Thursday, September 9, 2010

Section II coaches and players tackling brain concussions head-on

(Note: This story first appeared in the Kickoff 2010 preview section on Thurs., Sept. 2).

SCHAGHTICOKE -- Jacob Shave wasn’t planning on playing football at Hoosic Valley High School this season because two of the most important people in his life – his mother and his doctor – feared he runs the risk of sustaining yet another concussion.

Playing rough games of sandlot football with his friends, Shave had accidentally taken knees to the temple and received concussions four times. He loves the game, but the idea of another blow to the head had kept him away from signing up for the high school team.

"Me and my mom both were kind of worried about concussions because if I get another one it’s not good," said Shave, who enters his sophomore year of school next week. "I’ve already had four or five. That was my reason for not joining in the first place, last year or this year. That was the only thing that had run through my mind."

Hoosic Valley High School sophomore Jacob Shave is playing his first year of organized tackle football in 2010 after having received at least four concussions in the past playing backyard football. (Photo by Will Montgomery - The Record).

Yet with the Indians, a Class C team, suffering from a lack of numbers, head coach Jay Garvey needed players to keep the fifth-year program afloat. Garvey saw Shave running laps around the track at the high school as the team trudged out for practice during the first week of training camp. Aware of why Shave was holding out on signing up, Garvey still implored him to change his mind.

"For kids like Jake, who we know is concussion-prone, we try and play him at receiver instead of running back so there is a little less contact," Garvey said. "We’ll be careful when we do full contact drills. It’s all common-sense stuff. I’m sure everyone is doing it. It’s definitely a good thing that everyone is doing it instead of what we used to do."

Knowing his coach had his best interests at heart, Shave had a discussion with his mother and decided to give organized tackle football a chance, all risks considered.

"She was hesitant and she never wanted me to join football because of the concussions. And my doctor didn’t think it was a good idea," said Shave. "But she realized because I’ve been kind of bothering her about it for the past couple of years now. I think she realized that I wanted to do it. It was just one of those things I want to get done."

What exactly is a concussion?
A brain concussion occurs when a person’s head comes to a sharp stop, causing the brain to slide violently inside the fluid layer that insulates the skull. Brain cells panic and fire neurotransmitters in a rapid burst, often causing receptors in the brain to become blocked. Short-term and long-term memory may be lost and other symptoms include nausea, confusion and blurred vision.

Leading scientists believe that one concussion makes future head trauma incidents more likely to become concussions, as even a less violent event will cause a similar injury the original event.

One of the biggest issues in treating concussions is that no clear, standard definition for a concussion exists. Players suffering from dehydration, for example, may exhibit dizziness or lightheadedness and complain of headaches, which could skew an overly-cautions doctor’s diagnosis toward a concussion and unnecessarily keep a player off the field.

What’s worse, many student-athletes ignore the symptoms or battle through them trying to play it tough.

"My first concussion, things were just really blurry and it was hard to see," said Shave. "I had half of my vision. The second time, basically, it was black spots where you can’t see much. The third and fourth times were a lot like the second time.

"Nothing is really easy to do. You can’t think straight. I remember my doctor asking me who the president of the United States was and I said ‘George Washington."

Like Shave, Hunter McCarthy, a junior quarterback at the Albany Academy, has already had four concussions. A three-sport athlete at Academy, McCarthy has not suffered his concussions on the football field. Basketball and baseball were the culprits for him.

"The first time I had one, I’m not really sure when it was, probably a couple of years ago," McCarthy said. "I was playing basketball. I don’t remember much when it happened. But I remembered the next couple of days, anytime you get out of bed or stand up, you get really dizzy and you just don’t feel like yourself. It takes a week or two to start feeling normal again."

Albany Academy junior quarterback Hunter McCarthy plays only on the offensive side of the ball, partly because of his concussion history. (Photo by Mike McMahon - The Record).

Treatment strategies for concussions vary, but minimizing exposure to external stimuli is one of the most popular. Former University of Florida quarterback Tim Tebow famously holed up in a dark room after sustaining a concussion in a game against Kentucky in Sept. 2009, trying to let his brain relax and not bombard it with music, television, reading or conversation.

Later that season, Texas Tech head coach Mike Leach was accused of banishing sophomore wide receiver Adam James to a dark equipment garage after James was diagnosed with a concussion and showed up to practice in sunglasses and street clothes.

In December of 2009, the NFL imposed new rules which force from a game or practice any player who exhibits any sign of a concussion and bans them from returning to action that day. Posters have also been placed in every NFL team’s locker room, alerting players to symptoms and encouraging them to speak up to the coaching staff if they believe a teammate is hiding a concussion-type injury from the organization.

A number of former NFL players who recently died in middle age were posthumously diagnosed with chronic traumatic encephalopathy in autopsies, a condition forensic pathologist Bennet Omalu likened to "a 90-year-old brain with advanced Alzheimer’s" Disease.

Even professional baseball has taken steps to prevent concussions. This season, all minor league players were required to wear the Rawlings S100 model – David Wright of the New York Mets and Francisco Cervilli of the New York Yankees were among those who wore it in the big leagues – which is much larger than a standard batting helmet because of an extra layer of synthetic foam.

Still, all the padding in the world can’t stop the root cause of concussions, which is the acceleration and sudden stopping of the momentum of the brain. Another type of injury helmets cannot protect against is a rotational concussion, where the brain twists, tearing brain fibers and causing permanent damage.

National rates
Although concussions are notoriously difficult to track, a number of medical organizations have attempted to intelligently guess just how wide-spread is the epidemic.

The Journal of Athletic Training reported in 2007 that an estimated 300,000 sports-related traumatic brain injuries occur annually in the United States. For people aged 15-24, sports are the second-leading cause of concussions behind motor vehicle crashes.

The National Athletic Trainers Association released a report in 2009 that claimed between four and six percent of high school football players sustain concussions in a given year, which equals an estimated 43,200 to 67,200 injuries annually.

A study conducted by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio from 2005-08, which studied 100 high schools around the country, estimated that 130,000 high school athletes report concussions each year. Of the nine sports studied, girls soccer provided the second-highest concussion rate, a figure considerably higher than their counterparts on the boys soccer teams. In fact, rates of concussions for girls were higher in basketball as well.

Countless young people also receive concussions in unsupervised situations, many of which go unreported or worst of all, undiagnosed.

What are the solutions?
For local high school coaches, the first step in addressing the concussion issue is understanding how to know when to pull a player out of practice and send them to an athletic trainer or the doctor.

Cohoes head football coach James Ducharme is among the local coaches who attended a concussion seminar at the Glen Sanders Mansion in Scotia in recent years.

Cohoes High School head coach James Ducharme is one of many local coaches who have attended concussion-awareness workshops in the offseason. (Photo by J.S. Carras - The Record).

"We tell our kids from the beginning, if you get hit and if you get lightheaded or dizzy or if something doesn’t feel right, you need to let us know right away," said Ducharme. "As a coach, you can see it in a kid 90% of the time if he got hit hard and if he gets up and he seems a little woozy. But sometimes we don’t see that and you have to rely on the kid to tell us."

At Hoosick Falls, head coach Ron Jones praised Superintendent Kenneth Facin and Athletic Director Mike Lilac for being "ahead of the curve" on the issue, bringing the school doctor in to give a seminar on athletic injuries to the district’s coaches. Half of the presentation focused on concussions.

Hoosick Falls head coach Ron Jones, pictured above with his team during the first week of practice, said that the health and safety of his players is his No. 1 concern, as it should be with all coaches. (McMahon photo - The Record).

"That’s the understanding now. You can’t tough out a concussion," Jones said. "It’s a serious thing and I don’t know if the guys hid their symptoms before or if they’re worse now. I think we’re seeing more size and speed at every level and even the high school impact is going to increase. I like the idea that they’re recommending that they shouldn’t even be returning to school until they’ve had time to rest."

Hunter McCarthy and his head coach, Tony Fruscio, both celebrated the work of Academy’s athletic trainer, Ron Hutchins. Academy gives all of its contact sports athletes a baseline test prior to any activity, which Hutchins and the coaching staff can refer to and compare the results in case they suspect a player has sustained a concussion.

Albany Academy head coach Tony Fruscio leans on his training staff to keep on top of the health of his players. (Montgomery photo - The Record).

"I think the policing and the training staffs really looking at it is up," Fruscio said. "You need the training staff to be looking at these head injuries that can affect your life forever, not just thinking about one game. One game isn’t that important."

At Tamarac, a switch to Riddell’s Revolution Concussion Reduction Technology helmets – the slightly funky-looking headgear popularized by NFL players such as Peyton Manning and advertised to decrease concussion risk by 31% - has solved some of the Bengals’ headache issues.

Tamarac head coach Erick Roadcap talks to his team after a practice in training camp. The Bengals have awarded Riddell Revoultion helmets to the players known to be concussion-prone. (Montgomery photo - The Record).

"Revolution helmets have seemed to helped me a little bit," head coach Erick Roadcap said. "We have a little bit of an older style that we rotate out and we get six new helmets a year. We use those with a few kids. It’s the same two kids. It’s always consistently the same kids and what alleviated it was switching the helmets."

At Shaker, first-year head coach Greg Sheeler says he has his players checking the inflatable bladders in their helmets daily to ensure a proper fit.

Are kids giving up football for safer pastimes?
A number of high school football programs were forced to dissolve during the first week of practice when it was evident the teams would not have enough players to survive a full season at the varsity level. The New York State Public High School Athletic Association mandates that teams must dress at least 16 healthy players for each game.

There is no direct evidence to support the idea that children are abandoning football for "safer" sports. According to the Center for Injury Research and Policy’s report, football, at 4.36 injuries per 1,000 athlete exposures, is riskiest sport for all injuries, which factored in reports of sprains or strains, concussions, contusions, fractures, lacerations, dislocations, heat illness, asthma attacks and skin infections.

Wrestling was second with 2.50 injuries per 1,000 athlete exposures (defined as a standard practice or game situation that presented a chance for injury), followed by boys soccer (2.43), girls soccer (2.36) and girls basketball (2.01).

Cohoes’ James Ducharme will dress just 18 players most of the season. all personal reasons aside, he thinks more high school students should be playing sports instead of sitting at home on the couch, playing video games.

"I even said to my athletic director today, I think New York State should make some kind of educational law that a kid needs to play one athletic sport a year," Ducharme said during the first week of practice. "They miss out on so much. If they’re not playing an athletic sport, maybe they should be in the band or chorus, because that’s just like a sport with the amount of time they prepare. I think something has to be done to get kids more involved in their extracurriculars in school.

"I think it would do wonders to a small school like us or Chatham," Ducharme continued. "Even Ravena, their numbers are down and that isn’t like them. They have a storied history."

While many local football coaches were lamenting a lack of numbers this season, each and every one that spoke with The Record for this story admitted that they are taking the concussion issue very seriously.
The players, on the other hand, especially the concussion-prone, are doing their best to put their injury history behind them once they step onto the field.

Entering his third year as the starting quarterback at Academy, McCarthy is one of the team’s best athletes. Still, the Cadets’ coaching staff hesitates to use him on both sides of the ball, primarily out of respect for his injury history.

"I don’t play defense, so that helps," McCarthy said. "Sometimes you have to block it out because if you’re worrying about it the whole time, you’re not playing as well as you can."

In Schaghticoke, Shave cannot wait to finally don a jersey and tie up his cleats to play in a football game that matters, not a backyard game of two-hand touch. Mostly, he’s looking forward to popping the buckles on his helmet so he can leave the thought of having another concussion in the back of his mind.

"I’m not really taking any extra precautions," said Shave. "I figure the helmet is enough safety for me, I hope, anyway. I hope there is not anybody big enough to break the helmet through. That’s the only fear I have."

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Here is how it looked in the paper:
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