Every parent and coaches nightmare in football these days is for their athlete to suffer a concussion. As an eye doctor who helps patients rehabilitate from concussions affecting the visual system, I've been treating an increasing number of football players from the ages range of 8 and up. Click here to watch a TV News article on a 10 year old football player I treated with a concussion.
In 2012, the NFL started the Heads Up Program which is a initiative for their youth league, USA football, to help train young athletes to keep their head up and out of the tackle. The feeling is by keeping the head up, in control and out of the way of the tackle, there will be fewer concussions. Here is a link to watch Seattle Seahawks' Coach Pete Carroll train this technique: click here
There are several steps in the Heads Up Program. "Head up and Eyes up" are one of those steps in this training process.
If you look at many of the pictures on line and in videos of young athletes learning the heads up program, their eyes are inevitably pointing down or move down. This is because the natural instinct of the visual system is to look down to the ground during a fall to determine the safest place to land. Or, we will just chose to close our eyes as part of a "fear" mechanism in the fight and flight vision response.
In my blog today, I'd like to give you an exercise found on page 239 of my book, See To Play, which takes the "eyes up" portion of this training to a more detailed level. It can be performed daily at home
. It helps athletes learn how to train the position of the eyes, known as gaze control, so that the eyes are always in the right position, which is up .Later this year, I will be introducing my new "See To Play Gaze Stabilizer Exercise" which takes the Calendar Jump to the next level by integrating decision making. This incorporates gaze control exercising during physical activity while training the right and left sides of the brain.My best wishes as you learn to keep your eyes up, know where to look and decrease the risk of concussions. Calendar Jump: Page 239 of See To Play
Objective: To improve eye movement and eye scanning
Equipment: Two calendars of the same size
There is a little setup required. Place the two calendars at the same height on a wall at eye level to the athlete and so that they are four feet from each other. Each calendar should show a different month.
Instructions: The athlete stands 10 feet away from the wall and fixes her gaze on the first day of the month on the calendar on the left. She then shifts her gaze to the first day of the month on the calendar on the right, then moves to the second day on the calendar on the left, followed by the second day on the calendar on the right. She continues this back-and-forth movement all the way through all of the dates on the calendars and then starts back at the beginning.
Variations: As the athlete becomes proficient in the above exercise, begin to incorporate these variations to increase the level of difficulty. Begin at the top of the list, master that variation, and move to the next level of difficulty.
· Move the charts further apart, to five feet and eventually to about eight feet from each other.
· Bounce on a mini trampoline or jump rope.
· Use different-sized calendars, with one considerably smaller than the other.
Sammy Walker played cornerback for the Pittsburgh Steelers for 3 seasons with one blind eye (read more)
Tulane has a long snapper who is legally blind in one eye and completely blind in the other (read more).
Sacramento Kings' Rudy Gay played legally blind without contacts or glasses for years until he had LASIK (read more).
Bryan Berard played in the NHL with a 20/400 eye (more).
After Berard's injury, the NHL added a mandate that a player must see better than 20/400 in their bad eye to be allowed to continue to play (more) The other sports' leagues seem a little more vague for a definition as to what the allowed worst vision is that a player should exhibit while still being allowed to pursue a career in professional sports.
Should there be a mandate on vision?
By allowing a blind or blurry athlete to compete, aren't we going to add to major injuries?
Courts have started weighing in on these questions and are siding more with the athletes who want to continue to play regardless of their bad vision. The reasoning: if vision is interfering with play, these athletes will be weeded out of play anyway.
I wrote See To Play to help athletes push themselves from a vision standpoint so that they can "see the best and be the best". Trying to determine the adequate amount of poor vision for play is looking at this topic upside down and a topic a never considered. Definitely an interesting debate!
ye (click here to read more)
I've really enjoyed watching the ALS Icebucket challenge take off throughout the country. I'm also happy I was challenged, got to move it forward by challenging others, and made a donation.
I've also taken the time to talk with people who have participated in the challenge. It seems college age folks and younger don't know exactly what ALS is and who Lou Gerhig was. I'm using this blog to spread the word.
Lou Gehrig was a baseball great who played for the New York Yankees. He was stricken down by a disease that caused him to stop playing and eventually die. Here is the speech he made at a game where he was honored:
Fans, for the past two weeks you have been reading about a bad break I got. Yet today I consider myself the luckiest man on the face of the earth.
I have been in ballparks for seventeen years and have never received anything but kindness and encouragement from you fans. Look at these grand men. Which of you wouldn’t consider it the highlight of his career just to associate with them for even one day?
Sure I’m lucky.
Who wouldn’t consider it an honor to have known Jacob Ruppert? Also, the builder of baseball’s greatest empire, Ed Barrow? To have spent six years with that wonderful little fellow, Miller Huggins? Then to have spent the next nine years with that outstanding leader, that smart student of psychology, the best manager in baseball today, Joe McCarthy?
Sure I’m lucky.
When the New York Giants, a team you would give your right arm to beat, and vice versa, sends you a gift - that’s something. When everybody down to the groundskeepers and those boys in white coats remember you with trophies -- that’s something.
When you have a wonderful mother-in-law who takes sides with you in squabbles with her own daughter -- that’s something.
When you have a father and a mother who work all their lives so you can have an education and build your body -- it’s a blessing.
When you have a wife who has been a tower of strength and shown more courage than you dreamed existed -- that’s the finest I know.
So, I close in saying that I might have been given a bad break, but I've got an awful lot to live for.
On my icebucket challenge, I sent a challenge out to my cousin, Brian Williams, who is a physical therapist in Denver Colorado. Brian lost a good friend, Pat George, to this terrible disease. Here is a piece that ran featuring Pat's story. I hope this helps you learn more about ALS:
Vision Concussion 101:
Step 1: Refraction: Vision usually shifts and the change in refraction should be prescribed.
Step 2: The brain has to relearn processing information from the right eye separately, the left eye separately and then both eyes together.
There you go. That’s the two most basic principles in rehabilitation for athletes who have sustained a concussion in the vision area of the brain.
Sure, many athletes also exhibit convergence insufficiency and/or accommodation problems, but we have to get the brain to learn how to process information from each eye separately first. When we don’t, the athlete’s brain becomes overwhelmed…..overloaded from a bombardment of stimulus that it can’t figure out what to do next and where to go. The athlete becomes symptomatic and must be shut down.
The use of eyeglasses (tranaglyph glasses) which have a red lens over the right eye and a green lens over the left eye are used to help train the brain in what is known bi-ocular vision therapy. We then put the athlete through several exercises where the brain learns to interpret information from the right eye and left eye separately.
Our favorite exercise has been with the use of our Fit Light Trainer. We have programmed the trainer in a manner that half of the lights are set to flash red and the other half are set to flash green. The athlete’s right eye sees the lights that flash red and must wave is or her hand over it to turn it off and another light randomly appears. The athlete’s left eye sees only the lights that are programmed to flash green. Athletes stare with a straight ahead gaze, go through a series of three minute exercises using their side vision and eye hand coordination during this routine. This helps reboot the dorsal vision stream.
We shouldn't confuse the above exercises with computer exercises which use red/green or red/blue eyeglasses. We use such a computer trainer (the Vizual Edge) in the later stages of recovery because this trains the ventral vision stream. In early stages, the dorsal stream needs to be rebooted before we use training routines that are solely ventral stream.
Eye doctors and vision exercises are very beneficial to the recovery of athletes with concussions affecting the vision area of the brain. We are beginning to find instances, though, where some athletes are doing vision therapy without first addressing the most basic step discussed in this article. I liken this to a patient starting to run after an ACL surgery before doing basic strength exercises and walking exercises first.
Make sure your athlete is getting the best care so that they can avoid frustration and delay in recovery.
We had the honor of evaluating the vision systems of the new draftee's of the NHL Carolina Hurricanes and then ranking them first to last based on these visual skills.
A few days later, I gave a one hour "eye exercise" clinic. During this clinic, we go over their team ranking, show them individually their visual system's strengths and weaknesses, and then give them exercises to help them improve their visual status.
Many of these exercises and this ranking method is discussed in my book, See To Play.
Please don't miss out on making sure your strengthening your visual system so that you can reach your genetic potential!
How safe is your football players helmet?
Click here to read a news article discussing a ranking system on helmet safety. I found this very informative and wanted to share it with you.
The drop I recommend the most for athletes with allergies that affect their eye is Zaditor. It was originally a prescription drop and is now found over the counter (similar to the oral allergy medications, Allegra and Claritin). This drop is an antihistamine and mast cell inhibitor which means it stops the allergic response in two different ways.
I instruct athletes to avoid drops with whitening agents stay away from drops, such as Visine, because they have an ingredient that contricts blood vessels. This medication can actually cause a mild dilation of the pupils when used in larger amounts (or if the active ingredient as expired) and that dilation of the pupils can interfere with how well the athlete sees when playing their sport.
I recommend starting the Zaditor when the ocular symptoms start, instill one drop twice a day and use at least for a 2 week period.
For contact lens wearing athletes, you can instill one drop first thing in the morning, wait 15 minutes and then put in your contacts. The second drop can be used in the evening after you have taken out your contacts (do not use the drops directly on the contact lenses).
This drop can be used for extended periods of time and has little to no side effects to the body and eyes.
Another news article has appeared in the media promoting the benefits of vision training for sports performance. This article was found in the NY Times (click here to read the article) This article touts how vision therapy actually trains the brain more than eyesight. It also talks about how athletes may lose what they don't use in neuron firing.
But, where's an athlete to get started? The best place is in my book, See To Play; The Eyes of Elite Athletes. My book has two chapters dedicated to vision training. The first chapter on vision training is geared for the athletes that have not had any vision training before. The second chapter presents exercises aimed at more experienced athletes. The book also provides vision training logs that help you track where you are and where you need to go.
This website also presents a few eye exercises that you can get you started. (Click here to get started).
Reach your genetic potential. Begin a vision training program today!
I opened my Sunday paper and found a article presenting various eye exercises to improve their vision.
"Hitters try just about everything to improve vision". click here to read the article by AP
See To Play is full of eye exercises that athletes of all ages can use to sharpen their visual skills and help them reach their genetic potential. Their are two chapters dedicated to vision exercises; one for the athlete just starting out and another for athletes in their prime or past their prime.
These vision exercises are performed using items you have around your house.
Start improving your vision today, just like the hitters in the MLB.
The Peters/Price (See To Play) Vision Concussion protocol will be published in the March 2015 edition of the Optometry & Visual Performance Journal.
We are very proud that we were selected for publication. More importantly, we're very excited that this will make our concussion protocol available nationwide to help doctors begin to rehabilitate athletes with these types of concussions.
Click here to learn more about the OVP Journal