The new 2009 statement advises that a player who suffers a concussion should not return to play or practice on the same day if he shows any signs or symptoms of a concussion that are outlined in the return-to-play statement. It further states:

"Once removed for the duration of a practice or game, the player should not be considered for return-to-football activities until he is fully asymptomatic, both at rest and after exertion, has a normal neurological examination, normal neuropsychological testing, and has been cleared to return by both team physicians and an independent neurological consultant. A critical element of managing concussions is candid reporting by players of their symptoms following an injury. Accordingly, players are to be encouraged to be candid with team medical staffs and to fully disclose any signs or symptoms that may be associated with a concussion."

Based on the 2009 statement, a player who suffers a concussion should not return to play or practice on the same day if any of the following symptoms or signs is identified based on the initial medical evaluation of the player:

Loss of consciousness

Confusion as evidenced by disorientation to person, time or place; inability to respond appropriately to questions; or inability to remember assignments or plays

Amnesia as evidenced by a gap in memory for events occurring just prior to the injury; inability to learn and retain new information; or a gap in memory for events that occurred after the injury

Abnormal neurological examination, such as abnormal pupillary response, persistent dizziness or vertigo, or abnormal balance on sideline testing

New and persistent headache, particularly if accompanied by photosensitivity, nausea, vomiting or dizziness

Any other persistent signs or symptoms of concussion

"The evidence demonstrates that team medical staffs have been addressing concussions in an increasingly cautious and conservative way," Commissioner Goodell said in a memo to the NFL clubs. "This new return-to-play statement reinforces our commitment to advancing player safety. Along with improved equipment, better education, and rule changes designed to reduce impacts to the head, it will make our game safer, and set an important example for players at all levels of play."

Thanks to that experience, Bob took some athletic training courses and worked in the training room. "Until then," he says, "I never realized how much I loved physiology and science. I was fascinated by its application to the human body and to athletes, and knew I had found my career. During the summers of "88 and '89 I interned with the New York Jets, and that spurred my interest even more."

Bob graduated from UConn in 1988, and completed graduate school a year later. Soon after, he was thrilled to accept an assistant position with his alma mater. In July of 2002 he was named head athletic trainer, directly responsible for football and overseeing a staff of 13 that works with 650 athletes in 24 sports, year around.

"It's great to have been with UConn all these years," Bob says. "It has grown from one of the smaller Division I schools to one of the largest. When I started, there were 66 people working in the athletic department, and now there are about twice that many. Exciting changes have taken place over the years, and it's a great place to work."

Bob has also observed changes in the profession over the years. "When I first started in athletic training, I think it was seen as a blue collar type of medicine-that we just patched up athletes and sent them back out. Over the years, though, it has become viewed more and more as a science-based profession. I also think athletic training has struggled to define itself in recent years. That's a positive thing and has helped to elevate our profession. I've ridden the wave of all of this, and like where it's taking us."

Bob enjoys teaching and mentoring athletic training students. "I tell them this isn't just a job...it's a lifestyle. Succeeding takes hard work, and that frequently means long hours. You may have plans after a game, but if an athlete breaks a leg, that takes precedence. There are early mornings and late nights. To progress to higher levels, you have to mold yourself to the profession. And since you'll be completely immersed in your job much of the time, it's important to make the most of your time off!"

For Bob, breaks from work mean cherished time with his wife and two daughters who are in the 8th and 10th grades. "I'm happy to do whatever they want me to do when I'm home, as long as we're together."

Bob is enjoying his first year on Cramer's Athletic Trainer Advisory Council, and says, "It's a fantastic group, and it's a privilege to help the profession by giving input and feedback."

Researchers found that measuring exhaled breath levels of nitric oxide as well as the pH level of exhaled breath could be effective at predicting EIA and its severity. Both tests can be performed in a doctor's office while the patient is at rest. Previous research has shown that pre-exercise fraction of exhaled nitric oxide (FENO) levels, which is a marker of airway inflammation, is elevated in people who have EIA. FENO levels also are associated with post-exercise closure of large airways. This study demonstrated the same positive relationship between FENO and closure of small airways after exercise.

The second study found that study participants with EIA had significantly lower levels of exhaled pH, which might "indicate acidification of the airways in individuals with airway hyper responsiveness," according to the study. The pH level also was related to the degree of closure of the small airways.

In a third study at Indiana University, researchers found that the ingestion of caffeine within an hour of exercise can reduce the symptoms of exercise-induced asthma. A large dose - 9 milligrams of caffeine per kilogram of body weight - was as effective as the use of an albuterol inhaler, commonly used to treat or prevent exercise-induced asthma. Smaller amounts of caffeine - for example, 3 and 6 milligrams of caffeine per kilogram of body weight - also reduced the wheezing, coughing and other symptoms of EIA.

Timothy Mickleborough, an associate professor in the Department of Kinesiology and co-investigator of the study, said no additional benefit was found when caffeine was combined with an albuterol inhaler. Mickleborough and his research colleagues have been investigating the efficacy of a number of nutritional factors, and his research to date has shown that a diet high in fish oil and antioxidants, and low in salt, has the potential to reduce the severity of EIA and perhaps reduce the reliance on pharmacotherapy. This is especially important since prolonged use of daily medications can result in reduced effectiveness, and there is growing concern about the potential side effects of inhaled corticosteroid use.

Research findings of all three studies were presented at the annual meeting of the American College of Sports Medicine this past May. For more information, contact Mickleborough at 812-855-0753 or tmickleb@indiana.edu.

At first glance, the Emergency Kit looks like a piece of red luggage, complete with wheels and a built-in handle that pulls out. When unzipped, though, it immediately becomes clear that this is no ordinary piece of luggage...and no ordinary athletic training kit. Inside, you'll find four modular bags for organizing and separating supplies needed in specific situations. The top portion of each bag is clear, so you'll instantly know which one to grab, and there are card pouches for labeling each bag.

To make it even easier to organize the Emergency Kit, the handles of the four modular bags are different colors-red, yellow, blue and green. Perhaps you'll put blood management supplies in one; cardiac care supplies in another; emergency care utensils in a third. You're on the sidelines...an athlete is hurt...and you'll know exactly which bag to grab.

When closed, the Emergency Kit measures 28" x 15.5" x 13.5."  Mesh zipper pouches line the inside of the lid, providing easy access to supplies such as instant cold packs when the kit is unzipped. 

The Emergency Kit will be available on March 1, and according to Dave Chaffin, ATC, regional sales manager for Cramer Products, it's already receiving some positive buzz. "The feedback has been great when I've shown it to athletic trainers," he reports. "The kit is extremely roomy and allows for so much versatility. A portable defibrillator will fit perfectly into this bag along with the modular bags that are filled with supplies. Some may also want to put an oxygen tank in there. With the four modular bags, it can be completely customized each time it is used."

Dave continues, "Some athletic trainers are talking about using it as an emergency kit, but others have mentioned they'd like to use it as an every day bag. I've also heard comments that it would be a great doctors' bag, and that one of the modular bags could be used for syringes and injectable medications. This kit is just so versatile, there are dozens of ways to use it depending on what will be needed for a specific game or event."

The exterior of the Emergency Kit is made from 100 percent PVC tarpaulin for durability. It's a water resistant, waterproof material that won't hold dirt and is easy to wipe clean. It features an up-to-date travel design with larger wheels that won't sink in the mud or become jammed with debris. The retractable handle is built into the bag to protect it during travel.

In an emergency, seconds count. With Cramer's new Emergency Kit, you'll be ready for anything!