Players call it a "ding" or "getting their bell rung," but sports concussions -- on the football field, on the wrestling mat, on the soccer field or even among bikers and skiers -- are more dangerous than many people might think. They're also more widespread. It's becoming clear that the old "shake it off" treatment isn't good enough.

The Detroit Free Press reports that more athletics programs, even those for little kids, are taking sports concussions more seriously.

HealthLink, a Web site published by the Medical College of Wisconsin, reports that the injuries don't just happen at professional and college games:

Each year, 40,000 high-school football players nationwide suffer concussions, which are usually considered mild traumatic brain injuries (MTBI), but still require medical attention.

Many other sports and recreational activities, including wrestling, hockey, soccer (from head collisions), snowboarding and in-line skating, can also result in concussions. Even whiplash can cause a concussion. Altogether, about 300,000 traumatic brain injuries occur each year in sports and recreation in the United States.

Several National Football League players (notably, quarterbacks Troy Aikman and Steve Young) retired after suffering several concussions during their careers. Multiple concussions suffered over a period of months or years increases the risk of permanent brain damage and post-concussion syndrome, in which neurological or cognitive problems become chronic. Even mild concussions occurring within hours, days or weeks of each other can result in "second impact syndrome," which can be fatal. As a result, coaches and trainers are showing an increased sensitivity to the effects of concussions on their players.

The Gainesville (Fla.) Times has a story about a female high-school basketball player who suffered a concussion on the court last week. As women's athletics gets more physical, these injuries are attracting new concern.

The University of Pittsburgh Medical Center adds:

Approximately ten percent of all athletes involved in contact sports, such as football, hockey, and soccer suffer a concussion each season (some estimates are as high as 19 percent). Because many mild concussions go undiagnosed and unreported, it is difficult to estimate precisely the rate of concussion in any sport.

The American Academy of Neurology launched an awareness campaign about sports concussions. Hockey Hall of Famer Pat LaFontaine is the frontman for the campaign. Listen to the commercial here. The ad says 300,000 athletes, who play on teams from Little League to pro, suffer sports-related brain injuries while playing each year.

What should coaches and parents do when an injury occurs?

HealthLink suggests:

Anyone with a concussion should be seen by an experienced professional. Those who were knocked unconscious should see a doctor. A computerized tomography (CT or CAT) scan and other tests may be performed to help diagnose the severity of the injury. Make sure the physician knows about any drugs being used -- alcohol, natural remedies or supplements, over-the-counter or prescription medications, or street drugs. Even aspirin (or other blood thinners) might cause complications.

With a doctor's permission, acetaminophen (e.g. Tylenol) can be taken for pain. Rest is the primary treatment. While healing, individuals who have sustained a concussion should avoid activities that could lead to another brain injury.

Danger signs, which may indicate a blood clot or other serious condition, include:

An individual with any of these symptoms should be immediately taken to an emergency room. Young children who experience any of the above symptoms or won't stop crying, can't be consoled or won't nurse or eat, should also be taken to an emergency room immediately.

Recovery from concussion varies. Most people with mild injuries recover fully, but it can take time. Recovery is typically slower in older people. People who have had a concussion in the past may find that it takes longer to recover from their current injury.

The University of Virginia Health System Web site says:

Although certain sports such as football, rugby, ice hockey and martial arts are considered to be more prone to incidences of concussion, other forms of recreational sports, such as horseback riding, soccer, bicycling and skiing also carry a significant risk of concussion. Many concussions cause only temporary disruption of brain function and resulting problems fade within a week or two. However, fully 60 percent of people who sustain a concussion still encounter neurological problems one month [after the injury].

Here are some resources from a 2001 study by the Center for the Study of Retired Athletes:

• 62.5 percent of retired NFL players reported sustaining at least one concussion during their professional playing years.

• The average number of concussions sustained by retirees during their professional playing years was 2.04

• 24 percent of retired NFL players reported sustaining three or more concussions during their professional playing years.

• Retired NFL players who sustained three or more concussions during their professional playing years had a nearly three-fold risk of being diagnosed with Mild Cognitive Impairment (one precursor to Alzheimer's disease).

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Multiple Sclerosis 50 Percent More Common Than Thought

WebMD reports:

Multiple sclerosis (MS) may be 50 percent more common in the United States than previously thought, according to a new research review.

Almost one in 1,000 people in the United States has MS, according to the review.

"Our estimate of MS prevalence is about 50 percent higher than a comprehensive review from 1982," says researcher Deborah Hirtz, M.D., in an American Academy of Neurology news release.

"Whether this reflects improvement in diagnosis or whether incidence is actually increasing deserves further study," says Hirtz, who works at the National Institute of Neurological Disorders and Stroke.

You can find more information on MS here:

• National Multiple Sclerosis Society
• MedlinePlus MS information and news page
• NINDS Multiple Sclerosis page
• Mayo Clinic MS page
  

Airline Miles Expire Faster

USA Today points out that airlines are starting new policies that will mean lots of us might lose thousands of frequent-flier points if we don't cash them in or keep an account active.

The article details some of the changes being made:

"Frequent-flier miles are a liability on the company books," says Barbara Beyer, president of airline consultant Avmark. "The airlines really want to get rid of them as they clean up their balance sheets."

The story adds:

Of 16 U.S. airlines contacted by USA TODAY, only Continental and Aloha said miles do not expire in their frequent-flier members' accounts. Continental has a written policy stating that miles can expire if none are earned in 18 months, but the airline doesn't act on it, says spokesman David Messing.

AirTran and JetBlue have the strictest expiration policies, with credits or miles expiring one year after they are earned.

Banks Cash In on Debit Overdrafts

The Center for Responsible Lending says:

Banks across the nation are taking advantage of the upward trend in debit card use to make high-cost overdraft loans more common and still costlier, according to a study released by the Center for Responsible Lending (CRL) today.

"What banks are calling 'bounce protection' is starting to look more like a 'protection racket,'" said Eric Halperin, director of CRL's Washington office and a co-author of the report. "Banks are raking in fees from unwitting customers who would not overdraft if given a choice."

The report, "Debit Card Danger," analyzed the checking accounts of more than 5,000 customers of the nation's 15 largest banks and found that debit card purchases and ATM withdrawals trigger 46 percent of high-cost overdraft loans. Written checks, on the other hand, are responsible for just over one quarter.

Making an in-store debit card purchase is by far the most expensive way to overdraft, costing $2.17 for every dollar borrowed. By comparison, check-triggered overdraft loans cost $0.86 per dollar borrowed. These findings refute the contention commonly made by banks and credit unions, many of which also have fee-based overdraft programs, that they are protecting consumers by sparing them the expense of bounced checks.

MSNBC.com's Red Tape Chronicles has a nice story on this topic.

Al's Morning Multimedia

Every morning I bring you a new multimedia project -- or two or three -- to help you think through how to design online work that resonates with users.

Today's examples come from outside journalism but nonetheless demonstrate real innovation. First stop today -- Disney's new site. Rather than text menus and navigation bars, users click through neighborhoods.

It is so easy to use. I wonder how long it will be before a news site breaks out of the old template that we all use and shows innovation, like DIsney. I can imagine an idea like this one working for government Web sites, too.

Next stop -- Nickelodeon, the TV network that lit up a new site yesterday called Nicktropolis.com.

The Web site encourages kids to interact with the Nick brand in ways that get progressively more sophisticated as they get more online-savvy.

On the low end of the site is the "Pier" area -- filled with easy-to-use games. The high end allows users to create avatars and battle for Bikini Bottom, SpongeBob's home.

Nick's interaction builds a connection between kids and TV characters. It also allows the kids to continue to interact with the TV product even when they are online. In essence, Nick is saying, "However you want to be entertained, we can do that." The longer Nick keeps a kid on the site, the more opportunity there is to build brand loyalty.

Journos can learn from that attitude. The least important part of the word "newspaper" is "paper."