Pac 12 Student-Athlete Health Conference

7:45am Tandi Hawkey: Welcome Address & Announcements

7:50am : Pac 12 State of the Union Address

8:00am “Transforming Football to a Culture of Safety” Alan Sills, MD; NFL Chief Medical Officer

8:30am “The Player’s Perspective on the Changing Landscape of Football” Ernie Conwell; Player Director, NFL Player’s Association

Student-Athlete Health and Well Being Board – Doug Aukerman, MD (OSU)

Brain Trauma Task Force – Sourav Poddar, MD (CU)

Grants Committee – Dan Nordquist (WSU), Lynn Fister MA, CPA (Pac 12)

Mental Health Task Force – Shanyn Lancaster, MD (ASU)

Athletic Training Considerations Committee — Rob Scheidegger, ATC (UW)

9:45am
Title: Mental Health: #DamWorthIt Campaign
PIs: Taylor Ricci and Nathan Braaten
Oregon State University

Project Summary: The #DamWorthIt Campaign, which was launched at Oregon State University in 2018, has a mission statement of utilizing the influential platform of sport to open the conversation around mental health in collegiate athletics, ending the stigma to make every team, every sport, and every student-athlete know that they are #DamWorthIt! The #DamWorthIt Campaign is designed to be a comprehensive program that will work to end the stigma around mental health through three pillars: education, resources and awareness/comfort. The #DamWorthIt Campaign aims to normalize, destigmatize and spread awareness about the epidemic of mental health in collegiate athletics through these three distinct pillars. The focus of this grant project is to expand the #DamWorthIt program throughout Pac-12 Conference Athletic Departments and Student-Athlete Advisory Committees.

10:00am
Title: “The STEALTH Project Pilot Study: Student Athlete Health Assessment Using PROMIS Tools”
PI: Dr. Kenneth Hunt
University of Colorado, Boulder

Project Summary: The study proposes the use of National Institute of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS) surveys to assess the impact of participation and injuries in Pac-12 sports, inclusive of the physical, mental and social health of student-athletes before, during and after their competition seasons. The results of this pilot study will help identify student-athlete populations that may be at elevated risk, and allow for the identification of best practices that allow coaches, trainers, therapists and other healthcare providers to optimize student-athlete health and well-being as they participate over the course of a season.

Title: Student Athlete Health and Well-Being: Looking at the Past to Inform the Future
PI: Dr. Theresa Hernandez
Co-PI: Dr. Adam Bohr
University of Colorado, Boulder
Project Summary: In collecting and utilizing data from former student-athletes to inform current best practices, this study will assess longitudinal patterns of physical and psychological health while paying attention to the presence of chronic conditions (e.g., diabetes, heart disease, obesity, neurodegenerative diseases, etc.) and mental health diagnoses in student-athlete alumni compared to cohort matched student non-athlete alumni. The research will also aim to build upon previous related research by assessing socioeconomic and first-generation status as group profiles, as well as modifying factors of student-athlete health following their collegiate careers. The goal of this research is not only to characterize life-course trajectories, but also to utilize this information to identify best practices, thereby creating opportunities to improve and optimize the overall health and well-being of current and future student-athletes.

Title: Head Trauma: Designing Safer Helmets Using Advanced Materials and Modeling
PI: Dr. Christopher Yakacki
Co-PIs: Dr. Peter Jenkins, Dr. R. Dana Carpenter, Dr. Kai Yu, Dr. Sourav Poddar
University of Colorado, Boulder & Denver
Project Summary: The University of Colorado’s Boulder and Denver campuses have worked together to research football helmet design with a focus on lowering the severity of impacts and reducing the prevalence of concussions in the sport. Recently, the NFL released several computer models of helmets to investigate the influence of helmet materials and designs on head impacts. This study seeks to leverage this state-of-the-art technology and create new models to improve helmet safety using a recently developed high-performance polymer called liquid-crystal elastomers (LCEs). The LCEs will be incorporated in the helmet models and virtually tested to optimize their design. This approach will allow the investigators to rapidly test and evaluate the performance of new materials in helmets, without having to manufacture and physically validate each new configuration.

Title: Head Trauma: The Subtypes of Concussion – Classification and Recovery Trajectories in Pac-12 Student Athletes
PIs: Dr. Angela Lumba-Brown
Co-PIs: Dr. Jamshid Ghajar (Stanford), Dr. Masa Teramoto (Utah), Dr. Matthew McQueen (Colorado), Dr. Douglas Aukerman (OSU), Dr. Kimberly Harmon (UW), Dr. David Petron (Utah), Dr. Sourav Poddar (Colorado) and Russ Romano (USC)
Stanford University collaborating with the University of Colorado, Oregon State University, University of Southern California, University of Utah and University of Washington
Project Summary: The goal for this study is to advance the science of concussion care and change how concussions are diagnosed and managed, allowing for earlier and more focused rehabilitation and treatments. By performing clinical research, this study will look to characterize and compare concussion subtypes over time and by gender, sport, school and medical history, including cardiovascular health, while also assessing recovery trajectories by concussion subtypes over a six-month span to allow for anticipated outcomes and targeted-treatment options.

Title: Overuse Injuries/Injury Protection: Biomechanical metrics to improve performance and reduce elbow injuries in baseball
PI: Dr. Lori Michener
Co-PIs: Dr. Andrew Karduna (UO) and Dr. Roksana Karim (USC)
University of Southern California collaborating with the University of Oregon and University of California, Los Angeles
Project Summary: A common problem among baseball players is an injury to the ulnar collateral ligament (UCL) at the elbow. The UCL provides ~50% counter to elbow force (varus torque) during pitching, putting the UCL at risk for injury. Elbow varus torque increases as ball velocity increases, but not for all pitchers. Elbow varus torque may be mediated by player physical factors, such as muscle performance, joint motion, and stability. The knowledge gap is understanding the ball velocity – elbow varus torque relationship, and how physical factors can mediate the relationship to reduce elbow varus torque. This study will aim to characterize player risk of UCL injuries by developing player profiles that can be used to: 1) target the identified physical factors to reduce injuries and inform rehabilitation after injury, 2) specify return to sport criteria and 3) guide performance enhancement.

Title: Head Trauma: Reactive Postural Responses after Concussion: Objective Measurement of Balance Recovery and Prospective Injury Risk
PI: Dr. Peter Fino and Dr. Lee Dibble
Co-PIs: Dr. Daniel Cushman, Dr. Nicholas Monson, Dr. Angela Presson
University of Utah
Project Summary: Reactive postural responses are used to recover balance, but they have received relatively little attention after concussion despite being common in athletics and critical to athlete safety and performance. Prior research has shown previously concussed athletes experience a greater risk of musculoskeletal injuries, but the cause of this increased risk is not known. This study will focus on a critical barrier of current balance assessments for concussion by objectively quantifying reactive postural responses to determine the connection between post-concussion postural control and musculoskeletal injuries. This project seeks to have immediate impact on concussion management by establishing a protocol to assess postural responses that is tailored for concussions and clinical use and can be rapidly implemented through the Pac-12. Long-term, this study seeks to provide the framework for future studies to examine rehabilitative approaches that train balance recovery to accelerate the recovery and/or decrease the risk of musculoskeletal injury following concussions.

Title: Injury Prevention: Improving Rehabilitation Following Anterior Cruciate Ligament Repair with Real-Time Feedback during Low Intensity Cycling
PIs: Dr. James Martin
University of Utah
Project Summary: With an astounding 25% of athletes with previous anterior cruciate ligament (ACL) reconstruction surgery developing additional ACL injury following surgery, this study aims to reduce compensatory patterns during movement exercises while evaluating the relationship between cycling symmetry and return-to-play outcomes. Of concern, current data indicates that these patterns progress, rather than diminish, during the course of rehabilitation and can go undetected due to maximal tests typically taking place several months following surgery. Low-intensity cycling is commonly prescribed and known to be safe soon after surgery. This project seeks to improve symmetry by providing biomechanical feedback during low-intensity cycling. It also aims to determine if cycling symmetry leads to improved symmetry during weight bearing tasks and reduces subsequent injuries. If successful, we believe this technique may improve rehabilitation of a variety of other leg injuries as well.

Title: Student-Athlete Well-Being: Social Media Engagement and Mental Health in Pac-12 Student-Athletes
PIs: Dr. Christopher Barry
Co-PIs: Dr. Kelli Moran-Miller (Stanford)
Washington State University collaborating with Arizona State University, University of California, Berkeley, Oregon State University, Stanford University, University of California, Los Angeles, University of Southern California, University of Utah, University of Washington
Project Summary: By investigating the relationship between social media activity, self-perception and mental health among Pac-12 student-athletes, this project seeks to gain a better understanding of both the detrimental and positive aspects of student-athletes’ social media use, as well as the potential benefits of protective behavioral strategies involving social media (e.g., turning off electronic devices at night or restricting social media access during study time). The findings will seek to provide improved abilities to educate student-athletes on adaptive uses of social media and bolster their academic, mental health, physical and personal well-being.

Title: Head Trauma and Mental Health: From Head Impacts to Brain Injury, Determining the Mechanism Underlying Concussions in Pac-12 Football
PI: Dr. David Camarillo
Co-PIs: Dr. Gerald Grant (Stanford), Dr. Michael Zeineh (Stanford), Dr. Charles Liu (USC)
Stanford University collaborating with University of Southern California
Project Summary: In an effort to determine the causes of concussive injury, this study plans to implement the use of the Stanford Instrumented Mouthguard 2.0 (MiG2) in combination with MR imaging with the football teams at two Pac-12 institutions to collect data on concussions. This will expand upon recent research and data collected with an instrumented mouthguard in combination with MRI with the Stanford football program. In that study, researchers discovered that concussions could be predicted by peak head angular acceleration, correlating with signal changes on MRI. At its completion, this will be the first study to identify mechanisms of concussion by tracing the head angular acceleration input, to brain tissue damage, to advanced imaging detection of injury.

Title: Injury and Prevention: Developing a Comprehensive, Quantitative Understanding of Hip Morphometrics and Biomechanics in Collegiate Athletes at Risk for Developing Femoroacetabular Impingement Syndrome
PI: Dr. Andrew Anderson
Co-PIs: Dr. Ken “Bo” Foreman, Dr. Stepehen Aoki and Dr. Travis Maak
University of Utah
Project Summary: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and dysfunction among collegiate athletes, and a known precursor to hip osteoarthritis. Prevention is the key to reducing rates of FAIS, but research in this area is lacking. The research team believes effective prevention of FAIS starts with an in-depth understanding of how hip anatomy is altered in three-dimensions, and the extent to which abnormal hip anatomy disrupts hip biomechanics, prior to the onset of symptoms. In this study, researchers will compare 3D hip shape and biomechanics between collegiate athletes, control subjects that do not have a history of participation in the same sports, and FAIS patients who are seen in treated in the clinic. The future impact of this work is that it will support a prospective trial to determine if application of a modified training regimen reduces the prevalence of FAIS in athletes.

Title: Head Trauma: Roles of Nutritive Support and Supplementation
PI: Dr. George Brooks
Co-PI: Dr. Daniela Kaufer
University of California, Berkeley
Project Summary: Studies have shown that the brain uses lactate as a fuel source when available. Studies have also shown that patients with traumatic brain injury (TBI) are often undernourished, meaning the brain has less fuel sources to use for healing. The goal of this project is to determine whether or not supplementation with lactate on the background of adequate nutrition will improve TBI recovery by giving the brain an extra fuel source. This will be accomplished through a series of studies on laboratory rats, where rats with mild TBIs that mimic concussions will be given standard of care (inadequate) nutrition, adequate nutrition, and adequate nutrition plus extra lactate. Brain healing will be assessed to see if appropriate nutrition with and without lactate supplementation improves recovery time and outcomes.

Title: Overuse Injuries/Injury Prevention: Integration of Biomechanics-based Informatics for Prevention of Stress Fractures
PI: Dr. Michael Hahn
Co-PIs: Dr. Scott Delp (Stanford), Dr. Rodger Kram (CU), Dr. Alena Grabowski (CU), Dr. Jill McNitt-Gray (USC), Dr. Lorraine Turcotte (USC), Dr. Brent Liu (USC), Dr. Kormelia Kulig (USC)
University of Oregon collaborating with University of Colorado, University of Southern California & Stanford University
Project Summary: Stress fractures are a very common form of injury in athletes, especially long distance runners. This project’s goal is to analyze a group of runners’ biomechanical information such as foot motion patterns, foot-to-ground contact patterns, and accelerations and then track stress fracture development in these runners over a three year period to see which biomechanical patterns are associated with the development of stress fractures. This new biomechanics-based information can then be integrated with already known risk factors such as nutrition status and training volume/intensity to predict runners who are at a higher risk of stress fracture.

Title: Overuse Injuries/Injury Prevention: A Prospective Study to Improve Bone Health and Reduce Incidence of Bone Stress Injuries in
Pac-12 Female Distance Runners
PI: Dr. Michael Fredericson
Co-PI: Dr. Aurelia Nattiv (UCLA)
Stanford University collaborating with University of California, Los Angeles
Project Summary: The primary objective of this project is to improve the health of female collegiate distance runners, reduce the incidence and severity of bone stress injuries, and shorten recovery time. This will be accomplished with an active nutrition education program emphasizing the achievement of positive energy balance measured by increasing energy intake and/or reducing exercise energy expenditure.

Title: Mental Health and Head Trauma: Brain Health in Male and Female Basketball Student-Athletes at the University of Utah
PI: Dr. Deborah Yurgelun-Tood
Co-PIs: Dr. Charlie Hicks-Little, Dr. Perry Renshaw, Dr. Erin McGlade & Dr. Andrew Prescot
University of Utah
Project Summary: There is a need to better define the neurobiological, cognitive, and behavior changes in competitive athletes prone to head injury both pre- and post-injury. The aim of this study is to assess the association between concussive symptoms, mood states, cognitive performance, and brain changes in female and male basketball student-athletes and football student-athletes.

10:45am “Augmented ACL Reconstruction: Results and a Case Example” Kris Jones, MD (UCLA)

11:10am “Second ACL Injury Risk Prediction and Mitigation: Current Evidence and Clinical Applications” Mark V. Paterno PT, PhD, MBA, ATC (Cincinnati Children’s Hospital)

11:35am “Learned Non-Use Following ACL Reconstruction” Susan Sigward, PhD, PT, ATC (USC)

Orthopedic Physicians
Primary Care/Sports Medicine Physicians
Athletic Trainers
Mental Health Professionals
Dietitians

Michael Grandner, PhD; Director, Sleep & Health Research Program (University of Arizona)
Cathy Goldstein, MD; Associate Professor or Neurology (University of Michigan)

2:55 PM
Title: Injury Surveillance: Scaling Up Student-Athlete Exposure Tracking Using PacTrac
PI: Dr. Marc Norcross
Co-PIs: Dr. Samuel Johnson (OSU) and Dr. Christopher Scaffidi (OSU)
Oregon State University collaborating with Stanford University, University of California, Los Angeles and University of Washington

Project Summary: After a prior grant project developed PacTrac, a web-based application system that allows athletic trainers (ATs) to capture detailed athletic exposures to evaluate injury rate data, it was determined that the level of detail in which exposure is reported can influence injury rate estimates, and that the feasibility of collecting the most detail exposure information varied across AT staffing, sport and schools. The objectives of the proposal are to scale PacTrac for use conference-wide, engage stakeholders to develop conference-wide minimum exposure reporting standards for each sport, and assess the implementation feasibility of those standards using PacTrac. Upon completion, the project will provide the Conference and its member schools with the flexible exposure reporting system needed to harness the full potential of the Pac-12’s Sports Injury Registry Management and Analytics Program (SIRMAP) to support local and conference-wide improvements in student-athlete health and wellness.

3:10 PM
Title: Strengthening Concussion Education by Engaging Medical Staff: Continued Program Development and Evaluation
PIs: Dr. Kim Harmon, Dr. Emily Kroshus and Dr. Sara Chrisman
Co-PI: Dr. Ann Glang (UO)
University of Washington collaborating with Seattle Children’s Research Institute, University of Oregon and University of Colorado, Boulder

Project Summary: Expanding on a previous grant project (Pac-12 Student-Athlete Project on Developing Coach Education that led to the development of a web-based concussion training platform (www.GoHuddle.net), this study aims to 1) evaluate the effectiveness and implementation of the platform, and 2) enhance the impact of the platform through a preseason meeting between coaches and medical staff about concussion. This study will use a participant-engaged approach to develop materials to support such a meeting and will conduct an evaluation of the platform and the additive impact of the preseason meeting in all interested Pac-12 institutions.

Title: Student Athlete Health and Well-Being: Looking at the Past to Inform the Future
PI: Dr. Theresa Hernandez
Co-PI: Dr. Adam Bohr
University of Colorado, Boulder
Project Summary: In collecting and utilizing data from former student-athletes to inform current best practices, this study will assess longitudinal patterns of physical and psychological health while paying attention to the presence of chronic conditions (e.g., diabetes, heart disease, obesity, neurodegenerative diseases, etc.) and mental health diagnoses in student-athlete alumni compared to cohort matched student non-athlete alumni. The research will also aim to build upon previous related research by assessing socioeconomic and first-generation status as group profiles, as well as modifying factors of student-athlete health following their collegiate careers. The goal of this research is not only to characterize life-course trajectories, but also to utilize this information to identify best practices, thereby creating opportunities to improve and optimize the overall health and well-being of current and future student-athletes.

Title: Head Trauma: Designing Safer Helmets Using Advanced Materials and Modeling
PI: Dr. Christopher Yakacki
Co-PIs: Dr. Peter Jenkins, Dr. R. Dana Carpenter, Dr. Kai Yu, Dr. Sourav Poddar
University of Colorado, Boulder & Denver
Project Summary: The University of Colorado’s Boulder and Denver campuses have worked together to research football helmet design with a focus on lowering the severity of impacts and reducing the prevalence of concussions in the sport. Recently, the NFL released several computer models of helmets to investigate the influence of helmet materials and designs on head impacts. This study seeks to leverage this state-of-the-art technology and create new models to improve helmet safety using a recently developed high-performance polymer called liquid-crystal elastomers (LCEs). The LCEs will be incorporated in the helmet models and virtually tested to optimize their design. This approach will allow the investigators to rapidly test and evaluate the performance of new materials in helmets, without having to manufacture and physically validate each new configuration.

Title: Head Trauma: The Subtypes of Concussion – Classification and Recovery Trajectories in Pac-12 Student Athletes
PIs: Dr. Angela Lumba-Brown
Co-PIs: Dr. Jamshid Ghajar (Stanford), Dr. Masa Teramoto (Utah), Dr. Matthew McQueen (Colorado), Dr. Douglas Aukerman (OSU), Dr. Kimberly Harmon (UW), Dr. David Petron (Utah), Dr. Sourav Poddar (Colorado) and Russ Romano (USC)
Stanford University collaborating with the University of Colorado, Oregon State University, University of Southern California, University of Utah and University of Washington
Project Summary: The goal for this study is to advance the science of concussion care and change how concussions are diagnosed and managed, allowing for earlier and more focused rehabilitation and treatments. By performing clinical research, this study will look to characterize and compare concussion subtypes over time and by gender, sport, school and medical history, including cardiovascular health, while also assessing recovery trajectories by concussion subtypes over a six-month span to allow for anticipated outcomes and targeted-treatment options.

Title: Overuse Injuries/Injury Protection: Biomechanical metrics to improve performance and reduce elbow injuries in baseball
PI: Dr. Lori Michener
Co-PIs: Dr. Andrew Karduna (UO) and Dr. Roksana Karim (USC)
University of Southern California collaborating with the University of Oregon and University of California, Los Angeles
Project Summary: A common problem among baseball players is an injury to the ulnar collateral ligament (UCL) at the elbow. The UCL provides ~50% counter to elbow force (varus torque) during pitching, putting the UCL at risk for injury. Elbow varus torque increases as ball velocity increases, but not for all pitchers. Elbow varus torque may be mediated by player physical factors, such as muscle performance, joint motion, and stability. The knowledge gap is understanding the ball velocity – elbow varus torque relationship, and how physical factors can mediate the relationship to reduce elbow varus torque. This study will aim to characterize player risk of UCL injuries by developing player profiles that can be used to: 1) target the identified physical factors to reduce injuries and inform rehabilitation after injury, 2) specify return to sport criteria and 3) guide performance enhancement.

Title: Head Trauma: Reactive Postural Responses after Concussion: Objective Measurement of Balance Recovery and Prospective Injury Risk
PI: Dr. Peter Fino and Dr. Lee Dibble
Co-PIs: Dr. Daniel Cushman, Dr. Nicholas Monson, Dr. Angela Presson
University of Utah
Project Summary: Reactive postural responses are used to recover balance, but they have received relatively little attention after concussion despite being common in athletics and critical to athlete safety and performance. Prior research has shown previously concussed athletes experience a greater risk of musculoskeletal injuries, but the cause of this increased risk is not known. This study will focus on a critical barrier of current balance assessments for concussion by objectively quantifying reactive postural responses to determine the connection between post-concussion postural control and musculoskeletal injuries. This project seeks to have immediate impact on concussion management by establishing a protocol to assess postural responses that is tailored for concussions and clinical use and can be rapidly implemented through the Pac-12. Long-term, this study seeks to provide the framework for future studies to examine rehabilitative approaches that train balance recovery to accelerate the recovery and/or decrease the risk of musculoskeletal injury following concussions.

Title: Injury Prevention: Improving Rehabilitation Following Anterior Cruciate Ligament Repair with Real-Time Feedback during Low Intensity Cycling
PIs: Dr. James Martin
University of Utah
Project Summary: With an astounding 25% of athletes with previous anterior cruciate ligament (ACL) reconstruction surgery developing additional ACL injury following surgery, this study aims to reduce compensatory patterns during movement exercises while evaluating the relationship between cycling symmetry and return-to-play outcomes. Of concern, current data indicates that these patterns progress, rather than diminish, during the course of rehabilitation and can go undetected due to maximal tests typically taking place several months following surgery. Low-intensity cycling is commonly prescribed and known to be safe soon after surgery. This project seeks to improve symmetry by providing biomechanical feedback during low-intensity cycling. It also aims to determine if cycling symmetry leads to improved symmetry during weight bearing tasks and reduces subsequent injuries. If successful, we believe this technique may improve rehabilitation of a variety of other leg injuries as well.

Title: Student-Athlete Well-Being: Social Media Engagement and Mental Health in Pac-12 Student-Athletes
PIs: Dr. Christopher Barry
Co-PIs: Dr. Kelli Moran-Miller (Stanford)
Washington State University collaborating with Arizona State University, University of California, Berkeley, Oregon State University, Stanford University, University of California, Los Angeles, University of Southern California, University of Utah, University of Washington
Project Summary: By investigating the relationship between social media activity, self-perception and mental health among Pac-12 student-athletes, this project seeks to gain a better understanding of both the detrimental and positive aspects of student-athletes’ social media use, as well as the potential benefits of protective behavioral strategies involving social media (e.g., turning off electronic devices at night or restricting social media access during study time). The findings will seek to provide improved abilities to educate student-athletes on adaptive uses of social media and bolster their academic, mental health, physical and personal well-being.

Title: Head Trauma and Mental Health: From Head Impacts to Brain Injury, Determining the Mechanism Underlying Concussions in Pac-12 Football
PI: Dr. David Camarillo
Co-PIs: Dr. Gerald Grant (Stanford), Dr. Michael Zeineh (Stanford), Dr. Charles Liu (USC)
Stanford University collaborating with University of Southern California
Project Summary: In an effort to determine the causes of concussive injury, this study plans to implement the use of the Stanford Instrumented Mouthguard 2.0 (MiG2) in combination with MR imaging with the football teams at two Pac-12 institutions to collect data on concussions. This will expand upon recent research and data collected with an instrumented mouthguard in combination with MRI with the Stanford football program. In that study, researchers discovered that concussions could be predicted by peak head angular acceleration, correlating with signal changes on MRI. At its completion, this will be the first study to identify mechanisms of concussion by tracing the head angular acceleration input, to brain tissue damage, to advanced imaging detection of injury.

Title: Injury and Prevention: Developing a Comprehensive, Quantitative Understanding of Hip Morphometrics and Biomechanics in Collegiate Athletes at Risk for Developing Femoroacetabular Impingement Syndrome
PI: Dr. Andrew Anderson
Co-PIs: Dr. Ken “Bo” Foreman, Dr. Stepehen Aoki and Dr. Travis Maak
University of Utah
Project Summary: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and dysfunction among collegiate athletes, and a known precursor to hip osteoarthritis. Prevention is the key to reducing rates of FAIS, but research in this area is lacking. The research team believes effective prevention of FAIS starts with an in-depth understanding of how hip anatomy is altered in three-dimensions, and the extent to which abnormal hip anatomy disrupts hip biomechanics, prior to the onset of symptoms. In this study, researchers will compare 3D hip shape and biomechanics between collegiate athletes, control subjects that do not have a history of participation in the same sports, and FAIS patients who are seen in treated in the clinic. The future impact of this work is that it will support a prospective trial to determine if application of a modified training regimen reduces the prevalence of FAIS in athletes.

Title: Head Trauma: Roles of Nutritive Support and Supplementation
PI: Dr. George Brooks
Co-PI: Dr. Daniela Kaufer
University of California, Berkeley
Project Summary: Studies have shown that the brain uses lactate as a fuel source when available. Studies have also shown that patients with traumatic brain injury (TBI) are often undernourished, meaning the brain has less fuel sources to use for healing. The goal of this project is to determine whether or not supplementation with lactate on the background of adequate nutrition will improve TBI recovery by giving the brain an extra fuel source. This will be accomplished through a series of studies on laboratory rats, where rats with mild TBIs that mimic concussions will be given standard of care (inadequate) nutrition, adequate nutrition, and adequate nutrition plus extra lactate. Brain healing will be assessed to see if appropriate nutrition with and without lactate supplementation improves recovery time and outcomes.

Title: Overuse Injuries/Injury Prevention: Integration of Biomechanics-based Informatics for Prevention of Stress Fractures
PI: Dr. Michael Hahn
Co-PIs: Dr. Scott Delp (Stanford), Dr. Rodger Kram (CU), Dr. Alena Grabowski (CU), Dr. Jill McNitt-Gray (USC), Dr. Lorraine Turcotte (USC), Dr. Brent Liu (USC), Dr. Kormelia Kulig (USC)
University of Oregon collaborating with University of Colorado, University of Southern California & Stanford University
Project Summary: Stress fractures are a very common form of injury in athletes, especially long distance runners. This project’s goal is to analyze a group of runners’ biomechanical information such as foot motion patterns, foot-to-ground contact patterns, and accelerations and then track stress fracture development in these runners over a three year period to see which biomechanical patterns are associated with the development of stress fractures. This new biomechanics-based information can then be integrated with already known risk factors such as nutrition status and training volume/intensity to predict runners who are at a higher risk of stress fracture.

Title: Overuse Injuries/Injury Prevention: A Prospective Study to Improve Bone Health and Reduce Incidence of Bone Stress Injuries in
Pac-12 Female Distance Runners
PI: Dr. Michael Fredericson
Co-PI: Dr. Aurelia Nattiv (UCLA)
Stanford University collaborating with University of California, Los Angeles
Project Summary: The primary objective of this project is to improve the health of female collegiate distance runners, reduce the incidence and severity of bone stress injuries, and shorten recovery time. This will be accomplished with an active nutrition education program emphasizing the achievement of positive energy balance measured by increasing energy intake and/or reducing exercise energy expenditure.

Title: Mental Health and Head Trauma: Brain Health in Male and Female Basketball Student-Athletes at the University of Utah
PI: Dr. Deborah Yurgelun-Tood
Co-PIs: Dr. Charlie Hicks-Little, Dr. Perry Renshaw, Dr. Erin McGlade & Dr. Andrew Prescot
University of Utah
Project Summary: There is a need to better define the neurobiological, cognitive, and behavior changes in competitive athletes prone to head injury both pre- and post-injury. The aim of this study is to assess the association between concussive symptoms, mood states, cognitive performance, and brain changes in female and male basketball student-athletes and football student-athletes.

1. Femoral Acetabular Impingement – Sharon Hame, MD (UCLA)
2. POTS Treated with CBT — Doug Polster, PhD (UCLA)
2. Ankle Nerve Impairment — Sarah Lyons, ATC (Stanford)
3. Lateral Meniscus Repair — Tad Kremen, MD (UCLA)
5. Crisis Response to High Risk Mental Health Cases with Associated Case Presentations — Chris McLean (Cal)

Michael Dillon, ATC (UW) Substance Abuse Program Coordinator
Dylan Firsick, PhD (USC) Clinical & Sport Psychologist, Counseling & Mental Health

Title: Student Athlete Health and Well-Being: Looking at the Past to Inform the Future
PI: Dr. Theresa Hernandez
Co-PI: Dr. Adam Bohr
University of Colorado, Boulder
Project Summary: In collecting and utilizing data from former student-athletes to inform current best practices, this study will assess longitudinal patterns of physical and psychological health while paying attention to the presence of chronic conditions (e.g., diabetes, heart disease, obesity, neurodegenerative diseases, etc.) and mental health diagnoses in student-athlete alumni compared to cohort matched student non-athlete alumni. The research will also aim to build upon previous related research by assessing socioeconomic and first-generation status as group profiles, as well as modifying factors of student-athlete health following their collegiate careers. The goal of this research is not only to characterize life-course trajectories, but also to utilize this information to identify best practices, thereby creating opportunities to improve and optimize the overall health and well-being of current and future student-athletes.

Title: Head Trauma: Designing Safer Helmets Using Advanced Materials and Modeling
PI: Dr. Christopher Yakacki
Co-PIs: Dr. Peter Jenkins, Dr. R. Dana Carpenter, Dr. Kai Yu, Dr. Sourav Poddar
University of Colorado, Boulder & Denver
Project Summary: The University of Colorado’s Boulder and Denver campuses have worked together to research football helmet design with a focus on lowering the severity of impacts and reducing the prevalence of concussions in the sport. Recently, the NFL released several computer models of helmets to investigate the influence of helmet materials and designs on head impacts. This study seeks to leverage this state-of-the-art technology and create new models to improve helmet safety using a recently developed high-performance polymer called liquid-crystal elastomers (LCEs). The LCEs will be incorporated in the helmet models and virtually tested to optimize their design. This approach will allow the investigators to rapidly test and evaluate the performance of new materials in helmets, without having to manufacture and physically validate each new configuration.

Title: Head Trauma: The Subtypes of Concussion – Classification and Recovery Trajectories in Pac-12 Student Athletes
PIs: Dr. Angela Lumba-Brown
Co-PIs: Dr. Jamshid Ghajar (Stanford), Dr. Masa Teramoto (Utah), Dr. Matthew McQueen (Colorado), Dr. Douglas Aukerman (OSU), Dr. Kimberly Harmon (UW), Dr. David Petron (Utah), Dr. Sourav Poddar (Colorado) and Russ Romano (USC)
Stanford University collaborating with the University of Colorado, Oregon State University, University of Southern California, University of Utah and University of Washington
Project Summary: The goal for this study is to advance the science of concussion care and change how concussions are diagnosed and managed, allowing for earlier and more focused rehabilitation and treatments. By performing clinical research, this study will look to characterize and compare concussion subtypes over time and by gender, sport, school and medical history, including cardiovascular health, while also assessing recovery trajectories by concussion subtypes over a six-month span to allow for anticipated outcomes and targeted-treatment options.

Title: Overuse Injuries/Injury Protection: Biomechanical metrics to improve performance and reduce elbow injuries in baseball
PI: Dr. Lori Michener
Co-PIs: Dr. Andrew Karduna (UO) and Dr. Roksana Karim (USC)
University of Southern California collaborating with the University of Oregon and University of California, Los Angeles
Project Summary: A common problem among baseball players is an injury to the ulnar collateral ligament (UCL) at the elbow. The UCL provides ~50% counter to elbow force (varus torque) during pitching, putting the UCL at risk for injury. Elbow varus torque increases as ball velocity increases, but not for all pitchers. Elbow varus torque may be mediated by player physical factors, such as muscle performance, joint motion, and stability. The knowledge gap is understanding the ball velocity – elbow varus torque relationship, and how physical factors can mediate the relationship to reduce elbow varus torque. This study will aim to characterize player risk of UCL injuries by developing player profiles that can be used to: 1) target the identified physical factors to reduce injuries and inform rehabilitation after injury, 2) specify return to sport criteria and 3) guide performance enhancement.

Title: Head Trauma: Reactive Postural Responses after Concussion: Objective Measurement of Balance Recovery and Prospective Injury Risk
PI: Dr. Peter Fino and Dr. Lee Dibble
Co-PIs: Dr. Daniel Cushman, Dr. Nicholas Monson, Dr. Angela Presson
University of Utah
Project Summary: Reactive postural responses are used to recover balance, but they have received relatively little attention after concussion despite being common in athletics and critical to athlete safety and performance. Prior research has shown previously concussed athletes experience a greater risk of musculoskeletal injuries, but the cause of this increased risk is not known. This study will focus on a critical barrier of current balance assessments for concussion by objectively quantifying reactive postural responses to determine the connection between post-concussion postural control and musculoskeletal injuries. This project seeks to have immediate impact on concussion management by establishing a protocol to assess postural responses that is tailored for concussions and clinical use and can be rapidly implemented through the Pac-12. Long-term, this study seeks to provide the framework for future studies to examine rehabilitative approaches that train balance recovery to accelerate the recovery and/or decrease the risk of musculoskeletal injury following concussions.

Title: Injury Prevention: Improving Rehabilitation Following Anterior Cruciate Ligament Repair with Real-Time Feedback during Low Intensity Cycling
PIs: Dr. James Martin
University of Utah
Project Summary: With an astounding 25% of athletes with previous anterior cruciate ligament (ACL) reconstruction surgery developing additional ACL injury following surgery, this study aims to reduce compensatory patterns during movement exercises while evaluating the relationship between cycling symmetry and return-to-play outcomes. Of concern, current data indicates that these patterns progress, rather than diminish, during the course of rehabilitation and can go undetected due to maximal tests typically taking place several months following surgery. Low-intensity cycling is commonly prescribed and known to be safe soon after surgery. This project seeks to improve symmetry by providing biomechanical feedback during low-intensity cycling. It also aims to determine if cycling symmetry leads to improved symmetry during weight bearing tasks and reduces subsequent injuries. If successful, we believe this technique may improve rehabilitation of a variety of other leg injuries as well.

Title: Student-Athlete Well-Being: Social Media Engagement and Mental Health in Pac-12 Student-Athletes
PIs: Dr. Christopher Barry
Co-PIs: Dr. Kelli Moran-Miller (Stanford)
Washington State University collaborating with Arizona State University, University of California, Berkeley, Oregon State University, Stanford University, University of California, Los Angeles, University of Southern California, University of Utah, University of Washington
Project Summary: By investigating the relationship between social media activity, self-perception and mental health among Pac-12 student-athletes, this project seeks to gain a better understanding of both the detrimental and positive aspects of student-athletes’ social media use, as well as the potential benefits of protective behavioral strategies involving social media (e.g., turning off electronic devices at night or restricting social media access during study time). The findings will seek to provide improved abilities to educate student-athletes on adaptive uses of social media and bolster their academic, mental health, physical and personal well-being.

Title: Head Trauma and Mental Health: From Head Impacts to Brain Injury, Determining the Mechanism Underlying Concussions in Pac-12 Football
PI: Dr. David Camarillo
Co-PIs: Dr. Gerald Grant (Stanford), Dr. Michael Zeineh (Stanford), Dr. Charles Liu (USC)
Stanford University collaborating with University of Southern California
Project Summary: In an effort to determine the causes of concussive injury, this study plans to implement the use of the Stanford Instrumented Mouthguard 2.0 (MiG2) in combination with MR imaging with the football teams at two Pac-12 institutions to collect data on concussions. This will expand upon recent research and data collected with an instrumented mouthguard in combination with MRI with the Stanford football program. In that study, researchers discovered that concussions could be predicted by peak head angular acceleration, correlating with signal changes on MRI. At its completion, this will be the first study to identify mechanisms of concussion by tracing the head angular acceleration input, to brain tissue damage, to advanced imaging detection of injury.

Title: Injury and Prevention: Developing a Comprehensive, Quantitative Understanding of Hip Morphometrics and Biomechanics in Collegiate Athletes at Risk for Developing Femoroacetabular Impingement Syndrome
PI: Dr. Andrew Anderson
Co-PIs: Dr. Ken “Bo” Foreman, Dr. Stepehen Aoki and Dr. Travis Maak
University of Utah
Project Summary: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and dysfunction among collegiate athletes, and a known precursor to hip osteoarthritis. Prevention is the key to reducing rates of FAIS, but research in this area is lacking. The research team believes effective prevention of FAIS starts with an in-depth understanding of how hip anatomy is altered in three-dimensions, and the extent to which abnormal hip anatomy disrupts hip biomechanics, prior to the onset of symptoms. In this study, researchers will compare 3D hip shape and biomechanics between collegiate athletes, control subjects that do not have a history of participation in the same sports, and FAIS patients who are seen in treated in the clinic. The future impact of this work is that it will support a prospective trial to determine if application of a modified training regimen reduces the prevalence of FAIS in athletes.

Title: Head Trauma: Roles of Nutritive Support and Supplementation
PI: Dr. George Brooks
Co-PI: Dr. Daniela Kaufer
University of California, Berkeley
Project Summary: Studies have shown that the brain uses lactate as a fuel source when available. Studies have also shown that patients with traumatic brain injury (TBI) are often undernourished, meaning the brain has less fuel sources to use for healing. The goal of this project is to determine whether or not supplementation with lactate on the background of adequate nutrition will improve TBI recovery by giving the brain an extra fuel source. This will be accomplished through a series of studies on laboratory rats, where rats with mild TBIs that mimic concussions will be given standard of care (inadequate) nutrition, adequate nutrition, and adequate nutrition plus extra lactate. Brain healing will be assessed to see if appropriate nutrition with and without lactate supplementation improves recovery time and outcomes.

Title: Overuse Injuries/Injury Prevention: Integration of Biomechanics-based Informatics for Prevention of Stress Fractures
PI: Dr. Michael Hahn
Co-PIs: Dr. Scott Delp (Stanford), Dr. Rodger Kram (CU), Dr. Alena Grabowski (CU), Dr. Jill McNitt-Gray (USC), Dr. Lorraine Turcotte (USC), Dr. Brent Liu (USC), Dr. Kormelia Kulig (USC)
University of Oregon collaborating with University of Colorado, University of Southern California & Stanford University
Project Summary: Stress fractures are a very common form of injury in athletes, especially long distance runners. This project’s goal is to analyze a group of runners’ biomechanical information such as foot motion patterns, foot-to-ground contact patterns, and accelerations and then track stress fracture development in these runners over a three year period to see which biomechanical patterns are associated with the development of stress fractures. This new biomechanics-based information can then be integrated with already known risk factors such as nutrition status and training volume/intensity to predict runners who are at a higher risk of stress fracture.

Title: Overuse Injuries/Injury Prevention: A Prospective Study to Improve Bone Health and Reduce Incidence of Bone Stress Injuries in
Pac-12 Female Distance Runners
PI: Dr. Michael Fredericson
Co-PI: Dr. Aurelia Nattiv (UCLA)
Stanford University collaborating with University of California, Los Angeles
Project Summary: The primary objective of this project is to improve the health of female collegiate distance runners, reduce the incidence and severity of bone stress injuries, and shorten recovery time. This will be accomplished with an active nutrition education program emphasizing the achievement of positive energy balance measured by increasing energy intake and/or reducing exercise energy expenditure.

Title: Mental Health and Head Trauma: Brain Health in Male and Female Basketball Student-Athletes at the University of Utah
PI: Dr. Deborah Yurgelun-Tood
Co-PIs: Dr. Charlie Hicks-Little, Dr. Perry Renshaw, Dr. Erin McGlade & Dr. Andrew Prescot
University of Utah
Project Summary: There is a need to better define the neurobiological, cognitive, and behavior changes in competitive athletes prone to head injury both pre- and post-injury. The aim of this study is to assess the association between concussive symptoms, mood states, cognitive performance, and brain changes in female and male basketball student-athletes and football student-athletes.

Jean Georges Steakhouse
Sage
Julian Serrano

8:00am
Title: Pac-12 and NCAA Collaboration – Concussion Assessment, Research, and Education (CARE) Consortium Data Collection: Establishing a Research Infrastructure and Framework
PI: Dr. Doug Aukerman and the Pac-12 Brain Trauma Task Force
The Pac-12 Concussion Coordinating Unit – Project Director: Dr. Matthew McQueen, Co-PI: Dr. Theresa Hernandez & Dr. Adam Bohr

Project Summary: This project, co-funded by the NCAA, will create the first full-conference regional research hub of the landmark CARE Consortium. The Consortium is funded by a partnership of the U.S. Department of Defense Military Health System and the NCAA, and is a multi-site, longitudinal investigation of concussion and repetitive head impacts in NCAA athletes and military service academy cadets that addresses major gaps in the understanding of concussion. Through this project, each Pac-12 institution will be able to collect neurocognitive and neurobehavioral data on athletes at baseline, at the time a concussion occurs, and then at multiple time-points over the course of the year following an injury.

8:15am
Title: Health and Wellness: Assessing Student-Athlete Health and Performance
PI: Dr. William Byrnes
Co-PIs: Dr. Theresa Hernandez & Dr. Ken Wright
University of Colorado

Project Summary: The overall aim of our Pac 12 funded protocol was to identify important indicators of student-athlete health and wellness, as well as implement and disseminate important ‘best practices’ for sustainable student-athlete training and performance. To accomplish this aim we assembled a multi-disciplinary team with expertise in sports medicine, neuroscience, epidemiology, sleep physiology & exercise physiology spanning the athletic and academic environments at the University of Colorado Boulder. The outcome of this effort has been a series of projects utilizing approaches from each discipline examining health/well-being using survey tools, athlete sleep behaviors, athlete blood volume parameters and issues related to iron homeostasis.

ROOM ONE
8:40am Expanded Grants Presentation: “Health and Wellness: Assessing Student-Athlete Health and Performance” Byrnes (CU)

9:10am “Management of Fad Diets and Plant Based Diets in Athletes” Kristen Gravani, RD (Stanford)

9:40am Open Discussion: NCAA Guidelines for Preventing Catastrophic Injury & Death in Collegiate Athletes

ROOM TWO
8:40am “Non-Operative Management, Internal Bracing and Reconstruction of Elbow UCL in Throwing Athletes” Frank Petrigliano, MD (USC)

9:10am “Neuroplasticity After Injury: Strategies to Enhance Neuromuscular Control” Cody Criss (Ohio University)

9:40am “Hip Arthroscopy in Athletes” Alexander Weber, MD (USC)

Room Three
8:40am Eating Disorder Panel

9:40am TBD

10:20am A Multi-Disciplinary Approach to Thoracic Outlet Syndrome
10:20-10:45am Non-Operative Care – Shanyn Lancaster, MD (ASU)
10:45-11:10am Operative Care – Hugh Gelabert, MD (UCLA)
11:10-11:35am Nutritional Considerations – RD
11:35-12:00pm Rehabilitation Considerations – Deb Iwasaki, PT, ATC (Stanford)
12:00-12:25pm Psychology of Injury