Tag Archives: High school football

Constantly Learning and Watching: There is a Time to Act

16 Oct

It has been a truly busy season – in regards to injuries – where I perform my “day job”.  I was going over some records that I keep and this season has been the busiest in my 15 years.  In fact, when discussing with peers they too have had a high volume of injuries in the training room.  I would say it is karma; last season we were as slow as I could remember.

Part of what I do in my job is to evaluate the injuries and determine if there are any that could have been prevented.  Certainly preseason preparation – weights and conditioning – is a huge factor and we did that here, but there is always a place to learn and watch to make adjustments.  In reviewing the injuries (over 50 – not all concussions) I’ve encountered that required medical care beyond the athletic training room the results were “good”.  Only three were incidents that I considered “preventable”, one of which I posted about weeks ago. That is less than 10% of injuries that could have been prevented, which is good, not great, but good.  In years past I have seen numbers as high as 25-30% of injuries that I deemed “preventable”.  I take pride in doing my job and if I can prevent every single incident and only have injuries that occur on a “random” basis I will take it (has yet to happen in my 15 years).

Before we go further, I would like to give a glimpse into how I review injuries.  We will use a tib/fib fracture we had this year; this player was injured in a game and to me that is “un-preventable”.  However, a few years back we had a tib/fib fracture that occurred in practice – a practice with only “uppers” on and players were not supposed to take anyone to the ground – that incident was considered “preventable” to me.  If players and coaches were vigilant to the rules of practice that player would never have been rolled up on during a tackle.  Concussions are similar…

I feel that concussions can be “prevented” in practice with contact limits and proper technique during drills.  The other two incidents, thus far, I deemed preventable occurred in practices and were concussions.  One player was hit by a teammate during a non-contact soccer drill as a “joke” and the other did not use good judgement and ran into a pile and was rocked.

The take home here is that most injuries are part of sports and we must accept this.  Also, athletic trainers have much more to worry about and analyze than most think.

All of the observation and learning also pertains to return to play; whether that be orthopedic rehabilitation or concussion return to play protocol.  We, as athletic trainers, must express our voices when there is something going on that is a player safety issue.  This can be as simple as modifying team warm-ups all the way to the case I had yesterday.

One of the concussed kids was on his final step for RTP (full contact practice), he is Continue reading

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One Man’s (Athletic Trainer) Critical Eye and Observation From Week 1

18 Aug

It’s the beginning of high school football season across this glorious land.  I honestly love nothing more than getting back on the gridiron with the high school kids.  There are so many intangibles that the beginning of any sport brings; and in our massive consumption of football world this sport seems to bring a lot of people together, quickly.  You will see a lot of this “love for the sport” breeding through my posts and rants – the same love I have for all sports.  Seeing kids overcome hurdles and demons and using sport/activity to express their selves is awesome.  Seeing boys and girls using sports as a conduit to become better men and women by learning virtues such as: integrity, commitment, discipline and expecting to succeed.

Over the years I have obviously developed a keen eye for concussion as it relates to sport.  There is no greater sport for this injury to occur at my high school than football.  I have been blessed with coaches and administrators that listen to my input regarding overall safety, particularly when it comes to concussion.  But this past week I noticed something that perhaps I had seen plenty of times before, but it just finally hit me.

It has to do with the practice collisions and how things that start innocently enough can change and create issues.  I must give my head coach massive credit for being on the same wave length and even finishing my sentences when we were discussing my observations.  It shows, to me, that he has the best interest of the players in mind – and he wants a fully healthy team.  Secondly I happened to read a recent research paper about data collection on forces in football (while writing up my Sensor Overload post).

In a simple “technique” tackling drill two players were approximately five yards apart.  To either side of the players were agility bags spaced at about 4 yards.  The purpose of the drill was for the ball carrier to angle run to either bag, while the defensive player was to use proper technique and wrap up the ball carrier – not taking him to the ground.  The players were outfitted in helmets and shoulder pads only.  The players were directed to begin at “3/4″ speed and the ball carrier was to be willing to let the defender use current “proper technique” to achieve the form and fit for a tackle (face mask up, wrap-lift-drive through the man).  It started all well and good, and the players naturally began to increase their speed/effort as they became comfortable with the drill.  The drill lasted five minutes from setup to finish.

Upon completion of the drill – rather near Continue reading

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

Rules of the Game

18 Sep

I have waited about five days to collect my thoughts on this and honestly let my emotions calm a bit.  As some know I can be a bit outspoken and harsh at times but I wanted to refrain from letting emotion get in the way of an important message.  Yes, this post will be mainly about football, but don’t view it as an attack on the sport so many of us, including me, love.

This season across all the levels of play in football there has been a larger emphasis placed on player safety, most notably contact to and with the head while playing football.  It is a FACT that the helmet in football was designed and remains a protective device not a weapon or offensive piece of equipment.  Using the helmet in the later fashion is and should always be a penalty for both sides of the ball.  This is nothing new; since the mid 1970’s “spearing”, “face tackling” and “butt-blocking” (scroll to page 32 of that link) have been outlawed in the sport.  However, routinely those events on the football field are rarely called, now in 2013 there is an emphasis on these types of infractions.  Now there is a caveat of this type of action on the field called “targeting” which at the college level can have a player ejected if egregious enough. (BTW, that picture is a placard that was made in 70’s)

Before I go further, I would like to say that officiating at the high school and lower levels is a thankless job.  The pay is not life changing and most do it as a hobby.  Sure, I have seen some officials that the game has passed by or is too fast for them, but I have also seen men and women that do Yeoman’s work with nothing more than a handshake for a job well done.  It’s not easy folks, I have done it, but done correctly and consistently it is a thing of beauty.  At the college and pro levels these people do great work and often have other jobs besides being on TV and getting players, coaches and fans mad at them.  I can assure you they are doing the best they can.  But, I feel the game of football resides in their and coaches hands, for survival.

At the high school level in our state I know that officials have been told to watch out for targeting and the use of the helmet above the shoulders; this has helped at the cost of adjudicating the other, more established rules from the 70’s.  I have seen four flags in five games for “targeting”/”spearing” above the shoulders; I have seen zero flags for “spearing” when it was below the shoulders.  I didn’t write down every occurrence of these types of tackles in each of my games, however, I can vividly recollect at least 10 instances of spearing on both teams.  Side note here, if I see one of our players do it they get quite the ass chewing from me on the sidelines.

People need to realize that tackling with the head-down is not a safety measure for the person getting tackled, it is a safety measure for 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;

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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.

—–

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

Banning of football as a whole is NOT the answer

7 Aug

The goal of a writer is to bring eyes to their information/opinion to draw eyes for advertisers who in turn pay for the publishing of the article – in a very cut and dry manner.  With the troubles facing sports, particularly football, more and more articles have hit the interweb; often the most cited are those that trample on our beliefs of sport.

George Will penned an article that did just that as he opined that football should be ended because it cannot be “fixed”, a growing belief amongst some.  I am here to tell you that although football has its issues and concussions are high on the list, this is the case with many other sports; hockey, lacrosse and soccer being some off the top of my head.  Will does have some salient points;

After 20 years of caring for her husband, Easterling’s widow is one of more than 3,000 plaintiffs — former players, spouses, relatives — in a lawsuit charging that the NFL inadequately acted on knowledge it had, or should have had, about hazards such as CTE. We are, however, rapidly reaching the point where playing football is like smoking cigarettes: The risks are well-known.[...]

Furthermore, in this age of bubble-wrapped children, when parents put helmets on wee tricycle riders, many children are going to be steered away from youth football, diverting the flow of talent to the benefit of other sports.[...]

The lawsuits have nothing to do with the risk of injury, they have everything to do with whether the league knew about the long-term risks during that time and did not disclose that to the players.  The injury of concussion can occur outside of sports, in fact the majority of concussions come from recreational activities like: skate boarding, back yard touch football, playgrounds, bike riding and driving.  Even if the lawsuits are a reason for Continue reading

Commentary on Proposal for Limiting Contact in HS Football

23 May

It has been over a week now since I wrote the high school sanctioning body in Illinois about making a change to limit contact in high school football.  This was not done to promote myself, nor was it to hammer a sport many – including me – love.  It was an attempt to get out in front of the issue and make proactive changes to protect not only the players but the game of football.  It is a genuine good intention on my part.

Since the letter went out via email and on this blog I have had many responses from many different people and places.  There have been questions and comments about what was written and in this post I will address as many as possible.

Let us begin with the deafening silence on the issue.  As in only one email in response (24 sent out) from the IHSA and its board of directors.  That response was as follows; “Thanks, Dustin”.  Yup that is it.  Not that I was expecting an invitation to HQ to break this down but maybe some questions or comments or stonewalling, nope – nothing.

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Cost became a hot topic on this proposal.  Yes, I concede that hiring an athletic trainer will cost you some money, but seriously would you send you kid to a swimming pool without a life guard?  It is the same thing as sudden death, 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

Sobering Early Research

3 Feb

Last October, Purdue University released their first study on concussions and hits that high school players take in a season.  The take-away message from that initial study was;

Purdue researchers who monitored the helmets of 21 Lafayette Jefferson High School players found that players may be damaging their brains even if they have not been diagnosed with a concussion.

Another year and another set of data brings the West Lafayette group (Evan Breedlove, Eric Nauman, Lenny Leverenz, Thomas Talavage, Jeffrey Gilger, Meghan Robinson, Katherine E. Morigaki,  Umit Yoruk, Kyle O’Keefe, & Jeffrey King) – called the Purdue Neurotrauma Group – back into focus, now beginning to confirm their working hypothesis;

“The most important implication of the new findings is the suggestion that a concussion is not just the result of a single blow, but it’s really the totality of blows that took place over the season,” said Eric Nauman, an associate professor of mechanical engineering and an expert in central nervous system and musculoskeletal trauma. “The one hit that brought on the concussion is arguably the straw that broke the camel’s back.”

Using the same techniques of; neurocognitive testing, functional MRI and helmet impact telemetry the Purdue group Continue reading

This Trickles Down

24 Jan

Comments like these trickle down to the lower levels, either because the youth look up to players or their comments make ‘sense’ to them as football players;

“If I have a concussion these days, I’m going to say something happened to my toe or knee just to get my bearings for a few plays,” he told HBO’s Andrea Kremer during an interview for Real Sports. “I’m not going to sit in there and say I got a concussion, I can’t go in there the rest of the game.”

The above is attributed to all-pro linebacker Brian Urlacher and may be a popular/majority sentiment within the NFL locker room.  Brace yourself for the upcoming rant…

As professional athletes and adults I don’t think that players are exactly wrong in having these feelings, heck it is their job.  Given all the information about the lasting effects of all injuries and concussions players assume the risk.  That being said if they choose to abide by such comments these players should not be filing law suits after the fact.

The real issue is that comments like Urlacher’s 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

Can Small Schools (Districts) Handle The Concussion Issue?

11 Aug

With all the measures now being put into place a very interesting question is: can all high schools handle this?  The simple answer to this is: NO!

Required education for the coaches, parents and kids can only go so far; I have even touted this as the most important factor.  However, once there is “live fire” will it all sink in?  I believe it will, but not for all.  From personal experience, the high school I am at we have been hard at the awareness part for the above mentioned “players” in the concussion game and there has not been a 100% retention on the information or actions.  I would say that roughly 75-85% of those involved have grasped the information and action points.  I feel that our school is in a rather unique position as well; one of vigilant follow-up and re-education, almost to the point of annoyance.  How many schools have this going on?  Continue reading

McKee: Unpopular Changes Needed In Football

12 May

Dr. Ann McKee of Boston University was at a one day symposium about brain injuries discussing the effects of repetitive injuries to the head.  Dr. McKee has been on the forefront of the chronic traumatic encephalopathy (CTE) research has information that has changed her perception of the sport of football in particular (via Chicago Sun Times and Tim Cronin).

“It’s scary because we know so many people it’s affecting,” said McKee, a doctor of pathology at Boston University and the keynote speaker at Advocate Christ Medical Center’s one-day symposium on brain injuries. “You see so many individuals in the prime of life, both in the military and former athletes, people who are our heroes, struggling with life.”

Over a ten-year career she surmises that a linebacker may sustain 15,000 sub-concussive hits; those hits that do affect the brain but do not produce instant symptoms consistent with a concussion.  That is fifteen THOUSAND hits, hits that are similar to a low-speed vehicle accident.  The forces being produced are doing some damage in the brain, and the collective damage is causing problems that linger later into life; such as CTE and ALS (Lou Gehrig’s Disease).  To completely discount a “professor/doctor” because they don’t know sports would be wrong in Dr. McKee’s case; Continue reading

A Calling For Ease: Drew Fernandez’s Story

16 Apr

(Project Brain Wave)  High school football is one of the most exciting, defining, and proud markers of American culture, and is a level of play that to many, extends beyond being just a game.  The dreaded months of training camp, the long hours in the weight room and practice field, and the time spent studying playbooks to perfect a team’s system all contribute to the same goal—that being the unforgettable feeling of standing beneath the lights on a Friday night before your home crowd, set to take on the opponent you have prepared for.  This feeling that empowers our student athletes, that makes our parents proud and supportive, that makes our friends anxious to witness game day, is what the coaches and players live for.  High school football is defining, and is home to life lessons to be learned and experiences to cherish.  But for the Fernandez family, the high school football season of 2008 is one they will never forget.

Drew Fernandez, a young up and coming running back for his high school’s football program that was known for state championships in seven of the previous ten years, was productive both on the field, and off the field, executing plays on the field and performing well in his studies in the classroom.  His older brother had also been part of their high school’s championship legacy, and Drew was looking forward to contributing to such successes as well.  His first year in high school was in 2008, and it would be the first time he would have an opportunity to be a part of his hometown’s illustrious football program also.  According to his mother, Tracey, “football was everything to him.”

But such a mentality would soon be combated during one of his freshman football games, as Drew received the ball at running back during play, and then took hits from defenders in both the front and back of his head while he was being tackled.  Drew had sustained a concussion, and would be removed from play.  His mother told me of what events would then follow after her son took a blow to the head, resulting in his diagnosis.

“The trainer of the opposing team (the game was away) called me to tell me Drew suffered a concussion, and asked me if I wanted him to go back to school on the team bus or if he should call the paramedics,” said Tracey.  “I asked him to call the paramedics, and I met them at the ER.  The last thing Drew remembers from the day of his injury was riding on the bus to the game.  He has no recall of the trip to the ER via ambulance or anything thereafter until the next morning when he woke up at home.” Continue reading

Congressional Hearing

23 Sep

Today there was a hearing on the concussions and how they affect the student-athlete on “The Hill”.

Protecting Student Athletes from Concussions Act is what it will be called.  It is suspected that they will use language similar to Lystedt Law in Washington.

All of this is supported by the NFL and other sanctioning bodies.

CNN.com has a story

Sobering Research from the Past

15 Sep

First appearing in the Journal of Athletic Training in 2001, Frederick O. Mueller found that;

A football-related fatality has occurred every year from 1945 through 1999, except for 1990. Head-related deaths accounted for 69% of football fatalities, cervical spinal injuries for 16.3%, and other injuries for 14.7%. High school football produced the greatest number of football head-related deaths. From 1984 through 1999, 69 football head-related injuries resulted in permanent disability. Sixty-three of the injuries were associated with high school football and 6 with college football. Although football has received the most attention, other sports have also been associated with head-related deaths and permanent disability injuries. From 1982 through 1999, 20 deaths and 19 permanent disability injuries occurred in a variety of sports. Track and field, baseball, and cheerleading had the highest incidence of these catastrophic injuries. Three deaths and 3 injuries resulting in permanent disability have occurred in female participants.
 
 
I would be interested to see this study reproduced in 2010 or 2011.  There have been some deaths recently associated and blamed on high school football the most recent was Andrew “Drew” Fremont Swank, of Spokane, Washington.
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