Concussion crisis: Brain injuries become more prominent in high school athletics
Most high school football teams have been practicing in pads for
two weeks.
Nicole Salvesen has already witnessed a season’s worth of
concussions.
The Muscatine Physical Therapy Services Certified Athletic
Trainer – who works with Muscatine High School’s athletic squads -
has treated at least seven cases since the Muskies strapped on the
helmet and pads Aug. 11.
That is the equivalent of what an athletic trainer sees in a
year, she said.
“Hopefully, that number will decrease a little bit going through
the season,” Salvesen said. “It’s a big deal.”
According to the Centers for Disease Control and Prevention,
concussions are among the most commonly reported injuries in teens
who play sports, with up to 3.8 million reported each year in the
United States.
Regulations for high school athletes in Iowa have become more
stringent.
For the first time this fall, the Iowa High School Athletic
Association required that all football players have a signed waiver
from parents indicating they’ve read and understood the documents
that describe the warning signs and dangers of a head injury.
If an athlete suffers a concussion, he or she must be cleared by
a health professional before they can return to competition.
“The waiver is great,” Muscatine senior Tanner Bohling said.
“Because if you have one and don’t tell anybody, the second one
could be worse – leading to a serious brain injury.”
The IHSAA sent each school posters discussing concussion
symptoms, dangers of heat stroke and techniques of proper
tackling.
To avoid brain and spinal injuries, players are taught to tackle
with their head up.
“As time goes on, kids are bigger, stronger and faster,”
Muscatine head coach Jake Mueller said. “You see guys on TV leading
with their head on big hits. Most of the time those head and neck
injuries could be prevented if they tackled the way they were
supposed to.”
Past versus the present
Thanks to highly publicized cases across the nation, head
injuries are taken more seriously.
Former NFL stars Troy Aikman and Steve Young had their careers
cut short due to multiple concussions.
Mueller said he couldn’t recall having one as a player at Cedar
Falls.
“If I had, you’d sit out 30 minutes or maybe a day,” he said.
“It wasn’t that big of a deal. There were all kinds of kids who
would get their bell rung and be back.”
Even as a coach in the infant stages of his career, the
31-year-old often dismissed the notion of a serious head
injury.
“When I first started coaching, if a kid would come up and say
he has a headache, coaches and kids would give him a hard time
thinking he was trying to get out of something,” he said. “You
can’t do that now. All the coaches see it a little bit differently
than they used to.”
Salvesen said concussions are the most “tricky” aspect of her
job.
There is no concrete test to determine if the competitor should
be on the field – unlike a broken bone.
With that, Salvesen said it’s pivotal to form good relationships
with the athletes.
“There might be a kid who doesn’t want to practice, so he is
going to say he has a headache,” she said. “You have to treat that
kid the same as a kid who might say, ‘Oh, I just have a little
headache,’ but his head is pounding and he can’t remember anything
and can’t focus.
“People might think I’m ultra conservative, but if an athlete
has one and I put him back on the field and he has another one,
there is a chance he could die and that would be on my
shoulders.”
Degrees of concussions
Muscatine offensive lineman Nick Daly suffered a “Grade 2″
concussion recently during a tackling drill in practice.
Roughly 10 to 15 minutes after sustaining the hit, Daly was
nauseous and had a throbbing headache.
Salvesen put Daly through a series of tests.
The 5-foot-9 and 230-pound senior had difficulty remembering
words spoken to him five minutes before.
A week after the incident, Daly still wasn’t practicing.
“It’s extremely frustrating because you want to get in there and
people are counting on you,” he said. “You feel kind of
helpless.
“One minute, I feel fine and then a quick slap across the helmet
and I’ll have a splitting headache again.”
In addition to headaches and nausea, Salvesen points to
drowsiness, slurred speech, poor coordination and mood swings as
other warning signs.
If one of her athletes has these symptoms, she encourages them
to get a ride home from practice or have the parents come get
them.
“They put off an impression that they are drunk,” Salvesen
stated. “You’ll have kids that inadvertently go from laughing to
crying.
“Half of the time they don’t know what they are doing.”
There are three grades of concussions, with “Grade 3″ being the
most severe.
Nearly 90 percent of the concussions reported are “Grade 1″ -
where a participant suffers momentary confusion.
According to Salvesen, an athlete could return to the field the
same day if it was their first one. A second “Grade 1″ results in
being out of action for a week.
Bohling experienced a “Grade 1″ last summer at the Central
College team camp in Pella. His came on a helmet-to-helmet hit,
forcing him to miss a day of action.
“It was an instant headache and I was a little dazed,” he said.
“After I got looked at and they said I was fine, it didn’t faze me
too much.
“It is really scary, though. I was lucky it was minor.”
Louisa-Muscatine’s Blake Kemp wasn’t as fortunate.
The sophomore has had two head injuries in a short span -
including a “Grade 3″ concussion during a junior varsity football
game against Tipton last season.
Kemp’s first came during a fall league baseball game. He was
drilled in the head with a pitch.
“I stayed up and kind of wobbled, then fell down,” he recalled.
“I tried to get back up and fell back down.”
After sitting out a couple of weeks, Kemp returned to the field
and encountered his second one in football.
Right before halftime, the Falcons hiked the ball and it was
thrown toward Kemp. He looked for it and was hit.
Kemp lost consciousness momentarily. He was placed on a
stretcher and transported to the hospital.
“That one I don’t remember,” he said.
Kemp is back out for football this fall.
“There is concern of getting another one,” he stated. “I don’t
want to because I know that would be really bad, but I want to play
football. I just have to watch out for myself and protect myself on
the field.”
His coach, Guy Dierikx, said Kemp can’t play scared.
“If you are timid and afraid, then you are more suspectible to
it,” Dierikx said.
Proper head gear
Equipment has become a major focus.
Starting next week, the National Athletic Equipment
Reconditioners Association won’t certify or recondition any helmet
more than 10 years old.
“They do a much better job now of inspecting helmets,” Mueller
said.
There are specific helmets made to ease the blow – the
Revolution made by Riddell, and the Pro Elite made by Adams are a
couple.
Still, there is no helmet that is concussion-proof.
The Revolution offers large ventilation holes along the top, and
the facemask is more rounded to help deflect hits rather than
absorb them.
Kemp and his family purchased a Riddell model.
“It feels like it’s helping me out a lot,” he said. “The padding
is much better all around and it doesn’t let my head move.”
But cost is an issue for schools which are strapped for
funds.
The helmets are between $220 and $230 each.
“You have to buy what’s best for the kids, but you have to be
fiscally responsible,” Mueller said. “If you’re going to spend
money on something, though, it is probably the best thing.”
Salvesen said some colleges and universities are experimenting
with sensors in the helmets.
A computer on the sideline gives a “red flag” to the athletic
trainer if a player suffers a hit of enough force to the head.
“Is that extremely accurate? No,” Salvesen said. “Each person is
different. The way that helmet took the force is different in each
case and the computer obviously doesn’t calculate all that
information.”
While there were more than 60,000 concussions reported in high
school football last season, Salvesen said collisions at home plate
in baseball make her cringe.
“The football helmets are made to sustain a little bit higher
hit,” she said. “There is better padding.
“It is the catchers you worry about because those helmets don’t
have much to them.”
Regardless, you won’t hear the terms “dinged” and “bell rung”
used by medical professionals.
“It’s not just a concussion anymore,” Salvesen said. “It is a
brain injury – and that’s key for parents, athletes and coaches to
understand.
“The severity is different with each one, but you have to take
them all seriously.”