CONCUSSION CONCERNS AND MANAGEMENT IN ATHLETICS
". . . IT'S ESTIMATED THAT IN HIGH SCHOOL FOOTBALL ALONE, ABOUT 1 AND 5 PLAYERS SUFFERS A CONCUSSION."*
by Bill Welker, EdD
On October 19th, 2011, West Virginia's senior U.S. Senator Jay Rockefeller IV, Chairman of the Senate Committee on Commerce, Science, and Transportation, held a hearing on concussions and the marketing of sports equipment. His mission was to increase awareness of both the dangers of concussions for athletes participating in sports at all levels, and the misleading marketing claims about concussions made by sports equipment manufacturers.
Rockefeller convened the hearing because much of past discussions on concussions had largely focused on the dangers of concussions at the professional level. The truth is a significant percentage of those suffering concussions are children and high school students participating in sports, especially contact sports like soccer, football, basketball, wrestling, and hockey.
More recently in Shepherdstown, WV (April 12th), Senator Jay Rockefeller chaired a roundtable discussion with medical experts, sports professionals, coaches, and parents during Youth Sports Safety Month to help raise awareness of many of the causes and impacts of concussions and head injuries in young athletes.
"We all have a responsibility to make sure that kids, who play sports, are as safe as they can be," said Rockefeller. "Many past conversations about concussions have focused exclusively on professional athletes, but we must also be fully aware that concussions affect so many of our children on the field, court, mat, or track."
"This is the beginning of a science, a coordination of effort on a very serious subject," said Rockefeller. "We must determine the best way to educate parents and children on the dangers of concussions, how to properly identify a concussion on site, how to tell when a child is ready to play post-concussion, and how to fund getting the appropriate health-care professionals in place at West Virginia schools sporting events."
Rockefeller identified football and woman's soccer as the two sports most vulnerable to concussions. In fact, his son had three concussions as a young football player.
"He (my son) wanted to be a doctor, so he went to see a doctor about his concussions," Rockefeller explained. "The doctor said, 'You've had three concussions? Well, let's put it this way: If you have four, don't ever bother coming back to me.'"
That night, Rockefeller's son cleaned out his locker and never played football again.
Senator Rockefeller has also vehemently questioned the integrity of companies who proclaim in their advertisements they have made concussion-proof equipment, because such claims are marketing falsehoods.
"People get concussions. They wear helmets, and if people think those helmets have anything to do with stopping concussions, they're wrong," Rockefeller said. "There's nothing that can solve the problem of concussions in sports. So when companies tell you that having mouth pieces and/or helmets will eliminate concussions, their lying."
"There is this myth that, somehow, if you play football and you wear a helmet and you get a concussion, it's OK because the helmet -- per company advertising -- takes care of the concussion," Rockefeller said. "They are wrong; it does not! The only thing that the best helmet in the world does is to prevent you from having your skull shattered."
"You can't buy something that'll prevent you from getting a concussion. And concussions are really serious stuff."
"Playing sports doesn't just make kids stronger and healthier. It also teaches the athletes important values - hard work, leadership, and the importance of working together. I encourage everyone to tell their friends and family about how to better protect student athletes so that we can reduce head injuries, increase awareness about some false marketing of sports equipment, and make sure our kids stay safe in the athletic arena."
In essence, the roundtable provided an opportunity to discuss the dangers of concussions for young athletes, the steps that parents and coaches should take to protect young athletes from concussions, and the limitations of sports equipment in preventing concussions.
In Part Two of this series, we explore the symptoms and management of concussions.
Solomon, GS et al. The Heads-Up on Sport Concussion, Human Kinetics Publishing, 2006.
Concussion Concerns and Management in Athletics
"CONCUSSION IN WRESTLING IS A COMMON INJURY. . ."*
In recent years, there has been a growing concern, particularly championed by West Virginia's U. S. Senator Jay Rockefeller IV, regarding the matter of concussion injuries, especially in the sports of basketball, football, hockey, soccer and wrestling.
What is a concussion?
The National Federation of State High School Associations (NFHS) has been at the forefront of this serious athletic problem. The NFHS Sports Medicine Guide states that "a concussion is a traumatic brain injury that interferes with normal brain function." Keep in mind that athletes do not have to be comatose ("knocked out") to have suffered a concussion.
What are the symptoms?*
Deficiencies in brain functions, behaviors, and balance/coordination include:
Confused State - Dazed look, vacant stare, confusion about what has happened or is happening.
Memory Problems - Cannot remember assignment on play, the opponent, and the score of the game or period of the game. Cannot remember how or with whom he or she traveled to the game, what he or she was wearing, what was eaten for breakfast, etc.
Athlete Reported Signs - Headache, nausea or vomiting, blurred or double vision, oversensitivity to sound, light, or touch, ringing in the ears, and feeling foggy or groggy. Lack of Sustained Attention - Difficulty continuing to focus adequately to complete a task or coherent thought or conversation.
Speed of Brain Function - Slow response to questions, slow slurred speech, incoherent speech, slow body movements, and slow reaction time.
Unusual Behaviors - Acting in a combative, aggressive or very silly manner or just individual actions atypical for the athlete. Repeatedly asking the same question over and over when questioned. The athlete demonstrates restless and irritable behavior with constant motion, and attempts to return to play or leave after the injury. The athlete displays personal reactions which are very inappropriate. Changing position frequently and having trouble resting or finding a comfortable position.
Balance and Coordination Anomalies - Dizzy, slow, clumsy movements and the inability to walk a straight line or balance on one foot with eyes closed.
The West Virginia Secondary School Activities Commission (WVSSAC) and the Ohio High School Athletic Association (OHSAA) have dictated that if an athlete demonstrates signs of a concussion, the referee or official is required to remove the athlete from the match/game. Furthermore, the athlete can not return to competition and/or practice without the consent of an appropriate health-care professional. No referee, official, or coach has the authority or expertise to permit the athlete to continue to compete.
The WVSSAC requires that the appropriate health-care professionals include the following: Medical Doctor (MD), Doctor of Osteopathy (DO), Doctor of Chiropractic (DC), Advanced Registered Nurse Practitioner (ARNP), Physician Assistant (PA-C), and Registered Certified Athletic Trainer (ATC/R). As for the OHSAA, it requires that only an MD, DO, ATC/R have the authority to determine if an athlete can continue the match/game, or return to practice and competition.
The NFHS Sports Medicine Committee* offers the following suggestions and guidelines regarding concussion management:
1. No athlete should return to play (RTP) or practice on the same day of a concussion.
2. Any athlete suspected of having a concussion should be evaluated by an appropriate health-care professional that day.
3. Any athlete with a concussion should be medically cleared by an appropriate health-care professional prior to resuming participation in any practice or competition.
4. After medical clearance, RTP should follow a step-wise protocol with provisions for delayed RTP based upon return of any signs or symptoms.
The NFHS has also produced and offers a free course for everybody (coaches, officials, parents, fans, etc.) across the country to take entitled "Concussions in Sports - What You Need to Know" at www.nfhslearn.com.
In conclusion, concussions are very, very serious brain injuries. No parent would ever want their child to continue to compete in sports without the proper permission from an appropriate health-care professional. We are fortunate that the NFHS, WVSSAC, and OHSAA organizations have placed an extreme amount of emphasis on concussions in sports for our youth.
(Editor's Note: Dr. Welker was commissioned by U. S. Senator Jay Rockefeller and his staff to write a paper highlighting a more in-depth understanding and awareness of the impact of concussions in the athletic realm to the West Virginia and national public.)
Solomon, GS et al. The Heads-Up on Sport Concussion, Human Kinetics Publishing, 2006.
The NFHS Sports Medicine Advisory Committee webpage found at: http://www.nfhs.org/content.aspx?id=5786.
Return to the WV-Mat front page