Tag Archives: High School Concussions

Arkansas Looks Into Hit Limits

18 Jun

Over two years ago I sent an open letter and proposals to the Illinois High School Association (IHSA) regarding hit limits in football.  Some took this as a “candy ass” approach and one that was not needed.  I disagreed with that assessment, in fact, I felt that what I wrote at the time was proactive and could be a way for this state to be a leader in the area of protection in concussions;

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.[...]

Recent evidence suggests that even the subconcussive hits – those that effectively “rattle” the brain but do not produce signs or symptoms – become problematic as the season wears on, let alone a career.  As the researchers in this field gain focus and more specific diagnostic tools, I feel we will see damning evidence that will put collision sports in jeopardy as they are currently constructed – the key being “as they are currently”.  There can be a change, both positive and proactive, that will signal to everyone that the IHSA is taking this matter seriously and can set a nationwide standard.

Needless to say it was brushed aside and was ignored, except for a kind email saying things were happening behind the scenes.  Now, two years and one month later there could be a 12th – TWELVE – states that have contact limits in place for high school football; as Arkansas looks into the matter;

According to reports, the Arkansas Activities Association has passed a recommendation to ask school superintendents to cut full contact practice time to just three times during game weeks. With one of those being the game itself, it leaves just two days of tackling if the proposal passes.

Jason Cates is the lead trainer for Cabot High School, and the former President of the Arkansas Athletic Trainers’ Association, he says, “Something has to be done.”

“The more studies that are showing that hit counts do count and add up.”

The Arkansas proposal limits the full contact days to three, opposed to the two I proposed, but it seems to me that others have seen the light.  That light is both the end of the tunnel and the oncoming freight train.  Kids need Continue reading

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Have To Keep Educating & Holding People Accountable

6 Feb

The education of concussions is great, the legislation is in the right place but there is absolutely no accountability for instances where athletes are “failed”.  Before I go on, I am not perfect, I have and will continue to miss some things here and there (I missed an ACL in football which bothers me).  In fact, looking at the pressure I put on myself and hoping the world puts on my chosen profession of athletic training it may be a bumpy road.  However, missing obvious problems of health and welfare of athletes when one is an athletic trainer is inexcusable.  I implore anyone out there that feels I have missed something to call my ass to the carpet as well.

This brings me to something that I found in my inbox recently and it made me sick and should be handled.  This particular incident occurred in a state that has similar mechanisms for concussions as here in Illinois.  To create the back story on the “mechanisms” in play you should understand the state legislation and high school association concussion education;

  • Players, parents and coaches all have been given information regarding concussions
  • Officials have been given authority to remove player for concussion signs or suspicion including mechanism of injury (MOI)
  • Once removed they cannot return unless cleared by approved medical professional (IL is ATC, MD, or DO only)

With that information here is the email from a fellow athletic trainer – emphasis added is mine – (obviously stripped of identifying information);

Still have a long road ahead of education.

I was at a basketball game Friday night as a spectator and watched a player bounce [their] head off the floor.  Opponent had set a screen and athlete ran right into [defender], bounced off and landed on floor bouncing head off the floor.  The player then rolled around on the floor grabbing head and could tell [athlete] was in pain.  Time was called by the officials to attend to the player.   MOI would strongly Continue reading

Head Football Coach ‘X’: How to take a stand on player safety

26 Mar

Working on a cause is difficult, especially if you are trying to swim upriver. When the cause is in direct conflict with the juggernaut that is football it becomes even more difficult – even at the high school level. I received and provided counsel to this individual as he fights a good fight in regards to player safety, most notably concussions. I applaud this individuals effort, attention to detail, player first mentality, and his willingness to sacrifice his job. What we have below is a microcosm of the issues we face with concussions; detailed and beyond sufficient for action – that is not being taken except against this author.

This information was obtained mainly through email strings – all identifiable properties have been painstakingly scrubbed to the best of my knowledge. It has been understood and agreed upon by the author that publication of this information may identify him and place him in further jeopardy. He is willing to take that chance and I am willing to provide him a platform. Unless otherwise noted in the post with breaks all of this is his and his alone. We shall begin;

==========

A Little Context:

At the start of my advocacy for safer measures to be applied to the competitive arena in high school football, I involved many people who I trusted and cared for in helping find my voice. Those people usually ended conversations with the same question:

“Are you willing to Get Fired for this?”

I laughed at the question considering the fact that I am advocating on behalf of measures that enhance Student Athlete Safety. At no point was my advocacy meant to be an argument, so the extent in which there has been resistance to proactive thinking has been quite a disappointing surprise to me.

The last 3 months of my professional career have been a whirlwind as I have gone from Advocate to Agitator. When the time for action came to blaze a trail for the future, and promote all that can be good on behalf of our student athletes, we collectively passed as a school system, even though a safer future for the thousands of kids who choose to play football within it is still very attainable.

Through my advocacy I have felt empowered by the leading researchers in the field of sports injury supporting these ideas. Support from the actual people who could make these changes has been “Hot & Cold” in a way that led to me presenting to the Athletic Administration of our entire school system and then being handed a letter of reprimand. At the current time I am labeled as a “Demanding” Coach and a person “Searching for a Cause”.

What follows is a chronological story of advocacy on behalf of player safety at the high school level as well as an example of how far away we actually are from a safer future for the student athletes who choose to play the sport of football.

Authors Note:

Some of the Main Points of Resistance in this philosophy have been diffused by simple logic when it comes to providing a safer arena for competition.

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ORIGINAL LETTER TO RAISE CONCERNS & TO START MY ADVOCACY
January 8th 2013
To: (School System) Director of Athletics ————————
CC: (School) Principal —————–, (School) Athletic Director ———————, (School) Assistant Athletic Director ——————

Subject: Public Health Issue regarding (School System) Cross-District Scheduling of Football Competition

I am writing to make you aware of a safety issue that our county has unknowingly placed many of our student athletes in through our recent scheduling for football. (School System) Athletics cross district scheduling policy for teams in the newly formed ——– District, while making sense from a convenience and perhaps even a cost basis, exposes athletes at certain smaller schools to a greater risk of serious injury. I share these concerns with other Head Football Coaches within (School System) as was voiced at the —————- 2012 All-District meeting.

(School System) scheduling policy requires each (Small School) District football team, which is made up of schools that have been classified at the 3A and 4A level in the (State League) to compete with three schools at the 5A classification from the (Big School) District for the 2013-2014 scheduling cycle. The 2013-2014 scheduling cycle determines opponents for each school’s next two (2) seasons. ——————— High School (——) is a 3A school that, based upon the recent scheduling for the 2013/14 seasons, is expected to compete with schools classified at the 5A level on six (6) separate occasions, schools at the 4A level 12 times, and similarly sized 3A classified schools 2 times in our next 20 scheduled games.

A schools classification is predicated upon the (State Association) account for each school’s student enrollment. That enrollment produces the available population to field athletic teams. (State Association) has outlined parameters identifying like-sized enrolled schools to view as competition throughout the state. (School System) scheduling policy has ignored these guidelines in which the (State Association) believes our schools can equitably, and safely, compete in the sport of football.

Current scheduling policy lacks the awareness of a significant and measurable increased risk of injury to the players at (School) and similar sized schools. What is alarming, and requires immediate awareness, are the findings of the most recent and advanced studies related to head injuries. These studies strongly suggest that (School System) scheduling policy as currently constituted, subjects student-athletes of the smaller schools, not only to a greater risk of injury but to a greater risk of serious head trauma Continue reading

Parental Decisions Can Undercut Good Concussion Laws

6 Nov

We are beginning a new program here at TCB.  This one is called “Outreach”; the purpose is to publicize the good (we hope the vast majority) and sometimes the not so good of concussion management across this vast planet.  One thing I realized real quick in Zurich is that the stories of the bad are relatively the same, but unheard.  Meanwhile the stories of good are different and helpful and not heard at all.  I am asking our readers to send in stories of your cases (please be mindful identifying specifics) so we can share.  There are vast stories in the comment section but I would like to bring forward as many as possible.

The stipulations are simple: 500-2000 words with specific situations that we all can learn from and benefit from, email them to us at theconcussionblog@comcast.net and consent to possible editing as I see fit.  It would be nice if you included a bio or frame of reference, but if you would like to remain anonymous that is fine to (however, it would be good if you included something like “licensed doctor in _____ (state)” or coach, athletic trainer, mom, dad, etc.

As Dr. Kissick stated in Zurich it is high time we start sharing as much information as possible.  I will do my best to weed through the “complaints” and “uninformed” from the group; be a “gate-keeper” if you will.  Trust me (as you have witnessed on this blog) I will get information out!

———-

By Tommy Dean, ATC, LAT

You can’t turn on the TV today or open the newspaper without hearing about concussions. It seems like over the last few years there have been more superstar athletes who have suffered this injury, especially from those who played “back in the day” and are now coming forward and bringing their multitude of recent struggles to the forefront that have been caused by multiple concussions.

But the problem doesn’t start in the NFL. It starts at the youth level. It starts at home.

Every Saturday and Sunday families gather to watch collegiate and NFL games, bringing society together on common ground for a day or two. In a way, however, this culture can also tear us apart. When kids and parents see elite athletes take punishing hits and stumble off the field only to be returned by the medical staff just minutes later it raises questions and causes confusion about concussions.

What must be understood is that there is not one of these injuries that will be treated the same. Your son or daughter at home is NOT the same as RGIII or Melissa Gilbert (Dancing with the Stars). We are talking about the adult, or fully developed brain of an elite athlete who gets paid to do what they do versus the still developing brain of an adolescent who may not yet be legal to drive a vehicle. This is in no stretch of the imagination an apples-to-apples comparison.

What’s disconcerting to me as a certified athletic trainer and a father of two Continue reading

There Needs To Be More Of This

17 Oct

In Minnesota they are taking strides to get to the bottom of the issue of concussions, and frankly why more are not doing this is strange.  Why not gather the most data possible;

For the first time, solid numbers are being collected in Minnesota on how concussions really affect high school athletes.

The Minnesota Department of Health is tracking concussions at 42 high schools. Through the first seven weeks of the fall sports season, 373 student athletes have been diagnosed with a concussion.  According to one expert, the number seems to be on par with previous years.  This study is now providing a number for the issue.

The study reveals how many kids are getting hurt and how long the injuries are keeping them out of sports and out of school.  The medical professionals tracking student concussion in Minnesota don’t want the numbers to scare parents into pulling their kids out of sports, but rather make them aware of the symptoms and consequences.

Hey here is a bright idea; National Athletic Trainers Association why don’t you create a reporting platform similar to what is being done in Minnesota?  I would say state high school associations could do the same thing but AD’s and coaches are already bombarded by plenty of other things.

To grasp the total issue you must grasp the total problem; although unlikely perhaps concussions are not nearly the issue that some are making it?  Why not find out?

Someone get it done, and if needed I can collect the data; just need some resources and backing.

Concussion Series from Illinois

10 Jul

Saukvalley.com and Christopher Heimerman have been posting a series about concussions recently, legend found HERE.  Recently Heimerman took on the angle of athletic trainers as they relate to the “Hidden Injury”, concussion.  On the jump there is an interview with Sterling High School Athletic Trainer, Andi Sumerfelt seen here;

If you go to YouTube to watch it, it should bring up the series of videos that go along with the stories on saukvalley.com.

There was one column that caught my eye – both personally and professionally – athletic trainers in high schools;

Not having an athletic trainer is forgivable. Refusing to acknowledge the need for one? That’s different.

I sat down with Dixon School District Superintendent Mike Juenger and Athletic Director Jon Empen, hoping for some answers about what life was like after Andi Sumerfelt lost her job, and Dixon lost her free services as athletic trainer.

This is a common theme lately, athletic trainers losing their jobs at hospitals and hospitals no longer providing a service for free.  Schools are either faced with losing the coverage completely or pay for a reduced coverage.  In this column Dixon Continue reading

Outlet for Concussed High School Student

23 Mar

I would be remiss if I didn’t take the time to mention our loyal followers out there, thank you!  We get a lot of email from all sorts of places and most of it is very informative – with the occasional “will you link this” which turns out to be sports betting or worse.  I received this email a while back and while cleaning out the inbox felt compelled to share;

My name is Jacob Lichtenbaum. I am currently a senior at the Potomac School in McLean, Virginia. This semester, I’ve been writing a column about concussions in sports and also in general and your website has been a fantastic resource for me. I love the spins you guys put on all the issues and your candid, educated opinions on all concussion-related events. I especially appreciate your work because I am someone suffering from post-concussion symptoms myself.

This past summer, I suffered a concussion while participating in my varsity football training camp. You’ll be glad to know I was removed from action immediately, but my post-concussion symptoms unfortunately sidelined me for the entire season. I still experience the symptoms to this day, unfortunately with no end in sight.

I decided to write my semester-long column about concussions because I wanted Continue reading

Collecting Concussion Data: Massachusetts

20 Feb

As part of the concussion legislation put in place in the state of Massachusetts, the public middle and high schools must report all head injuries/concussions to the state Department of Public Health.  Although plans have not been set for the actual purpose of the data collection, it can provide a snapshot of what high schools are dealing with.  As Lisa Kocian of the Boston Globe wrote;

Football and soccer players from 26 area high schools suffered more than 300 head injuries last fall, the first time athletic departments were required to collect data under the state’s new concussion law, according to a Globe survey.

Football players accounted for 207 of the injuries found in the survey, exceeding the totals on soccer teams at most schools. Girls’ soccer programs reported nearly twice as many head injuries as boys’ soccer teams, 85 compared with 46.

The sample set of data has been put in graphical form, click on the link above to see it.  The average injury reports Continue reading

Recent Trend

4 Jan

The real job of this author not only includes being an athletic trainer for a local high school, but also doing rehabilitation on the entire spectrum of the population.  However, from time-to-time I am called upon to be a physician extender in a sports medicine doctors office.  The past few weeks I have been doing that more frequently and have noticed a very surprising trend.

Granted there is no “scientific evidence” of this trend, rather just my observation and upon asking questions to the doctor and the rest of the regular staff, they too have noticed relatively the same thing.

As we have progressed in the concussion era the doctor that we work for has been near the front on the concussion issue.  To his credit he used all the resources in the program to develop this progressive attitude and has taken all of his information along with others and developed a comprehensive concussion program.  When he started many, including some athletic trainers in the sports med program were in disagreement with the longevity and “conservative” nature of the treatment/management.  That quickly subsided with much of the evidence we have seen in the recent year, but it never really translated to acceptance among local coaches, school administrations, and players/parents.

All of the original skepticism about concussion care has slowly been washed away and this doctor has been accepted as one of the “go-to” guys in the area for this injury.  This is not the trend I speak of, although it is very nice to see; all the hard work of the athletic trainers has begun to sink in.

Rather the trend I am beginning to see is something mirrored in the national/international press Continue reading

The Hardest Part Of My Job

14 Dec

As an athletic trainer there are many difficult situations that arise on the job.  Broken bones, overzealous parents, concussions, weather and a myriad of other things get to you.  However, there is nothing more troubling and depressing than what I just had to do.

Back story is a female basketball player who has sustained multiple concussions over her high school years in various sports/activities.  Each one was handled to the best of our ability and under the concussion policy at this school, even had great conversations with the MD on the case.

After her last concussion, last December, we discussed that because of the number (then at 4) for her the resolution would be longer and possibly met with more difficulties.  We also discussed that if all her care takers; parents, coaches and Continue reading

Examples Of Horrible and Great Decisions

23 Nov

Two weeks ago I highlighted the clear message from the International Rugby Board about concussions, however what I didn’t know is that this protocol was apparently not used for a French player in the World Championship match.  There were two comments, one that led me to the write up about this situation;

Parra took what appeared to be an accidental blow to the side of his head from the knee of All Blacks’ Captain Richie McCaw in a ruck, and appeared to be visibly concussed, looking shaky on getting up after receiving lengthy on-field medical attention. Continue reading

“I’m Not Going To Risk My Life For Football”

21 Nov

The 17-year-old senior at Belleville West is part of the growing number of players in a variety of sports who find themselves permanently sidelined by concussion and post-concussion syndrome.

“You know what? I’m not going to risk my life for high school football,” said Behnke, a Millstadt resident who got his second concussion while playing for Lutheran South in St. Louis County in 2010 and his third playing for Belleville West this season. “It was really tough. I really wanted to play. I didn’t mind so much my junior year because I knew I had one more year in me.

“But it really stunk not playing my senior year.”

In a story found in the Belleville News Democrat, Alex Behnke once was devoted to the sport of football, however Continue reading

Lucky To Be Alive

11 Oct

Adrian Padilla is lucky to be back where he wants to be, on September 19th he suffered a major brain injury that required emergency removal of part of his skull.  The fact that it was taken care of in time to save his life is a great thing, but after reading a story about his triumphant return to watching his teammates there was a passage that has me extremely concerned;

Padilla can recall everything that happened leading up to when he collapsed on the sideline at the San Luis Obispo game.

He said he had suffered a minor concussion two weeks before the game, but felt well enough to play. Everything seemed normal until he blitzed the quarterback leading with his helmet.

“After that, I got up and ran to the sideline and told coach what happened. He told me to go sit down, and I tried going to the bench and moving some bags. Then I collapsed,” Padilla said. “The next thing I remember was waking up in the hospital four days later.”

The fact that Padilla recognized Continue reading

Correct Information Is Key

5 Sep

I was forwarded this article from Michelle Trenum as she continues to help The Concussion Blog in getting the proper message out.  As she noted there were many concerning things written in the way of awareness.  We will break down the article appearing in the Amarillo Globe-News by Ricky Treon;

Sargent had the longest hospital stay. He was released from NWTH at about 6 p.m. Saturday with a severe concussion but no permanent damage after an MRI found no swelling or bruising near his brain, said his father, Jason Sargent.

“He’s got a severe headache and his neck is very sore,” Jason Sargent said.

Zach Sargent was taken off the field in a helicopter during McLean’s home game against Motley County.

The first issue we see is that “no permanent damage” Continue reading

Very Gratifying Day

24 May

I have blogged multiple times about the concussions that I have dealt with in my job.  They are from the obvious to the “right place at the right time”, but finding them is the easy part.  In fact it is becoming much easier at the school I work with as more and more have “bought in” to the system.  Parents, teachers and kids themselves are letting me know about possible head injuries, it is not so taboo around here anymore.

One of my most recent episodes occurred with a pole vaulter, who refused to come to me only basically dragged in by his mother after seeing the blog and knowing what was going on.  His evaluation was straight forward and was definitely concussed, but after 15 days of adjusted scheduling (rest, away from school, graded return), fish oil and listening to our advice he was back to perfect.  In fact his post ImPACT was better than his baseline, but what was even more evident was his demeanor and general disposition, he looked like him again.  He is going to stay out of contact sports for another two weeks before beginning football activities.  A success!

However, this is not the point of my gratifying day.  Remember this day for me and the Continue reading

IHSA Clarifies Concussion Mechanism

19 Apr

The Illinois High School Association (IHSA) and its Board of Directors approved the new recommendation for return to play for athletes (high school only mind you).  Currently Illinois does not have legislation in place for concussions, but when the current HB200 gets mixed with SB150 the legislation will give the authority for policies to the IHSA.  In lieu of not having legislation the IHSA has taken the NFHS rule a bit further in determining when a “concussed” player can return to practice or activity, period;

The new Policy reads: “In cases when an athlete is not cleared to return to play the same day as he/she is removed from a contest following a possible head injury (i.e., concussion), the athlete shall not return to play or practice until the athlete is evaluated by and receives written clearance from a licensed health care provider to return to play.  

For the purposes of this policy, licensed health care providers consist of physicians licensed to practice medicine in all its branches in Illinois and certified athletic trainers working in conjunction with physicians licensed to practice medicine in all its branches in Illinois.”

A proactive step by the IHSA that should be applauded, and also a step in the right direction in defining who exactly can clear an athlete; MD/DO or ATC ONLY.  There are other “doctors” that would be competent in dealing with concussions (see neuropsychologists) and perhaps in the future the IHSA will expand the licensed health care providers to include them.  This clarifies a lot of questions that many, including myself had in this state.

PBS Frontline: Football High

12 Apr

Just finished watching the Frontline TV magazine show from PBS about high school football.  Link to FULL VIDEO (53 minutes).  A very smart and “eye-opening” piece for those that do not know much about the inner workings of high school football.  The episode dealt with concussions, athletic training, and heat illness, all within the guidelines of winning at the high school level.  The information was nothing new to any of us that deal with ALL of those things as a professional.  What it showed everyone else is the “scary” side of this beloved sport.  However, a lot of these issues can be attenuated with an athletic trainer on the sidelines.

The focus was mainly on the unknown/unseen dangers of the sport we watch and in which we participate, starting with the reporting of the heat strokes of two Arkansas prep players, one of which succumbed to the injury.  They compared the two individuals in terms of immediate treatment for heat stroke.  One player was on a high school team that has an athletic trainer, and the other is not.  The outcomes were vastly different as the player who had an athletic trainer was evaluated and had managed care survived, and even played later in the season after three weeks in the hospital.  The other player, who did not have an athletic trainer, paid the ultimate price and was unable to survive the injury.

Continue reading

New Study: Concussions May Be on Rise

28 Feb

The American Journal of Sports Medicine has published a study that indicates that concussions may be on the rise for high school aged individuals.

In 25 public schools from 1997 to 2008, and six different sports each for girls and boys, there were about five concussions for every 10,000 times high school athletes were on the field, the research — published in the American Journal of Sports Medicine — found.

That’s up from slightly over one per 10,000 times on the field in 1997.

Breaking it down by some sports and gender in the study:

Football was the riskiest sport, with a rate of about six concussions per 10,000. Boys’ lacrosse and soccer came next. For girls, concussions were most common during soccer at three and a half per 10,000, followed by lacrosse and basketball.

However, when boys and girls played similar sports, girls were about twice as likely to get a concussion. The same has been found in college athletes, but nobody really knows why.

The study author Andrew Lincoln did make mention that this could be due to increased awareness about the injury, and the fact that Continue reading

Adolescent Concussions & Numbers That Shock

30 Jan

This article comes from the Cape Cod Times, written by Amanda Comak and takes an in-depth look at concussions in the youth of that area and the overall problem.

When Mikaela McGuire’s post-concussion symptoms were at their worst, the normally bubbly 16-year-old would cry herself to sleep.

If the piercing headaches, sensitivity to light, drastic memory loss and uncharacteristic mood swings weren’t bad enough, there were times she would sit and stare blankly at her homework.

Her brain – her memory – betraying the honor student so completely she would crawl into bed, her eyes welled with tears, craving sleep.

“I wouldn’t tell anyone, but that’s how frustrated I’d get with myself,” McGuire said, more than 12 weeks after the Nauset Regional High School sophomore sustained her fourth concussion – this one from taking a close-range shot off her temple during soccer practice.

“It’d just be me, sitting there, trying to finish my homework at night thinking, ‘I can’t do this. What’s wrong with me?’”

A very dramatic and sobering set of facts that people are now just coming to grips with.  There are many kids out there dealing with the same set of issues that are either ignoring them or not understanding why this may be occurring.  Granted the time in our lives Continue reading

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