Heading off injury: Prep football players at higher risk for brain trauma - East Valley Tribune: VarsityXtra

Heading off injury: Prep football players at higher risk for brain trauma

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Posted: Friday, October 14, 2005 12:10 am | Updated: 8:15 am, Fri Oct 7, 2011.

It was a play like any other for Gilbert quarterback Micah Parker. In an Oct. 8 game against Chandler last season, Parker ran the option and braced for a big hit. He got more than he bargained for.

“I just got hit hard,” said Parker, who now plays tight end, fullback and linebacker for the Tigers. “My head hurt for a while. I went back in a few plays and then came out and I didn’t play the rest of the game.”

Upon examination by the team’s training staff, Parker was diagnosed with a mild concussion.

Parker said he never felt bad enough to go to a doctor. He sat out one practice and took it easy the rest of that week before returning to action.

The only aftereffects he experienced were headaches. He had no trouble with memory or mental functions afterward.

Parker was lucky.

Experts in the field say it’s not smart to play with a head injury, generally recommending at least 10 days of recuperation to avoid the risk of a second, more severe concussion.

In fact, playing sooner could be permanently disabling or — in the worst case — fatal.

“It’s sort of the hidden issue” in sports, said Barry Cohen, a spokesman for the Brain Injury Association of Arizona who said there are no Arizona-specific statistics on brain injuries. “It’s hard to get people’s attention. Everybody believes, ‘It’s never going to happen to me.’ ’’

But it does happen and not infrequently. An estimated 60,000 concussions take place each year in high school sports, about 63 percent in football, according to a leader in this field, the sports medicine concussion program at the University of Pittsburgh Medical Center.

Though head injuries are most common in football, “Concussions can happen to any athlete in any sport,” said Dr. Ileana Arias, the injury center director for the Centers for Disease Control and Prevention.

“They should never be ignored.”

The CDC is promoting awareness of the problem with a kit designed for coaches, trainers and players.

Included is a video detailing the story of a player who is permanently disabled after sustaining a second concussion during a game. The player emphasizes it’s better to miss a game than to miss a whole season, or — more important — the promise of a healthy future.

This experience highlights a rare but potentially fatal condition called “secondimpact syndrome,” where a person takes a second blow while still vulnerable from the first.

The second blow does not have to be particularly strong, either. Literature on the subject strongly suggests players who suffer a concussion sit out at least a week to 10 days.

More than 90 percent of recurrent concussions take place within 10 days of the first injury, said Tamara Valovich McLeod, an assistant professor in sports health care at the Arizona School of Health Sciences in Mesa.

She strongly argues that no athlete should return to contact sports before a determination is made that his or her recovery is complete.

Returning too soon “affects your ability to perform and makes you more susceptible to concussion and brain damage,” said Steve Erickson, a local sports doctor with experience in the field.

And yet, “Lots of kids want to play and tell you they don’t have symptoms.” Fortunately, the worst cases are rare.

In 1968, 36 brain and cervical spine fatalities took place in college and high school football, according to the National Athletic Trainers Association.

That number dropped to zero in 1990 and has averaged about five per year since, thanks to heightened awareness of the problem, stricter rules about use of the head, less contact in practices and better equipment.

Of course, as Basha High coach Tim McBurney pointed out, “There’s no such thing as an injury free helmet.”

But to reduce the risk as much as possible, the Basha family donated $12,000 to the school to purchase top of the line helmets for players.

Interest is growing in other areas as well.

Computer software programs have been designed to test players immediately and help make a determination on whether they have suffered a concussion.

Schools can purchase such programs for about $1,000, said Erickson, who once helped develop data at ASU that eventually helped establish one prominent program called ImPACT.

Erickson said schools need a professional on hand to administer the test on the sideline and interpret the results.

“About 600 high schools on the East Coast are using it,” Erickson said.

Unfortunately, “We’ve got none here.”

The test uses such techniques as a computer flashing 12 words on a screen, one at a time. The list appears twice.

Then 24 words appear on the screen. The player is asked which ones were part of the original 12 words.

Though the pros and top college conferences now are using these tests, current management of concussions at the high school level is at the standard-care level of five years ago, Erickson said.

“There’s a slow acceptance because it costs schools money,” he said. “It’s not the end all and be all on the subject. But it’s a very useful tool to help the decision as to when the person has completely recovered.”

McLeod said these sorts of evaluations are most accurate when athletes have been tested before the season starts.

“They should be tested when they’re healthy, so if he has an injury, you can compare him to himself instead of a standardized test score,” he said.

The test can counter arguments from kids who say they are OK to play, Erickson said.

The tests also can point out when players have not returned to normal when they otherwise exhibit no outward problems.

“I’d like to see our community embrace the technology and make sure all people who suffer concussions are managed appropriately,” he said.

Cohen agreed.

“Now that there are objective measurements, schools should take a serious look at it,” he said.

Jon Foster, the head athletic trainer at Desert Mountain High School in Scottsdale, said he uses an assessment tool that is basically a scorecard that checks for such problems as dizziness, balance problems, memory, vision issues, headaches, ringing in the ears and nausea.

“It basically gives you a score. If they don’t pass, you send them to a doctor.”

Typically, an athlete will have to exhibit no symptoms for about a week before he is allowed to return, he said.

“Every concussion is different,” Foster said. “About the only thing in common is a headache.”

With that in mind, experts urge coaches, administrators, trainers, parents and players to educate themselves about the dangers of head injuries.

A conference on the subject has been set for Feb. 18 at the Arizona School of Health Sciences.

“Anyone who is involved in high school sports is our target audience,” McLeod said.

Symptoms of TBI (Traumatic Brain Injury):

• Loss of consciousness or loss of conscious awareness

• Post Traumatic Amnesia

• Seizure

• Nonreactive or unequal pupils

• Blurred vision

• Concussion

Sudden impact

How much force is necessary to cause permanent brain damage is still unclear, but somewhere between 10 and 50 forces of gravity (g-forces) can be the starting point. The impact of 50 g’s is equivalent to being hit with a 13-pound bowling ball travelling 20 mph.

Plopping down into an easy chair .... 10 g’s

Being hit by a boxer ........................ 52 g’s

Driving an Indy Car (not crashing) ...80g’s

Being hit on afootball field ................ 200 g’s

Whiplash

Woodpeckers generate 1,200 g-forces, but do not suffer brain damage in part because they keep their heads in the plane of their body; the head does not rotate in a “yes-no” manner during the pecking. Race car drivers try to simulate this protection with the HANS device to stabilize their heads. Some football players (think Bryan Cox) use a high collar behind their head to prevent whiplash.

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