By Leigh Steinberg - click here for the original article
March 3, 2012 | 9:27 p.m.
The specter of athletic concussion dominates the news this week.
There are multiple lawsuits by retired NFL players moving through the courts alleging the NFL failed in its duty to warn and protect players of the short- and long-term damages that concussion posed to player health.
The league is contemplating disciplining the Cleveland Browns for leaving quarterback Colt McCoy in a game last season after they knew he had suffered a concussion.
I have called this situation a “ticking time bomb” and “undiagnosed health epidemic” and have written on the dangers in the past. If I wrote this column repetitively warning about the concussion awareness, prevention and treatment it would still be merited considering the millions of concussions occurring at every level of collision-risk sports.
San Diego Charger offensive lineman Chris Diehl just announced his retirement after being left in a game with damage last season.
I reached the point in the early 90’s that I could not continue to stack dollars in the bankbooks of NFL players without becoming an activist on this issue. I felt like an “enabler”, facilitating the participation of clients in an activity that carried such dire risks of long-term damage. What separates this injury from any other is the fact that it impacts memory, personality, and what it means to be a sentient human being. It is one thing to realize that collision sports risk breaking down the joints of the body in a way that will make it difficult for a father to lean over at age 40 to lift his child — it is quite another not to be able to recognize that child.
Remember always that competitive athletes are in a state of denial concerning their long-term health. They are taught from Pop Warner and Little League to ignore pain and injury. They fear losing their starting position or separation from their peers.
The concept of long-term health is an abstraction and remote concern to athletes in their teens or 20s and they blot out the risk. This is why it is incumbent on parents and family to be proactive in concussion prevention and treatment. What is significant about these lawsuits is that it is the first time that retired athletes have been open in admitting to the world some of the realities of their condition.
I was desperate with multiple concussion sufferers like Troy Aikman and Steve Young in the 90’s to find out the answers to “how many hits should be the trigger to retire” and “what the long-term impact of multiple head injuries?”
So I convened three “player safety” seminars in Newport Beach, with clients listening to neurologists as to the state of the art in knowledge. The brain is the last frontier of medical research and there were no firm answers. Six years ago I co-hosted a series of seminars with the Concussion Institute in Los Angeles and we had national press cover the latest neurological studies.
It was reported that after three concussions the risk of dementia, premature senility, Parkinson’s and depression rises exponentially. The risk of an athlete suffering a concussion in a game playing again too quickly is that “second concussion syndrome” is at risk — slowed reflexes leading to the propensity for a much reduced blow to occasion a “perfect neurological storm.”
Two in close temporal proximity multiply the impact — one plus one adds up to much more than twice the damage.
To his credit, NFL Commissioner Roger Goodell convened a physicians conference and issued a “whistle blower edict” to encourage athletes to report their teammates that seemed impaired. The Berlin Wall of concussion denial fell. But with bigger, stronger, faster athletes colliding the physics of a hit changes, with more force causing worse consequences. Baseline testing, developed by Dr. Mark Lovell, which is now mandated by the NFL was a breakthrough.
Giving a cognitive test prior to an athlete going on the field of play and then being tested again after suffering a blow to the head provided the first objective way to gauge the effect of impairment. Trainers and physicians were better able to make sure that an athlete was asymptomatic at rest, on an exercise bike, and at practice before allowing them to return to play. Although the NFL receives the majority of coverage on this issue, millions of concussions occur in all collision sports at the pro, collegiate and high school level. And, that creates an especial danger for teen athletes. Their brain is still forming and the consequences of a concussion can lead to more severe consequences than to an older athlete. These teens take much longer to recover, and they are students.
There are promising supplements which have been developed, helmets are improving, and forbidding blocking and tackling with the head and neck are helpful, but nothing prevents a concussion.
It is critical that parents demand baseline testing for their teen athletes. I once proposed to State Superintendent of Public Instruction Jack O’Connell and the CIF Medical Committee that I would be willing to fund this testing for school districts that cannot afford it. There should be a major corporation looking to safeguard our youth that can help.
Please be vigilant in protecting your children — they will not protect themselves!
LEIGH STEINBERG is a renowned sports agent, author, advocate, speaker and humanitarian. His column appears weekly. Follow Leigh on Twitter @steinbergsports or blog.steinbergsports.com.
ASPEN, Colo. — A 5-year-old boy’s helmet was cited as the reason he survived a violent collision with a tree while skiing at Colorado’s Aspen Highland’s resort in 2002. Several days later, Aspen Skiing Company made helmets mandatory for all students taking ski lessons age six and under.
No helmet, no lesson, no exception.
“We feel these ski school kids are in our care, and we have to take care of them,” explains Aspen Senior Vice President David Bellack.
As of this season, the helmet policy was extended to all skiers under the age of 17 and to all employees who are on-duty and out on the mountain on skis or snowboards.
The new rule applies to roughly 2,000 salaried employees including ski patrol and ski instructors, regardless of whether they are teaching children or adults.
The company recommends all age participants wear a helmet, which can be rented for as little as six dollars.
Aspen Skiing Company which operates Snowmass, Aspen Highlands, and Buttermilk resorts estimates that more than 80 percent of guests and employees already wear helmets. The company said if employees do not own a helmet they will provide one to them free of charge.
Nothing about concussions is humorous. But the Globe and Mail ran an article this week entitled, “NHL’s all-concussion team would be lock for Stanley Cup” that offers some perspective on the number of star players currently off the ice, due to concussion.
Some, like the game’s best player, Sidney Crosby of the Pittsburgh Penguins, suffered a relapse when he returned from a 10-month hiatus. Others are newly injured, like Philadelphia Flyers’ Claude Giroux, the league’s top scorer.
A look at the talent that is currently on the sidelines suffering from a concussion or post-concussion syndrome:
Sidney Crosby: The league’s best and brightest star took two hits over the holidays last year that resulted in a 10-month struggle with post-concussion syndrome. His long-awaited comeback culminated in a triumphant return until he and a teammate collided on Dec. 5. Originally scheduled for a two-week recovery period, he is out indefinitely. He played eight games this season.
Claude Giroux: Leading scorer for the NHL, Philadelphia’s Giroux is out after an accidental hit by a teammate Dec. 10. After he left the game, his symptoms worsened and he was diagnosed with a concussion three days later.
Marc Staal: Staal has missed training camp and 29 games so far this season after suffering a concussion after a collision with his brother Eric last year. The New York Rangers defenseman is currently skating but not competing.
Marc Savard: The Boston forward suffered two concussions in less than a year and has not played since February 2011.
Milan Michalek: A collision with a teammate on Dec. 15 left the league’s top goal-scorer with a concussion. The Ottawa forward’s status is day-to-day.
Chris Pronger: The Flyers’ captain was ruled out indefinitely on Dec. 15, due to severe post-concussion symptoms. He will miss 63 games.
Guillaume Latendresse: Missed 15 games and on his first game back he left after scoring two goals. The coach for the Minnesota forward told reporters he was suffering from post-concussion symptoms.
Robert Bortuzzo: Pittsburgh defenseman was hurt Dec. 8 against the Flyers. He joined concussed teammates Kris Letang and Zbynek Michalek on the sidelines.
Jeff Skinner: Carolina Hurricanes’ leading scorer was hit during a game against the Oilers on Dec. 8. He is out indefinitely.
Joni Pitkanen: Joins teammate Skinner on the ‘indefinite return’ list. Pitkanen is the Hurricanes’ top-scoring defenseman.
Nathan Gerbe: Buffalo forward has missed three games so far after a hit from behind during a game against the Flyers caused a concussion Dec. 7.
Kris Letang: A hit by Montreal Canadiens’ Max Pacioretty on Nov. 26 broke Letang’s nose and caused him to suffer a concussion. Pacioretty was suspended for three games as a result. Last season, Pacioretty suffered fractured vertebrae and a concussion after a vicious hit by Bruins’ Zdeno Chara forced him into the steel post that anchors the plexiglass surrounding the bench. Pittsburgh’s Letang has missed seven games so far.
Some players have returned from their injuries to compete again this season, as recovery times have varied. St. Louis forward David Perron’s comeback this season follows a post-injury recovery period that lasted 13 months, causing him to miss 97 games.
By PAUL DOMOWITCH - Philadelphia Daily News - Click here for the article
Not so long ago, the NFL refused to even acknowledge concussions.
“I remember one year, (then NFL commissioner) Paul Tagliabue said concussions were a function of pack journalism,” said agent Leigh Steinberg.
The league acknowledges concussions now. It just doesn’t always see them. Two weeks ago, you didn’t need to be a doctor or even play one on TV to know that Browns quarterback Colt McCoy had suffered a concussion after taking a vicious, nationally televised hit from Steelers linebacker James Harrison.
Yet, two plays after McCoy was knocked unconscious, he was permitted to return to the game. Wasn’t even given a concussion test on the sideline because the team’s medical and training staffs never saw the hit and thought he had injured his hand, not his head.
Browns president Mike Holmgren acknowledged a few days later that the team’s doctors and trainers were working on other players when McCoy got cold-cocked and never realized the severity of the hit or the nature of the injury until after the game.
Last year, the same thing happened in an Eagles game when linebacker Stewart Bradley suffered a concussion after hitting his head on a teammate’s knee. Millions of viewers at home watched him get up, stagger like a drunken sailor and fall down again. But the Eagles’ doctors and trainers didn’t.
“I have to tell you, it’s hard to imagine him coming back in this game in light of what we just saw,” Fox analyst Troy Aikman, the victim of more concussions than he cares to remember during his Hall of Fame career, told viewers. “With all the attention being given to head injuries, it’s hard to imagine he’ll be put back in.”
But four plays later, he was. While the Eagles claimed they gave Bradley a concussion test before letting him go back in, trainer Rick Burkholder tested him again a little later and realized Bradley had concussion symptoms.
After the embarrassing incident with Bradley, the NFL and the players union both said steps were being taken to see that something like that didn’t happen again.
“The fact that they didn’t know or have a description of what happened probably needs to be looked at more carefully,” Thom Mayer, a medical adviser for the NFLPA said. “We need to make sure the people treating the player have a clear description of what happened when they’re evaluating the player.”
Yet, a year later, the same thing happened to McCoy. You saw it and I saw it, but the Browns doctors and trainer didn’t see it. And nobody else on the team’s sideline who saw the hit apparently had enough sense to give the doctors and trainers a heads-up.
This past week, the NFL, reacting to the massive criticism it has received for the Browns’ mishandling of McCoy’s concussion, announced that it will put independent certified trainers in the press box at every game to monitor for head injuries.
Steinberg, who once represented the majority of the league’s quarterbacks, including Aikman and fellow Hall of Famer Steve Young, has spent the better part of the last 20 years trying to get the NFL to take the issue of concussions seriously. Since the early ’90s, he has been lobbying the league to put a neurologist on every NFL sideline. Since the early ’90s, it has ignored him.
“The NFL is, by 2-to-1, the most popular sport in the country,” Steinberg said. “There was a week recently where five of the top 10 shows were nighttime football games. NFL football symbolically sets the trend for college and high school football and also sets the trend for other collision sports.
“The NFL should be leaders in this. It’s a question of priorities. If concussion consciousness and danger really are in the forefront of the minds of medical staffs and training staffs, then there never would be a time where something like this (the McCoy and Bradley incidents) could fall through the cracks.
“A neurologist could monitor hits. We’re talking about a business where billions of dollars are being made and paid. This concept of an additional cost (to put neurologists on the sidelines) is minimal. You’ve got new TV contracts that are going to blow the roof off already sky-high revenue. In the vernacular, that’s chump change for a team.”
Because he represented so many of the league’s most prominent stars, Steinberg was able to help force the NFL to finally face the concussion issue. He issued a white paper in the ’90s recommending neurologists on the sidelines and the abolishment of blocking and tackling with the head or neck and mandatory missed games for players diagnosed with concussions and a grading system for concussions.
“The (changes in) blocking and tackling was the only part that was adapted,” he said.
Since Roger Goodell replaced Tagliabue as commissioner in ‘06, the NFL has taken concussions much more seriously. They have implemented return-to-play guidelines that prevent players from playing again until they’ve passed testing and been cleared by an independent neurologist.
But there still remain holes in the process for initially diagnosing concussions. Eagles offensive lineman King Dunlap suffered a concussion during a mid-November game against Arizona. He played the entire game with the concussion, and no one on the team’s medical or training staffs noticed anything wrong with him until he mentioned after the game that he wasn’t feeling well. He ended up missing three games before he was able to pass his concussion testing and get cleared to play again.
“It’s an extraordinarily dangerous risk to put someone who’s had a concussion back out on the playing field,” Steinberg said. “Reflexes become slower. If it takes a strong force to cause the first one, the brain is already set up for the second one. Two in proximity are the perfect neurological storm.
“I’m encouraged by a lot of this because I used to think the only way there would be movement on this issue was the death of a player on the field. You can’t count on the player to give you honest answers. The player wants to play under any and all circumstances. Asking him (how he feels) is akin to asking a drunk driver if he’s drunk. He doesn’t know.”
Via SportsConcussions.org - Click here for the article
Nearly a week after Steelers’ linebacker James Harrison clocked Browns’ quarterback Colt McCoy with the crown of his helmet causing him to suffer a concussion, the NFL issued a one game suspension without pay, costing Harrison about $73,000.
Harrison is the first player to be suspended for a helmet-to-helmet hit, an escalation of previous consequences that resulted in hefty fines.
But the infraction may be the catalyst for bigger changes to the league’s concussion policy.
The NFL and Players Association are holding talks to discuss what many view as holes in the current protocol. These apparent deficiencies allowed McCoy to return to the game after sitting out for two plays.
His father criticized the team for not holding his son out of play after the hit knocked McCoy backward to the ground. “He never should have gone back in the game,” Brad McCoy told the Cleveland Plain Dealer.” He was basically out (cold) after the hit.
Browns’ Coach Pat Shumer says McCoy’s symptoms did not appear until after the game, although the team has not been forthcoming about the details of McCoy’s sideline evaluation. Shumer said he is confident the athletic trainers followed the NFL concussion guidelines.
Harrison has been outspoken about the new concussion policies, threatening to retire last year stating that he couldn’t play under the new rules. In 2010 alone he was fined $125,000 for hits ruled illegal or unnecessary.
The Steelers have been fined at least 13 times this season for illegal hits.
Harrison is unable to practice or appear at the team’s facility during his suspension. He is scheduled for reinstatement December 20. He can request an expedited appeal.
One issue under consideration during the NFL and union review is the placing of an independent neurologist at every game, according to ESPN’s Chris Mortensen.
Injury observers are now present in the press box at every NFL game to aid sideline personnel who cannot see all players from their vantage point on the field. The NFL added these safety personnel after San Diego Chargers’ Kris Dielman suffered a concussion during the fourth quarter in a game against the Jets, continued to play, and suffered a grand mal seizure on the team plane enroute home to California.
Nicholas Harris, 17, was allegedly sent back into a junior varsity football game last year in Medford, Oregon, after telling his coaches he had sustained a concussion. That could cost the Medford School District $585,000, according to a lawsuit filed by his mother on Oct. 17.
In Pittsburgh, Pennsylvania, Megan Alt says her son’s cognitive disabilities are the result of him being forced to play while concussed, by Highlands School District football coaches. Her lawsuit, filed in federal court in April 2011, cannot specify a dollar amount but is in excess of $75,000, says her attorney.
Concussion-related lawsuits, particularly at the high school level, get a bad rap.In an unrelated case involving a high school player who required brain surgery, I watched the media coverage, talked to community members, and perused the comments in their local newspaper after this student’s lawsuit was announced.Overall, the public’s view was quite negative, many believing that the boy’s family should be held solely responsible because they had allowed their son to play football, an inherently dangerous sport. Most felt that the school district and coaches were not to blame.
Right now, with the adoption of new concussion laws pertaining primarily to youth athletes, no one really knows what the legal ramifications will be.But what I do know is that the impairment can be very real.I know too many teenagers who have participated in a variety of sports –not just football – who have dropped out or postponed college, dropped out of high school, or are just looking for some relief after years of suffering from post-concussion syndrome.They need help, and in some cases, compensation.
In Harris’ case, the lawsuit states that he was struck in the first quarter of the game and then again in the second. He told his coaches after the second hit that he thought he had a concussion, but was allegedly told to keep playing and was returned to the game. Shortly afterward, he was struck for a third time, suffered a seizure, and lost consciousness. Taken by ambulance to the hospital, Harris was placed in a medically induced coma and admitted to the intensive care unit. According to the lawsuit, he suffered brain damage, along with post-concussive seizures and other symptoms.
Zachary Alt, now 19, is unable to work a full day due to numerous concussions he suffered as a varsity fullback in 2007 when he was a 15-year-old sophomore, according to the complaint. That season he suffered at least three concussions within the span of a few weeks, the last one when he was put back in the game after wandering “aimlessly” on the field from a previous hit. He has no recollection of his last block. Taken to the hospital, he was diagnosed with a significant concussion. Even though he missed much of the following semester and struggled with his schoolwork he was given straight-A’s and graduated on time. The case is being heard in federal court on grounds that Alt was denied the right to an education. Alt’s suit names the school principal, assistant principal, football coach, and athletic trainer as defendants.
My own son’s non-catastrophic injury cost nearly $25,000, and we did nothing over and above the accepted standard of care.Several ambulance transports, three ER visits including an evaluation at a regional trauma center, imaging, and post-concussion care lasting several months, all added up.
For those athletes that require overnight hospitalization or surgery, the financial burden on the families is tremendous.Shoring up medical coverage on insurance policies or spending a few extra dollars on secondary coverage is a wise move.As our trauma care bills started rolling in, I was glad we were “over-prepared,” realizing now, there is no such thing, particularly if you have a child involved in contact sports.
In November 2008 when my 16-year-old son sustained a concussion playing football, we were completely on our own.Concussion awareness had not reached the level where it is today, state laws were virtually non-existent, and unbelievably, there was very little information on the internet.It took me 10 weeks to find competent medical care, the longest weeks of my life.I thought my bright, energetic, talented young son’s life was over, because he was no longer “there.”Thankfully, his brain repaired itself, and the nightmare for us was over after four months.
Three years later, the landscape is completely different.Remarkably, the “culture change” many have been calling for has been rapid and thorough, albeit incomplete.
While many have worked tirelessly to change this tide for decades — long before anyone was listening – several key factors fell into place that accelerated today’s heightened awareness.
In 2009, Washington State became the first in the nation to pass concussion legislation calling for the removal of athletes from a game or practice if a concussion was suspected, and not allowing them to return without written medical authorization. Named after Zackery Lystedt, a middle school football player who suffered a catastrophic injury, the law captured NFL Commissioner Roger Goodell’s attention. By 2010, Goodell had adopted Zackery’s cause and urged all state governors to pass similar legislation. To date, 34 states and the District of Columbia have done so.
At about the same time, researchers at the Center for the Study of Traumatic Encephalopathy in Boston, Massachusetts, were finding abnormal proteins called tau, in the brains of deceased athletes, many of whom had suffered repetitive head trauma.Asked to testify before Congress, the researchers presented data that was difficult, if not impossible, to ignore.Concussions became linked to a degenerative neurological disease called chronic traumatic encephalopathy (CTE), and there was no turning back.
So when my son and I met Roger Goodell last year, it was at the beginning of the sea-change.He encouraged my son to set high goals for himself as an athlete, and later spoke to the crowd about his commitment to addressing the concussion crisis.He kept his word.Enormous fines were levied for head-to-head contact and players got the message.NFL veterans changed the way they hit, and rookies followed suit.It’s filtering down to our youth.
And that may be Goodell’slegacy.Under his watch, we can all breathe a little easier.The devastating hits of the past may remain there.Youth coaches now have tacit permission to modify their practices and drills, while still emulating the pros.High schools and colleges can graduate athletes with fewer checkmarks on their lifetime concussion cards.
We’re by no means done.Several states now require school districts to keep track of the number of concussions sustained by their student-athletes. When these numbers start rolling in, it will send shockwaves through every family with an athlete at the dinner table.But we need to know the magnitude of the challenge.That knowledge will spur funding for more research, instigate policy changes where necessary, and result in a smarter, safer game from Pop Warner on up.
All in all, changing society’s perception of concussions is probably not what the commissioner thought would be one of his greatest contributions.But life is funny that way, and Goodell has certainly stepped up to the challenge.
What evidence guides us to believe that one or more early childhood concussions has healed? The answer is the remission of symptoms such as pain, swelling, and the mental impairments that sometimes, but not always accompanies the concussion.
To understand this you must realize that healing is used as a relative term. It is relative from two standpoints.
First, symptoms that are gone are not generally correlated to other seemingly unrelated behaviors or symptoms such as aggressiveness or depression. Often these symptoms may be delayed by months or years. Hence, a diagnosis of these other symptoms at a later time may never be tied to the childhood concussion.
There are at least 111 other symptoms that are associated with concussion. Second, the nature of Post-Concussion Syndrome is that it may lurk around for many years, presenting with either unnoticed or mild symptoms that are easily credited to some other cause.
Drugs done experimentally may trigger the emergence of PCS, leading the patient and observers to believe that it’s a ‘drug problem’ rather than a brain problem that led to a drug issue or experimentation. Additionally, stress and, in particular, traumatic events can trigger the sudden emergence of PCS symptoms.
It is not known how or why this long delay can occur from brain trauma, just that it is a phenomenon that many researchers agree is real. It is also a reason to extend and expand our vigilance that mental and/or physical symptoms can and do emerge from brain injury and these symptoms can be delayed for half a lifetime.
In this author’s opinion, childhood concussion may someday be proved to be THE cause of many forms of ill health.
Her son, Sam, plays left tackle for Newport Harbor High’s football team. She had read and heard of the dangers from concussions and felt as a parent she had a responsibility to safeguard her son’s health.
She mentioned her concerns to her husband, Blaine, who is president of the Newport Harbor Football Booster Club, and he too felt frustrated at the lack of protection for their son and other athletes. He ran into a fellow athletic parent, Bill Lewis, who mentioned a process he was aware of called, “baseline testing.”
They agreed that it should be instituted by the football team and they contacted imPACT, which is run by a friend of mine, Dr. Mark Lovell, their CEO who has been a seminal figure in the fight to reshape the treatment protocol for this injury.
They ran the possibility by Principal Michael Vossen, Athletic Director Mike Zimmerman, and Coach Jeff Brinkley and found them to be supportive. Very shortly, all of the players will be tested on campus. Blaine is on a mission to share what he has learned with other parents at local high schools.
I have been haunted by the spectre of concussion consequences for 35 years. It is the only injury that impacts consciousness, memory and what it means to be human. As I’ve written in this space before, we all know that sports like football take a toll on every joint in the body. We know that anyone who plays football long enough will have damage to their knees, back and shoulders. But it is one thing to feel pain while leaning over to pick up a child at age 35, it is another not to be able to recognize that child.
And I was frightened by injuries to NFL players like Troy Aikman, Steve Young, Warren Moon, Drew Bledsoe andBen Roethlisberger.
I have called concussion “an undiagnosed health epidemic” and a “ticking time bomb” because the damage is so often overlooked and the symptoms may not show up for years. I began holding seminars in Newport Beach in the 90s by inviting neurologists, helmet and playing surface experts, and players and parents to participate in “white papers” suggesting change. The brain is the last frontier of medical research. It wasn’t until the last five years, when I was involved in three more seminars, that research was conducted that showed that three was the magic number. And that premature senility, dementia, Parkinson’s Disease, Alzheimer’s Disease and elevated rates of depression could be directly tied to multiple blows to the head.
We pushed the NFL to take action to warn players of the danger and utilize methods of prevention and treatment that seriously addressed the problem. Players who have been hit in the head are not the best judges of their own impairment. Under the leadership of new Commissioner Roger Goodell, the NFL started to tear down the Berlin Wall of denial that surrounded the impact of multiple concussions. The NFL instituted a “whistle blowers” edict asking players to report when other players seemed to functioning at subpar levels on the field. They also mandated baseline testing for all players, as many other professional leagues are now doing.
Although the NFL is the focus for most concussion news, this injury occurs in a variety of sports, at the professional, collegiate and high-school levels. The consequences are most devastating for younger athletes. Concussions occur in AYSO and club soccer, Little League and Pony League baseball, basketball, water polo, field hockey and skateboarding. The adolescent brain is still developing and the first role of these athletes is to be students with academic studies. It takes significantly more time for the younger brain to recover from symptoms like dizziness, headache, nausea, impaired vision. And all athletes in collision sports tend to be in a state of denial about their short and long-term health. They are so anxious to be part of a team and compete that they will put themselves at risk and neglect their symptoms. This is why the role of parents like the Bushes is so vital.
Parents and families need to protect their precious children who can’t see life beyond the next play.
Dr. Mark Lovell, longtime neurologist at the University of Pittsburgh Sports Medicine clinic, knew the pressure on players, coaches and trainers to rush athletes back onto the field of play after suffering concussions. The state of the diagnostic art was embryonic, with players being asked how many fingers were held up in front of their face.
Dr. Lovell developed an objective way of judging impairment following hits to the head, and a protocol regarding return to play. It is a simple cognitive test which takes less than 30 minutes.
A player is tested before he goes out on the field of play and then tested again after a suspected concussion. This gives the health professional a way of knowing how severe the impact has been. Then players must prove they are asymptomatic at rest, on an Exercycle and at practice before being allowed to play again. This prevents “second concussion syndrome” in which an athlete still struggling with concussion symptoms enters the field of play. His or her reflexes and coordination are compromised and they get hit in the head again. It takes less force to produce another concussion and two in close temporal proximity to produce what is referred to as a perfect neurological storm.
This is why I went to the State Superintendent of Instruction in California and the CIF medical community to advocate baseline testing for all high school athletes. Expense was a problem for the less affluent students and Wells Fargo stepped forward to make testing available for as little as five dollars per student.
People tell me I can’t save the world, but we can certainly insure that every high school in this area mandates baseline testing. As the old United Negro College Fund ad stated, “The mind is a terrible thing to waste.”
Newport Harbor parents insisted on cardiac screening for their student athletes. And great credit should go to those local parents who are insisting on an elevated standard of care provided by baseline testing.
LEIGH STEINBERG is a renowned sports agent, author, advocate, speaker and humanitarian. His column appears weekly. Follow Leigh on Twitter @steinbergsports or blog.steinbergsports.com
One incoherent young man being dragged through a field by medical personnel supporting one side, friend on the other. Not far away, another lies on a stretcher, head immobilized by a cervical collar. A third sits nearby, too beaten to continue, looked over by a young man with an arm sling. Four ambulances with lights flashing create a red/blue blur against which all available medical personnel prepare the wounded for transport.
Afghanistan,…. Or Iraq, perhaps? No. Small town America’s version of fun, Friday night high school football.
Is this an anomaly? Other teams seem to have it all together. Injured players are whisked off the field by athletic trainers who give them a thorough examination and start treatment immediately or call 911. But most of America doesn’t have it so nice.
Note: The volunteer medical staff at this game consider this school district to have a “broken system” of care for their athletes. There are no known safety systems or procedures in place, they are not provided with players’ medical histories, and the athletes do not have recent concussion baseline test results. In spite of this, they continue to offer their services to the athletes as often as possible.
High hopes
With a good volunteer medical team in place and trained coaches as per our state law, I sat back to relax and watch my good friends’ boys play, something I have done for the past many years. My son was the starting QB on this team his entire high school career, but has now moved on to college baseball.
Five minutes into the game, I see a hard hit that causes one of our players’ head to snap back and to the side. I know those rotational forces can be particularly worrisome, so my antennae go up. Sideline personnel ask him a few questions after the play, he says “I’m fine,” as they all do, and he continues back to the line for the next play. Thankfully, one of them has a change of heart, runs out onto the field and takes the athlete out of play. I breathe a sigh of relief as he is evaluated on the sideline.
The athlete “passes” all of the sideline concussion tests and is sent back into the game. Maybe they were right after all, and he is fine. I worry. I know what I saw. I lose track of him before the half.
Locker room
At halftime, some notice the athlete can’t remember his locker combination and is fumbling for answers to simple questions. A medic takes his jersey and tells him he’s out. He walks back to the field to take his place on the bench to watch his team finish the second half, and is checked on frequently. He’s in good hands so I do not worry.
Things don’t go as planned. I see the player now hunched over, sinking lower and lower on the bench, covered by blankets. It is now about an hour since his hard hit. I’ve been here before, when my son sat on that same bench for 45 minutes in 2008, losing his eyesight, and his hearing, lacking the cognitive ability to cry out for help. But this young player was being attended to. I must have faith.
Another 45 minutes passes and I see a staff member and a teammate drag this athlete across the field, heading for the parking lot. My hopes dim when I don’t see an emergency vehicle, but his mother’s waiting car. My heart skips a beat.
My first close-up look at the athlete sent me into a state of shock. He was incoherent, barely able to stand, and could not pick his head up or look up at all. They placed him in the car and strapped his seatbelt around him. His head hung down and stayed there.
He needed to get to the hospital, and fast. He had deteriorated rapidly over the two hour period, and now his mother was considering taking him home. I needed to stop her from leaving. I’m not the hood-sitting type, but it crossed my mind.
My EMT friend ran over to the emergency crews for help. I was running out of time. I stalled his mom as best I could, and the crew arrived. They headed for the ER. Now at least they’ll know if he has a hematoma or a skull fracture.