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 andmyself feel she fully recovered that we would allow her to pick one sport for the following year and play. Play with a couple of stipulations; play hard and be honest with me.
She recovered around February and spent the next 7 months slowly getting back into playing shape with few setbacks. When October rolled around she was pumped to begin conditioning and 100% effort in all activities to show she was ready to play once again.
As practice began in early November all was well, things were going great and no symptoms presented themselves, the daily check-in’s with me were becoming boring and redundant; “Everything fine, school was good, practice was good, I got good sleep,” she would tell me. Reports from the coach and my witnessing of practice told us that she was improving and very confident. She was one of the most hard-nosed players on the court diving for balls and playing the sport she loved.
Then it happened, in a game on Monday night while diving for a ball she fell awkwardly and a player landed on her head forcing it off the floor. The bummer was the coach had sub for her at the bench for the sole purpose to get her out of the game for protection. As I arrived to her on the floor she was crying, not because it was hurting (reported headache and blurry vision), but because she KNEW.
A quick evaluation confirmed what was seen, she had a concussion; balance was off, vision was off, headache was getting worse. She was accompanied home, given instructions to stay out of school with the slim hopes that this incident would possibly be transient. That did not come to fruition, the headache was worse, and she slept very long and did not feel rested. She KNEW.
She attempted school today feeling better but by lunch it was too much, the symptoms were worsening and mom came and got her. She KNEW.
Mom and her arrived to my office about 30 minutes ago to go through the formal process of the worst part of my job. They both knew, as I began I could sense no resistance, no denial, no bargaining (like the times before). I looked into her teary eyes as I told her what she KNEW, but did not want to hear; “It is of my professional opinion and for your safety going forward you should retire from contact sports.”
There was a simple response from her; “I know.”
The Concussion Blog 
Always a terrible situation, and one of the driving forces of my involvement in raising awareness and education on the concussion injury in my community. After being advised by three different athletic trainers and an independent doctor, I was forced to give up football- a game that I loved and worked so hard for. It took me awhile to accept the decision, but this girl will understand the long-term concerns of your position that are based on the information we have available to us today.
I knew. And I was exactly where she was, sitting in our school’s athletic training room up on a bed crying in front of the trainer and my father. I knew that my career was over when I sustained the injury at training camp, but the effect really doesn’t hit you until you’re removed from the game-play atmosphere and sitting one on one with another individual, such as yourself, in this case. It’s terrible, and we need to do all we can to protect and preserve the athletes’ futures in our high school and youth programs. But we must also view these athletes as students, too, and must consider their own future aspirations aside from that involved in sports.
I’m sure you’ll remain in contact with this girl at the school, and be a helping hand in keeping her involved with her team and sports for that matter. I’m not sure what year she is in of high school, but there’s multiple outlets following a situation like this. I found an outlet through sports broadcasting, by being a color commentator for football on our school’s television network and I was also welcome as a figure in the locker room during the season and even during half-times of games.
I thought you would appreciate this story John. And yes she has a standing invite to be a student athletic trainer, once she is stable in school with grades and such.
I have offered to tutor if needed and help her along the way. It is not easy, but sometimes the right decisions are the hardest…
And as cliche as it may sound, sometimes these things are meant to be, as tough as the times are when an event like this occurs. My concussions have ultimately led me to an internship with a Division-I athletics program. If her interests lay in the field of athletic training, maybe she may find through understanding her injury an avenue of interest that could open may doors for her future. The most important thing with brain injury is looking to make the best of the situation you’re presented with, and with the help of others, she may find the right fit for her, and for her to help others.
The hardest part ? The most courageous part! And congratulations to you and this family for getting to this point in concussion awareness so that everyone KNEW. Speaking as the parent of a PCS athlete, it does represent progress. After a 14 month recovery, my daughter became a student coach for ice hockey and took up a non-contact sport for the spring season.
That is tough – but if it were easy, there would be something wrong. Having an alternate path, another way to stay involved in that team environment can be key. Losing my ability to be involved on that level helped to send me down a path of some seriously bad choices, when I was in high school and had a couple of concussions. Of course, back then, we didn’t know about this “stuff” and there wasn’t any support. There was just “suck it up” and get back to work, however possible.
It’s a huge blow to your sense of self, your identity, when you lose that — long-lasting effects from any traumatic brain injury can do that to you, and it’s something many, many struggle with. I can’t say enough, how important it is for those who experience it to have an equally engaging and equally supportive path to follow, other than the one that’s fraught with danger.
I would really encourage you (or someone else at your school) to follow up with this athlete and see how she’s doing in another few months. Hopefully, she’ll be honest and straightforward with you and not hide any deficits she’s having. That’s a common path that many follow (whether we’re aware of it or not), and it can lead to even more lasting issues.
It’s hard and it can really hurt, but it’s gotta be done. And congratulations to you for handling it well.