Sports • Tom Kotopoulos & Ryan Finneran
Concussion cases have increased significantly over the past few years in numbers, severity and media attention. Unfortunately, concussions are an ailment that many Thayer students have had to endure and overcome. Is the increased physicality and intensity in sports the cause of this, or is it solely that trainers and athletes are just starting to recognize what has been occurring for decades? For those who haven’t had one (thankfully) here’s a look into the typical protocol designed for a student with a concussion: the treatment, obstacles, and recovery. A Trainer Explains Ellen Malloy, Thayer’s Head Athletic Trainer, says, “Concussions are tricky and one can’t always tell right away”. She compares this delay to a quad injury. “With a quad injury you feel pain right after impact but usually you can continue playing. The real pain or stiffness doesn’t come until the next day. The same goes with concussions. It takes time for the chemical reactions in your brain to respond to an impact.” According to the Centers for Disease Control (CDC), a concussion is, “a mild form of traumatic brain injury (TBI) caused by a bump, blow or jolt to the head.” Symptoms include headaches, nausea, changes in sleeping patterns, difficulty concentrating, and/or dizziness. Information sheets, handed out by the Athletic Trainer’s (AT’s) Office, caution, “a student who returns to academics or athletics too soon risks slowing the recovery process and unnecessarily prolonging symptoms for weeks, months or longer.” Over the past few years the AT’s Office has emphasized this idea, which has molded the protocol used today.
2
Avery Devlin Art
Typical Protocol When a student is suspected of having a concussion, a trainer will guide the student through a specific series of neurological questions and tasks. This evaluation, conducted within minutes of the incident, tests balance, agility, eye-tracking and memory but isn’t always accurate. The next step involves the IMPACT test (Immediate Post-Concussion Assessment and Cognitive Testing). Ellen says that the IMPACT test is, “an impartial tool. It allows us to compare the student to themselves.” However, if there is no baseline test (that is a test when the athlete is 100% healthy) this test is useless. So… make sure to GET AN IMPACT TEST. This is one of the main tools the AT’s Office uses to gauge a student’s responsiveness, symptoms and overall health. Next, the results of the post-injury IMPACT test, as well the athletes’ medical history, are sent to Dr. Neal McGrath of Sports Concussions New England. Dr. McGrath, a neurophysiologist, is a neutral party. His expertise in sports concussions helps the AT’s Office make the best and most informed decision about a student’s health. Dr. McGrath praises the IMPACT test because the baseline test will, “control for effects of medication, learning disabilities, attention deficit/hyperactivity disorder (ADHD), and other preexisting conditions.” In addition to Dr. McGrath, the Health Office, the athlete’s pediatrician’s office, and Mr. Chiari and Mr. Gibson, the Upper and Middle School Deans of Academic Support respectively, are all consulted. They work hand in hand to accommodate students’ needs (physically, mentally and academically) as well as schedule an appropriate recovery time.
Throughout recovery, rest is stressed. However, Ellen emphasizes that simple activities like texting, or playing on an iPad can hinder the recovery process. These activities involve multitasking. “An absence of activities that involve both the right brain and left brain, help with the healing process.” Once a student has progressed, he or she can start to make up missed work. This is where Mr. Chiari and Mr. Gibson act as advisors between students and their teachers. Dr. McGrath has suggested specific accommodations teachers can make for students with concussions. Extended time is a main point, and Dr. McGrath stresses, “diminished information-processing speed is one of the most common post concussive problems. Extended time is frequently needed by student-athletes who are symptomatic but who feel well enough to attempt to continue with their scheduled examinations.” Once a student has completed all academic work, the IMPACT test is taken again, however, this time a student-athlete participates in some sort of exercise before the test is administered. Scores must be “at or above baseline scores” for a student to be cleared. Again the AT’s Office warns, “In rare cases, an athlete can suffer more serious and permanent brain damage if a second injury occurs before the first concussion is fully healed.” Although the process is drawn out, and at some points redundant, it is all put in place to make sure students recover fully.
Personal Accounts Sophomore Emma Jaeger has sustained three concussions while playing soccer. “This last one was definitely the worst because it was a double impact. I hit my head twice; once against another player’s head and then again on the ground after I fell down. People have told me what happened, but it’s just black in my memory.” Emma wasn’t able to play soccer for three months, and because of limited physical activity her return to the field was difficult. But more importantly, Emma was completely out of school for two weeks. Slowly, over the next month she completed limited work before she fully returned to the classroom. “I had to lean all the old material along with all the new material, while making up every test. All my teachers were very understanding that it was going to take time for me to catch up. The school has been extremely accommodating and helpful throughout the process.” Senior Ainslie Eck, who has had two concussions, agreed that, “the most difficult part was trying to catch up with all of the work afterwards. Although, I liked being able to sleep a lot.” However, concussions aren’t always a result of an in game collision. Ainslie sustained two unlucky concussions. “The first was when I was sitting in the “nook” (a place in the old student commons). Two rather large boys were tossing around a lacrosse ball, and one of them missed the ball and it hit my head instead. The second was at a cross-country race. During warm-ups, a ball flew out of bounds from a nearby soccer game and hit me in the head.” Ford Murphy, a junior, had a similar experience when he was, “kneed in the back of the head while rehearsing a fight scene in West Side Story.” The timing of his concussion further complicated his situation. Ford was diagnosed three days before opening night, during the week of midterms and SATs. “I didn’t really know how to handle the workload, but the faculty handled it well. Of course, Ellen took good care of me too.” Recovery According to Ellen, recovery times vary depending on the student-athlete. Age is a huge factor because younger athletes are more susceptible, as their brain hasn’t fully matured, and therefore need more time to recover. The type of “hit” and the severity of the injury also impacts the recovery time. Although each recovery is different, Ellen says that the average is about three weeks to a month. Even with these guidelines, concussions are inevitable. According to the CDC, an estimated 1.6 to 3.8 million concussions occur each year, most of which go untreated. They represent 8.9% of all high school athletic injuries and there was an estimated 60% increase in the number of Emergency Department concussion cases. Even the number of concussions here at Thayer is higher than at other ISL schools. Ellen attributes this to the fact that, “We’re a day school. In the Middle School, and even the Upper School, kids play on more than one team. Kids now have 12 practices and 8-10 games per week with multiple teams, versus a typical ISL schedule of 4-5 practices and 2-3 games per week. The opportunities for concussion have increased. Thankfully education and awareness have also improved. In our AT’s Office we have learned to recognize them better than others.” Tom Kotopoulos Design
The Concussion Problem
3