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Brad Keselowski says more needs to be done to diagnose mild concussions

NASCAR Sprint Cup Series Ford EcoBoost 400 - Practice

HOMESTEAD, FL - NOVEMBER 19: Brad Keselowski, driver of the #2 Miller Lite Ford, stands in the garage area during practice for the NASCAR Sprint Cup Series Ford EcoBoost 400 at Homestead-Miami Speedway on November 19, 2016 in Homestead, Florida. (Photo by Jerry Markland/Getty Images)

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DAYTONA BEACH, Fla. — Brad Keselowski says all sports face a challenge in diagnosing mild concussions and until such a tool is available to do so, “all of sports are playing from behind.’’

Keselowski’s comments come less than a week after NASCAR upgraded its concussion protocol and on a day where Danica Patrick said the number of concussions she could have suffered in her racing career is “thought-provoking.’’

Keselowski said Wednesday at Daytona International Speedway that the next key area for all sports is to “find a definitive way to diagnose a mild concussion. Until we can definitively define a mild concussion, we’re going to have one or two end results.

“We’re either going to have drivers sit out when they don’t really have a concussion, or we’re going to have the long-term effect of drivers that have faced multiple concussions and developed CTE (Chronic Traumatic Encephalopathy), Parkinson’s, Alzheimer’s, all the things that go with it. We need a definitive tool to diagnose a mild concussion.’’

As part of its updated concussion protocol, NASCAR announced Feb. 17 that it will require infield care center physicians to incorporate the SCAT-3 diagnostic tool in screening for head injuries. A SCAT test is used by IndyCar and the NFL in diagnosing concussions.

Keselowski’s issue is with hits defined as subconcussive. Enough of those can impact an athlete.

“A race car driver does have, over the course of a long career, repetitive head injuries,’’ Dr. Robert Cantu, clinical professor Neurology/Neurosurgery at the Boston University School of Medicine, told NBC Sports’ Nate Ryan in August. “It’s not just concussions. It’s the subconcussive violent shaking that can contribute as well. So I think it’s very important that we have the opportunity to study the brains in someone involved in racing.’’

Asked about drawing a line from concussions to CTE, a progressive degenerative disease found in those with a history of repetitive brain trauma, Cantu said:

“I think it’s fair to draw the line from repeated head injury, both at the subconcussive and concussive level, with the risk of developing CTE, and it goes up the more trauma you’ve taken.’’

Patrick, 34, says she believes she’s had her share of concussions in a racing career that began when she was 10 years old.

“Every time you crash, you have a concussion of a varying degree,’’ she said Wednesday at Daytona International Speedway. “(Dale Earnhardt Jr.) said something about having 12 concussions, I was like, ‘Oh, I’m sure I’ve had 12 concussions.’ It is a little bit thought-provoking is what I would say for sure.’’

Earnhardt has never revealed how many concussions he has had, although he has sustained at least five concussions during his 17 seasons in NASCAR’s premier series.

Patrick has not suffered a concussion since racing in NASCAR in 2010.

“While we’re not football players, we don’t get the repeated hits in succession over a short amount of time, but it’s rough in the car and the hits are probably singularly bigger, maybe,’’ Patrick said. “I’m just assuming going 200 miles an hour, going 150 miles an hour, has got to be a fairly big hit compared to running.’’

Patrick noted that SAFER barriers and collapsible items on NASCAR vehicles have better protected drivers. Still, Earnhardt missed the final 18 races of last season because of concussion symptoms that stemmed from a crash at Michigan International Speedway in June. It marked the second time in his career that Earnhardt has missed races because of concussion symptoms.

He wasn’t the only driver to sit out last year for similar issues. Matt DiBenedetto was forced to miss a Cup race last season although he questioned if he had been diagnosed correctly after an incident in November at Texas. John Wes Townley missed two Camping World Truck Series races last year because of concussion-like symptoms suffered after two crashes in a June race at Gateway Motorsports Park.

Earnhardt’s openness about his symptoms and recovery is viewed by many in the sport as trendsetting and raised the profile of the issue.

“I was very, very sick,’’ Earnhardt said Wednesday.“I had no business being in a car. I just did everything my doctors were telling me to do.

“If it helps somebody, that’s important. But I was just looking out for myself, listening to my doctors. If it taught someone a lesson or helped someone, that’s awesome. I definitely became more educated through the process.’’

A day before Earnhardt returned to the car last weekend at Daytona International Speedway, NASCAR updated its concussion protocol for competitors. The policy states:

#As part of the new rule regarding damaged vehicles, a driver whose car sustains damage from an accident or contact of any kind and goes behind the pit wall or to the garage is required to visit the Infield Care Center to be evaluated.

#The medical portion of NASCAR’s Event Standards now require that Infield Care Center physicians incorporate the SCAT-3 diagnostic tool in screening for head injuries.

#AMR will provide on-site neurological consultative support at select NASCAR events during the 2017 season and will work directly with NASCAR in the continued development of concussion protocol.

Martin Truex Jr. and Jimmie Johnson each said they had no issues after their separate incidents in Sunday’s Clash.

“They just evaluated me,’’ Johnson said after his visit to the infield care center. “It seemed like a normal routine, so I don’t think I was in question to go into protocol mode.’’

With a doctor and paramedic in an emergency vehicle that responds to crashes, it allows medical officials to view drivers more closely after the incident instead of waiting until the drivers arrive to the infield care center. If the doctor or paramedic see something that raises a concern, it can trigger the concussion protocol program.

For as much as is being done, Patrick recognizes the dangers associated with concussions.

“It’s our life, and if there was someone that told me, and I would hope that any other driver that if you had another wreck you could have a serious problems (that) they would be out,’’ she said. “I would be out. I love what I do, but I love lots of other things, and I also love life. I’m too young to have it be over.’’

So with the emphasis on concussions, what more can be done?

“No. 1 for me is taking note of symptoms, being really aware, which I feel that I’m pretty good at that,’’ Patrick said. “I would almost call myself hyper-sensitive just because of how much I take care of myself with food and working out. I feel very, very perceptive to any little change to my body.

“Hopefully, it puts NASCAR in a position and the safety team into a position where they start to address it differently from a recording information standpoint or a data or testing of some sort. There are some different protocols. The question is what can we do really? Just be aware of your symptoms and be honest.’’

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