The Baldy Center Podcast

The Baldy Center for Law and Social Policy at the University at Buffalo

Fall 2023, Episode #36

Podcast recording date: 11/06/2023

Host-producer: Logan

Speaker: Helen “Nellie” Drew and 3L students Maddie Drechsel, Matt Pickard, and Juliette Miranda

Contact information: BaldyCenter@buffalo.edu

Transcription begins.

Logan:

Hello and welcome to the Baldy Center for Law and Social Policy Podcast. I'm your host Logan. On this week's episode, we are joined by Professor of Practice in Sports Law, Helen “Nellie” Drew, Director of the UB Center for the Advancement of Sport, along with her students, Maddie Drechsel, Matt Pickard, and Juliette Miranda. We discussed the ins and outs of their current research projects and why their research is desperately needed within the world of sports. From emergency action plans to youth sports injuries, we dive deep into their interdisciplinary research and learn more about the holes that are currently found within sports law. 

Logan:

Well, thank you everyone for joining me today. I really appreciate your time. I wanted to first start off with having everyone introduce themselves and talk about your academic journey.

Nellie:

I drafted them. I'm Nellie Drew, I'm the Director of the Center for the Advancement of Sport at the Law School and Professor of Practice in Sports Law. I run the main sports law concentration and they were naive enough, I guess, to take my sports law classes, and I kind of pitched it to them. A couple of the things. I think it was sort of mutual, but you [Maddie, Matt, and Juliette] definitely displaying initiative. So when we had Sports Law II, which is a class that we had last spring, we do a virtual expansion in the NFL and we do various things, but as part of every class we talk about current issues in sports. And one of the things that I'm involved with is Project Play Western New York, which is an arm of the Wilson Community Foundation of Greater Buffalo, which is very much invested in developing best practices that we distill down from the Sabres and the Bills to try to make recreational activities the most rewarding, the safest we possibly can. And as part of that, I have connected many times with Dr. John Leddy and Dr. Barry Willer, who are concussion experts here at UB in the Concussion Management Clinic, as well as Dr. Leslie Bisson, who is the Buffalo Sabres and Bills team physician, and whom you probably know as the guy who saved Damar Hamlin's life. They are very much interested in reinventing policy to provide a safer, more applicable experience for people, typically youth sports. And so, we mentioned this in some class discussions and they [Maddie, Matt, and Juliette] were like we would like to be part of that. We are fortunate to have the Practicum and under the umbrella of the Practicum, Maddie and Matt have been with me since last spring on this initiative, and I want them to describe it more fully.  This initiative to provide a model law, which would require greater protection for sport of all levels for a variety of different reasons. And Juliette had a particular interest in injuries resulting from chronic abuse, which is a major issue we're seeing now with the professionalization, if you will, of youth sports.

Logan:

That is really interesting. And I'm not sure if we want to go right to left or left to right. 

Maddie:

I’ll start. Thanks so much for having us here today. My name is Maddie Drechsel. I am originally from Potsdam, New York, so more upstate. And I did not go to UB for undergrad. I went to Queens University in Canada, then after college, worked for a few years at a law firm, which ultimately led me to want to attend law school. And as Professor Drew said, just being in her classes, Sports Law I and Sports Law II, we would always talk about current happenings in sports and that's what brought us here today. So I'm excited to be here.

Matt:

I’m Matt Pickard, I started off my undergrad at Syracuse University where I played soccer for a year and then decided didn't want to play anymore, so I transferred back home to Buffalo, went to UB and then graduated with a finance degree. Well, I guess I was a physical therapy major. And then after sophomore year, switched to finance and then I think junior year during the winter didn't know what I wanted to do, so I decided to take the LSAT to go to law school and then ended up at UB Law. The fall semester of 2L year I took Sports Law I with Professor Drew, and then spring semester Sports Law II with Professor Drew. And then, like she said, during that spring semester, class discussions, some of her pitching, and our interests led us to inquiring about some of the opportunities she had for Practicum and experiential stuff. So then we ended up here and working on what we are now.

Juliette:

I'm Juliette Miranda. I graduated from New York University in 2021 with a Bachelor's in science and social work. And then I decided that I wanted to go to law school my sophomore year of college. So I did a lot of research and I decided that UB law would be the best choice for me. My brother lives in Buffalo. I'm originally from Westchester County, but my brother was here, and I absolutely loved it when I visited him. So I decided that this would be a good opportunity for me. You can't tell via podcast, but I am 6’. I come from a very large family. My brother is 6’6”; we're all massive in our family, so obviously we had to play sports. But no, I didn't play basketball. I refused to because everybody told me I should, so I didn't. That wasn't for me. So I ended up playing volleyball and I also ran track, but I had a wide array of injuries, especially with poor alignment I had in my ankles going to my knees. So that also led to my interests specifically with youth injuries.

Logan:

Now, I know you all touched upon how you met Professor Drew. I was wondering if you could dive more deeply into what your projects are about and your roles within those and your specific interests within that research.

Maddie:

So for me and Matt, we are working on drafting a model law aimed at incentivizing sports venues to implement emergency action plans. So this includes outlining both the equipment that should be on hand as part of an emergency response, and we're calling them “kits”, which is what we're working on building out, and then a procedure for how to respond to these medical emergencies.

Matt:

Yes, AEDs, we're focusing on EpiPens, heat stroke, heat illnesses, overall stretching.

Maddie:

Concussions. 

Matt:

Yes, concussions. And then basically we are breaking them down and looking at how often they occur to start with and then the cost of preventing them. And also, the cost of recovery, after a concussion or after a heart incident like Damar Hamlin, how much it cost to recover.

Maddie:

Yes, so we're basically trying to show the cost benefit analysis of how this would benefit anyone that would be subject to it. And then in support of the model law, we're writing a white paper, and our research is assessing what he [Matt] just said, whether this would reduce the number of injuries and decrease the costs associated with those injuries. And we basically just split up the research in half and then are marrying it as we go through. But part of my interest in this research, in general, is a lot of where we start is pro sports, college sports and organized competitions, which is very important and there's a lot of data for that, but once you start thinking of all the levels and venues that it affects, you realize it could affect anyone. It could affect your daily life. Like me, I go spinning a couple times a week now I'm like, where's the AED at my spin studio? It really can affect the average person that's not a professional athlete or attending a huge sporting event. So I think that drives home the importance of what we're looking at and how it can affect youth sports. So once you start doing the research, you realize it's more common than the public realizes. The numbers we're seeing drives home the need for this.

Matt:

And again, to interject, with AEDS, Professor Drew had a friend who was just tailgating for a Bills game, got there and was outside the stadium and all of a sudden had a cardiac arrest. And luckily emergency personnel were very close that they could help him, but it doesn't just happen on the fields of players, it affects the fans and the spectators, mom and dad in the stands, that are there to watch.

Logan:

And Juliette, if you could provide an overview of your project as well.

Juliette:

Sure. So I'm writing a paper specifically regarding player injury mitigation and youth athletes, specifically from elementary all the way to high school. My paper is proposing the necessity for a mandated program for youth athletes, and coaches as well, to provide basic training to understand signs of overuse injuries being displayed in the specific sport of focus. And from that it would instill injury risk mitigation strategies to youth based on their position. The program proposes mandated stretching, injury prevention and mobility training before and after training sessions, games, and pre-, post- and during season as well. But since it's such a big topic, for brevity purposes, my paper only hones-in on elbow injuries in youth pitchers, specifically, as an example for the necessity of the program. For elbow injuries in youth, it's usually called “little league elbow.” Around 44% of the youth who played baseball in 2022, suffered an elbow injury. And 47% of youth baseball players will experience arm pain of varying severity that could lead to just general discomfort, or it could lead, later on to surgery. And specifically, I'm proposing this program because there are massive socioeconomic barriers that are getting in the way. For example, in 2022, an inflated number roughly, an individual can save last year an average of $2,000. That is highly inflated, because obviously there are people that are saving a lot more and a lot less, if any at all. The average cost of an X-ray is around $4,000 without insurance or copay. How are people paying for that? If a youth gets injured and they're having elbow pain, how are they going to get the X-ray if they can't afford it?  Let alone physical therapy, surgery, or anything else aside from that, it's impossible. So then all of a sudden, the youth can't play their sport anymore or they fight through the injury causing further lifelong pain. This program is hopefully created to mandate these preventative programs to be able to help youth so that they don't have to deal with pain, and hopefully they won't have to get those further needed care and expenses as well.

Logan:

Now as you speak more about each of your projects, I'm hearing more and more areas of overlap. Has there been any collaboration between your project, Matt and Maddie, with your project, Juliette? Or what has that process looked like? What does that collaboration look like?

Matt:

We have not worked directly together, but there definitely is overlap as far as I know. One of our main things is stretching, and especially in baseball, I know you [Juliette] have been looking at Tommy John Surgery, and a huge thing is proper stretching, proper warming up. And that goes in regard to any injury, especially ACLs. The cost of an ACL from diagnosis to surgery to physical therapy to all of the recovery, it's thousands, thousands of dollars versus instruction, it’s free. It doesn't cost you anything to stretch and take 10 minutes before you exercise to stretch and warm up properly and to prevent these injuries from happening. Something that's free can negate a massive cost to the families or if you're in college, the colleges. So there is definitely overlap there, in that regard.

Nellie:

It's education. A large part of this is pushing out information. Again, getting back to the point that we have this information from the best possible resources. The NHL and the NFL are very well funded, and so they know very, very well how to avoid bad outcomes. And so why wouldn't we take that information to distill it down, push it out to other people and make it more broadly available.

Maddie:

And I think the lower you implement it, at the youth sports, then eventually those young athletes become college athletes and pro athletes. I think starting lower, it implements it through the system.

Logan:

Now for your research, was there a particular event or a particular sport that really piqued your interest, or that you wanted to focus on more specifically that really drew you into your project? How did that go about for you guys?

Maddie:

I would say Damar Hamlin would be the tip of the iceberg for us for that. And we were again in her [Professor Drew’s] class last spring after that happened. That sparked those conversations with his injury and his incident. And as I said earlier, you read about the big name and then you start doing the research and there's so many other instances that have happened. And so we're trying to be as broad as we can, and that's actually an issue that we're dealing with right now, how to present all of this information in a cohesive way. And we keep expanding the venues and then the types of sports. And for different sports there's different injuries and different specifics to the venue. So it's becoming very broad, but it started with just football and then obviously there's certain sports that have more data available, but we're trying to pull it all together and be as broad as we can.

Nellie:

We were mentioning some of them just the other day that we were thinking of that we hadn't thought of before, right? Like skiing. And each of them, the challenges there involve venue specifics. Maddie and Matt did a great job of breaking down various types of venues you might be looking at. But each of them has their own peculiarities. And one of the biggest “no-brainers” I think that occurs to us, is that it's not that much, again, it's not that expensive for each particular type of venue to put together some sort of thought-out plan and response. There's an emergency, who is going to respond? How are they going to access the venue if it's a field or an arena or whatever? What role do various people have?  In particular, with respect the Hamlin incident, there are like three things that they tell you that you need to be able to do to respond to a cardiac incident. Somebody has to call 911. Somebody has to start CPR. And somebody has to run and get the AED. It took me what, less than 10 seconds to say that. So it takes five minutes, really, for someone to talk about those things, in the specific sense, to say that you're the person to do this, you’re this person to do that and you’re the person to do the other thing.  But that's all you really need. It's a no-brainer, but in the moment, if it's an emergency and nobody has had that conversation, it doesn't happen. 

Matt:

And the issue too, I feel like there is no regulation on a lot of the things, which is why we're creating this model law and this paper. There is no regulation on a lot of these things.

Maddie:

And since we're kind of starting from nothing and from the beginning, we want it to be as good as we can if it's a model law. But then it's just the process of fine tuning every little piece.

Logan:

Now, could you explain to me what a model law looks like or is? You're talking about how expansive your research is or how broad the research topic is? So, is this deliverable going to be a thousand pages? What does this look like for you both?

Nellie:

Matt?

Matt:

I was just going to say, no it is literally just a document that is one to five pages, let’s say, one to ten pages at the most.

Nellie:

For the model law. 

Matt:

Yes, the model law.

Nellie:

And what we didn't mention is that both of these papers have already been submitted to the Sports Analytics program at MIT Sloan, because that is also what was driving this, trying to come up with project ideas for that. But essentially model law is a form that each of the 50 states can choose to adopt that will provide sort of plug and play, if you will. And so the challenge is to incorporate, as I said, elements of each of the aspects. We're talking about concussion management. We're having discussions with some people from the American Heart Association, and they added to it, ironically enough, bleeding, a tourniquet kit. And this was right before that incident of the poor young man in England who died from the skate cut. I was like, that was a no-brainer to add to the kit. With all of these things, we provide the background and the white paper supporting it. We'd like it to make it such a no-brainer that it will be accepted and passed across as many states as possible.

Maddie:

And it's interesting in doing the research about what other states have done. It might be the Damar Law for New York State, but other states have other laws named after others. So it’s happening across 50 states whether it is accidents like that. 

Nellie:

At all levels. And that takes us very nicely actually into Juliette’s because everybody has a bad coach story, everybody. And I've got lots of kids, so I've got lots of bad coach stories. It's not because they are bad people. Well, they are usually volunteers who mean very well. The fact of the matter is oftentimes, they are not trained well. They don't have the best information and bad things can happen. And I know you [Juliette] have had a few like that.

Juliette:

Absolutely. So the New York State Education Department actually only requires coaches to have First Aid, CPR and AED training. That's it. So you could go online…

Nellie:

That’s high school.

Juliette:

High school, yes. And you can go online, and you can find resources for that, but you can't find any resources for basic mobility and strength training. It doesn't make any sense. So for me, I definitely had a lot of biases coming into this project just because of my own experience, friends. My brother was an ex-Division One baseball player. He played baseball and he had a persistent elbow injury that eventually led him to the cessation of his career because he couldn't keep up to the level that he needed to. And because of that, he actually ended up becoming a doctor of physical therapy, studying and figuring out all of these details that actually could have made him better. And he is like, if I just would've known this younger, I could have potentially been much better at the sport and not had to quit in the way I did. And it's not just him, it happened to me too. I mean, I have constant knee pain and I've never got the help that I needed. My coaches couldn't help me, and they didn't have the training to, so it's not their fault. They are busy people. Most of them have a bunch of other jobs, kids, lives, so I can't fault them for that. But if we do have a mandated program, hopefully we can start preventing these issues and hopefully people will be healthier and happier and be able to play sports in whatever level they want to, whether they want to go pro, to give them that opportunity or if they don't, just to play and have fun and not have lifelong pain down the line. That is why we need a program. We need a program that is taught by athletic trainers, doctors of physical therapy, and surgeons all with industry specific knowledge in that sport to help the youth so that they can really succeed in whatever sport they choose to without injury.

Nellie:

Your generation [Juliette] I think has more the brunt of play one sport 12 months a year. I'm guilty too. By the time my oldest and my youngest, we went from playing virtually every sport, whatever the season was to my younger kids played pretty much one or two sports. And the repetitive motion injuries are just, well, you [Juliette] have got the data. It's ridiculous.

Logan:

The nature of your research obviously is very interdisciplinary. So what does your collaboration with other departments or schools, like School of Public Health and Exercise Science, is there any collaboration there?

Nellie:

We are actually working right now on a consult with Ryan Krzyzanowicz who heads the Athletic Training program here at UB.  We have been collaborating with people from UB MD.  We shared some with our friends over at Data Analytics for their thoughts as well. So yeah, it has just been a comprehensive effort, and I'm sure there is more to come.

Maddie:

Even the UB librarians. 

Nellie:

Oh, they are amazing.

Maddie:

They have been helping us with our research and I don’t know, it's just funny the more people that see it, we get new ideas.

Nellie:

More feedback.

Maddie:

Different angles and it has been really helpful. Meeting with the people from the American Heart Association. They, I think, are working on something similar. 

Nellie:

Yeah, that was fascinating, wasn't it? Do you want to talk about that, Maddie? Some of their challenges.

Maddie:

They were telling us about the CARES project, which is an app, kind of like a way to streamline an AED response. Data tracking as well.

Nellie:

It is like social media, you are crowdsourcing first aid. Is that correct? 

Maddie:

Yes.

Nellie:

Because you think about, I mean again, with the challenges of youth sports, it is a decentralized, right? And there's no overarching…

Maddie:

Governing body.

Nellie:

Exactly. Or even the ones that are, some of them may be clubs that are related to national governing bodies, but they are not under anybody's direct supervision and there is no collaboration. And even with CARES, my first question was can you tell us, can you identify for us how many cardiac events occur at Highmark Stadium inside and outside the stadium? They were like, well, not really. And I'm like, huh? They are like, well, no, we really can't. Why? Well, because they have different…

Maddie:

Response EMTs

Nellie:

Inside and outside the stadium and the ones outside the stadium may or may not participate in CARES. They are not required to by law. And it is like a no brainer to have it, to require reporting in the law. Because CARES exists, why wouldn't you want to centralize that data so that you have the information? We haven't come across it again, I don’t think, but one thing we have been struggling this is how many AEDs do you need to have. Is it by number of people present? Is it by…

Maddie:

Capacity?

Nellie:

Or number of?  I don’t know, do you need more of them at a hot Bills game than, I mean, I don't know.

Matt:

I feel that there are so many things that go into that. The CARES people too had said that you [Nellie] had asked about incapacity, and they said that wasn't a factor for that. 

Nellie:

Right.

Maddie:

They said that the distance to the AED was how they calculate that for each. 

Nellie:

And that's a major challenge. What did they say?

Matt:

Well, I don't know if it is a statistic, but they had that app that Maddie was talking about too. 

Maddie:

It’s not the CARES app. It might be called something else. 

Matt:

So I think CARES is either creating an app or they have an app that basically is a map of AEDs on the app. On the app you could see where AEDs were. And that is also part of one of our issues with the AEDs. Not an issue, one of the initiatives with the AEDs is how to notify people where they are. So whether it be an announcement before the football game or signs or a flashing blue light or whatever it may be. And I know too, last semester when we were talking about the AEDs notifications, we reached out to the Engineering school to inquire about maybe ways to manipulate the AED device to when someone needed to, almost like a fire alarm, you could pull something in, it would sound off.

Nellie:

Or ideally you call 911 and you report a cardiac event. And then the operator pushes a button, and the AED light starts flashing, making noise. One of the challenges is, okay, where do you put it, and I said, stupidly, well maybe between the gym doors. They were like, no, no, when the doors are open nobody can see it. But isn’t there some kind of a uniform place? There is so much of this that seems like it is just basic common sense. 

Matt:

And with AEDs too, it is easy in a building to have a flashing light, but when there is, at a high school a football game, a soccer game, and a cross country meet all going on at the same time, we can't just have them floating around in the middle. So that is part of our plan. What we are trying to figure out now too, is do we have multiple people on golf carts driving around? Do we have it at certain set locations? Or where do we have them?

Nellie:

Was it every minute you lose 10%? Isn't that what was the percent?

Matt:

Yes, every minute that there wasn't an AED being used, you lose 10% of surviving, which that adds up quick.

Nellie:

Yes, so three minutes. The goal is three minutes, but that still has already taken you down to 70% chance to survive. 

Maddie:

And the survival rate with an AED itself isn't even 100%. 

Nellie:

No, no.

Logan:

And I wanted to quickly touch on back to Juliette's project, what your final deliverable looks like.

Juliette:

Mine is definitely more niche. It is a very big topic, but because it is so big, I had to focus specifically on one example just to be able to show how important this really is. It is a paper. I take the reader through the start of the injuries with youth and then also how that goes into adulthood as well. So if you don't catch it as youth, the paper slowly goes into saying, okay, here are all the issues that can happen into adulthood. And even if you are that little shoestring that makes it into the MLB, you can easily just end your career within a year because of your elbow injuries. For example, this past season in the MLB 153 players were out of the season because of an elbow injury. That was the biggest injury they had all year.

Nellie:

Could you imagine how much money that is?

Juliette: 

I think it is around $400 million in 10 years, if I am remembering that correctly, just in the MLB alone. And they have the money to facilitate that. So could you imagine a parent trying to take care of their child and they don't have the facilities for that. So my paper does that. It goes into when they are young, into when they get older, and then also the proposal of the program and the fact that I am only a law student, so I don't have the knowledge that's needed, but professionals with industry specific knowledge in each specific sport should create a program and deliver that to the coaches and to the students as well so that they can grow and that they can pick up on common overuse signs and ways that they could take care of themselves to avoid that in the first place.

Maddie:

To add on to that too, with the amount of information that is available on the internet, like you [Juliette] were saying you have had to look up. But something like your paper or our project might eliminate some of the confusion about which method should I be choosing? What is the best practice? If we can establish the best practice, it takes some of the guessing out for parents and schools and other venues. So I think that is kind of important.

Matt:

That and just having everything in one spot. It is not even so much for the one-off parent who can go and look at what do I do when this happens? More so for schools and universities and national sports organizations, to go in and implement plans based on this information too. Then counteract any of the negative effects of the lack of knowledge that they might have had prior.

Logan:

And could you talk more about that timeline? Where you are at now and where is the finish line?

Nellie:

Well, we are definitely going to have these published. My objective is to have a website where we have all this information available. Our State University, flagship university, of New York, that is worth something. And having the UB MD permitter is also helpful. It will also help us push that out. But having the Center be this home for information, that can be a resource. If we have a site at the Center for people from anywhere can access and understanding the essential codes of things that you need to have to be safe. First of all, it is great for lawyers. Secondly, but more importantly, it is a wonderful thing as a policy net.

Maddie:

And as we have said with all the venues, we are going to try to address as many variables as we can, but each venue will have its own layout, own specifics, depending on the sport. Having a central place where people can go to look and say, this is how it should be, and now I can tweak that for the needs of my facility, I think would be really good. 

Nellie:

Even something as simple as EpiPens, right? Having this conversation with my husband other day because some of his work is preparing school districts to install turf fields and just anecdotally, they happen to know that gee, turf fields seem be great homes for wasps. So if you have got a football player out there who does not know that he has an anaphylactic reaction to wasp sting and he happens to get some four or five times, you have got a major issue. Well, it is a no-brainer to have an Epi on the field, you would think. Except we found out they are subject to prescription, so we have got to figure out a workaround for that. We will get there; we will get there. But that is not like rocket science.

Logan:

Will these projects be wrapping up within the next year?

Maddie:

We are all actually in our last year, so I think our timeline is finishing up the papers this semester and then next semester trying to push them out, get them published and work on building the website, getting the model law.

Nellie:

Building out the website and getting resources lined up.

Maddie:

Working with third parties to try and get support.

Matt:

Reaching out even to public, whether it be different schools or organizations to get their feedback and see what they do and maybe even try to help them implement something.

Logan:

Well, I thank you all so much for your time. I really appreciate being able to learn about your research and your ongoing projects.

Nellie:

We really welcome the opportunity to do this. It has been a great project. I mean, what I like about it is…

Matt:

It is enjoyable. 

Nellie:

It is. I feel like so much of teaching is you hope you get the message across, but this feels like we are actually accomplishing something. It is not my hoping that they get it, it is them brainstorming, coming to me with ideas and putting them into actual action, which is fantastic.

Matt:

I agree that it is not just a theoretical, scholarly thing that you are publishing. It is more of a physical, practical topic that can help people.

Maddie:

To draft a model law is a pretty cool experience. When we were starting to draft it with you [Professor Drew], we were like, I don't know how to draft a model law then you do.

Nellie:

Somebody has to. 

Logan:

Well, I definitely think that the research in your projects will generate lots of interest from those within and outside of the city of Buffalo. Being aware of the sports culture within the city of Buffalo, I definitely think that people will be very interested in reading and learning about the fruits of your labor from this research.

Maddie:

Hopefully.

Juliette:

Absolutely. No, it is truly wonderful to have the opportunity to be able to have this sort of experience in law school. We take all of our general classes and I just never thought that I would have the opportunity to pursue an interest that I have had, but it has never come across. I am very grateful to have this opportunity.

Nellie:

Light bulb went on. And I was like, yeah, we can do this.

Logan:

Well, thank you so much for your time. 

Nellie, Matt, Maddie, Juliette:

Thank you.

Logan:

That was Professor of Practice and Sports Law, Helen “Nellie” Drew and her students, Maddie Dreschel, Matt Pickard, and Juliette Miranda. And this has been The Baldy Center for Law and Social Policy podcast produced by the University at Buffalo. Let us know what you think by visiting our Twitter @baldycenter or emailing us at baldycenter@buffalo.edu. To learn more about the Center, visit our website, buffalo.edu/baldycenter. The theme music for this season was composed by Matias Omar. My name is Logan and on behalf of The Baldy Center, thank you for listening.

End Transcription.