and the relatively low rate of fractures. The rate of concussion is fairly high however. Even at 16-17 yrs I can see fairly significant long term injuries arising from the impacts themselves.

At international level it is frightening and also humbling as to how this guys can go out there and this over and over and over again.

regards

ANdy

[Ken Jakalski]

Hi advantage1!

Many NHL atheletes suffer consussions and don't report them. There is still that mentaility that you have to 'suck it up' and be a man.

This is indeed accurate.

Back in the 90's ProCap came out with a foam over-helmet attachment, but only a small number of players actually wore it.

Adam Fusfeld noted the following in his article, "Would Pro Football Players Risk Looking Like Dorks for Better Head Protection?"

"While lineman are often willing to ditch form form for function, skill position players – the ones most likely to get jarred by a vicious blow to the head – are not. They would probably claim the bigger helmets limit their speed to avoid having to wear it.

There's also the toughness factor. The same NFL doctrine that mandates players play without sleeves in the snow, immediately pop up after getting hit, and play through the injuries that result from those hits, would prevent them from donning a helmet that looks like it comes from outer space in the name of protection.

That points back to the problems with the concussion discussion as a whole. While onlookers want as safe a playing field as possible, players don't seem to care. They step on the field well aware of the dangers – that's why they occasionally compare themselves to soliders – and willingly subscribe to the league wide dogma that every play could be their last."

[Ken Jakalski]

Some players actually thought the ProCap would increasse neck trama because the foam would absorb the the impact unlike the smoother "glancing blow" of a typical helmet.

[caro]

Given the time and place wherein he was playing, I've always admired how he took a stand..

Can't resist. We all grew up with this theme song here in Québec... Different times, different game.

[advantage1]

Studies in the United States show that men who play five or more years in the NFL have a life expectancy of 55, 20 years less than the average in the general public. For linemen, perhaps due to their size, the life expectancy is 52.

Here is a link to a sad story about the CFL's Edmonton Eskimos of the late 70's and early 80's who's former players are dying young likely due to head injuries:

http://www.cbc.ca/sports/football/st...headgames.html

[amacs]

That's interesting, wonder if rugby is similar. Must see if there are any references for that?