News

Experts: Athletes, coaches need to recognize concussion

By Sunnie Clahchischiligi
Navajo Times

FRUITLAND, N.M., Nov. 14, 2013

Darrell Boling thought he was OK.

The Ganado starting quarterback took a hit in a big game last month that left him with a head injury that caused him to miss two games. He tried to shake it off but it was later determined that he faced a major concussion.

The senior star was cleared after two games and was ready to play -- or so he thought.

His head coach Brandon Newcomb said Boling seemed fine and ready to continue his leadership duties on the team.

"He was released to play and he played in the game, and he complained of headaches," Newcomb said. "He thought his future was in jeopardy, so he decided not to continue to play the rest of the season."

With about three games left in the regular season, Boling decided to cut himself loose from the team, for fear that the concussion he suffered would ruin any chance he had in football after high school.

But not all high school student athletes, specifically football players, would have done the same.

In fact, millions of student athletes across the country continue playing with after head injuries, and most are not even aware they have a concussion. Most do not understand the severity of the long-term effects a concussion can have. That is true even for the thousands of athletes on or near the Navajo Nation.

Concussions in high school, college and professional sports have been making national headlines.

Retired athletes such as NFL retired running back Tony Dorsett are fessing up to possible injuries due to multiple concussions during their glory days. In a recent LA Times article, it stated that Dorsett was becoming frequently forgetful and confused, and has shown signs of a brain disease scientists say is caused by head trauma and is linked to depression and dementia.

And the number of concussions suffered in high school athletes increases every year, especially in the surrounding area.

Just over the weekend, Hopi running back Charles Youvella passed away after suffering a severe head injury during the Arizona Division V playoff game against Arizona Lutheran Academy on Saturday night. It is not yet determined that Youvella suffered from a concussion.

According to Hopi coach Steve Saban, Youvella caught a pass and was tackled. On the way down he hit the back of his head with seven minutes left in the game.

He was taken to St. Joseph's Hospital and Medical Center in Phoenix in critical condition where he remained until his death on Monday night.

"This is a surreal moment," Saban said on Monday. "It's like a bad dream."

At press time, funeral arrangements were pending.

Concussion report

According to a report released by the Institute of Medicine and National Research Council recently, concussion rates are more frequent among high school athletes than college athletes in some sports, especially football.

The report examined concussions in young athletes ages 5-2. It found that there was still little research having to do with concussions and youth. The report also stated that there was little evidence to support the idea that the design of a helmet could reduce the risk of concussions. Lastly, the report stated that as many as 20 percent of young athletes who suffer a concussion will experience symptoms for weeks, months or even years.

Young athletes in the United State face a "culture of resistance" when reporting concussions because they feel it will keep them from playing whatever sport they're in, according to the IOM report.

But that doesn't appear to be the case for athletes in the local area.

Deborah Waters, an adolescent sports medicine specialist at Northern Navajo Medical Center, has been a team trainer for various area schools in Northern New Mexico for 19 years. She said the national average for high school football concussions is three to five per team. She said the number seems unsettling but could be due to a number of factors.

Educating the athletes, parents

"We're seeing a few more concussion than we have in the past," she said. "Nothing outrageous."

It could be because more local student athletes and coaches are educating themselves about concussions and more athletes are prone to report them.

Waters said she has tried to do her part in educating athletes, coaches and even parents when it comes to concussions. Before the start of each season she gives a lecture to each team about concussions, but sometimes lectures aren't enough.

Waters said she has found that more education is needed.

"My feeling is that we have to educate the parents and the student athletes so they can look out for each other and put pressure on the coaches to take it serious," she said.

In New Mexico, all student athletes and their parents are required to sign a concussion information form provided by the New Mexico Activities Association. The form outlines the symptoms and provides what-to-do information. It also notes the State of New Mexico's Senate Bill 1 or the Concussion Law, which indicates safety protocols and education regarding brain injury resulting from school athletic activities.

The law states that high school coaches and athletes must be educated on risks of brain injury resulting from student activities, especially if a student athlete is to return to a sport after suffering a concussion.

Waters said coaches have sought her help in educating them and the student athletes. She said their knowledge of concussions has proven to help local athletes.

"They see somebody take a shot and see them react a certain way and think,ÔThat's not right,'" she said. "They (teammates) understand their role is important in the protecting the injured athletes. They're great advocates for each other."

Arizona is also emphasizing education on concussions.

All incoming student athletes are required to take an hour-long online course called the "Brainbook" and coaches are required to take two courses on the National Federation of State High School Association's website. One is general knowledge for coaches and the other is specific to concussions.

Eric Leonard, athletic trainer for Winslow High School, said even though he has educated many students and coaches on the effects of concussions, he too thinks more education is necessary.

Concussion: its long-term effects

"A lot of people don't see the long terms effects of it. A kid can have a concussion and be fine in a week; they can't see the long-term repercussions," Leonard said. "I think a lot of people are still new to the idea. They need more education about it, more knowledge about what exactly is a concussion first of all, then what is the treatment for a concussion."

In his eight years with Winslow, much like Waters, Leonard has found that the number of concussions reported has increased, and for similar reasons.

"I would say it has increased, just because kids are more aware of it -- they are coming to me and saying, ÔI need to get checked out,'" he said.

However, athletes alerting coaches of a possible concussion is not enough.

Proper blocking techniques

Newcomb, who has been the Ganado head coach for four years, said after losing Boling and another player (who later returned to finish the season) to concussions he's recognized how important it is for coaches to be involved.

e said as a coach he's taken the responsibility of teaching his players how to properly tackle and block.

"When I played we used to get our bell rung and you'd be dazed for a short period of time but then you went back out there and played," he said. "I've always coached blocking techniques, not because of concussions but because of neck injuries. I didn't want to have people be paralyzed."

Waters commends those who teach proper techniques and have a conditioning program that better prepares athletes so they don't sustain extensive injuries.

She said if athletes are better able to protect themselves with the proper tools, all the better.

"The teams that have a really strong condition program will see fewer concussions than schools that don't," Waters said. "Teams that don't have that are at a higher risk."

According to the IOM report, there has been some evidence that enforcing rules and standards can help reduce the occurrence of sports-related injuries but there is still a question on whether that applies specifically to concussions.

"Though there is some evidence that rules and playing standards can affect the incidence of concussions in youth sports, there is a need for much more research on this," the report states.

The committee who wrote the report also recommended that the NCAA and NFSHS conduct evaluations to find if practice standards do in fact reduce sports-related concussions and others.

When speaking of prevention and protection, most are quick to refer to the football helmet for safety.

Sports helmets don't decrease risk

In the report, the committee found that there was little evidence that demonstrated that the design of a sports helmet reduced the risk of concussion. Though use of the helmets reduces risk of other injuries, there is no evidence specifically related to concussions.

United States Sen. Tom Udall (D-N.M.) and Chairman of the Committee on Commerce John D. Rockefeller IV (D-W.V.), who introduced the Youth Sports Concussion Act, S.1014, to protect young athletes from concussions by changing advertisement claims and pushing for improvements to sports equipment safety standards, said the information from the report is a step in the right direction for their campaign.

"While we can't reduce every risk, we should do everything we can to stop misleading advertising that gives parents a false sense of security. I'm glad to see today's report, which provides a level of unbiased and authoritative information on this issue," Udall stated. "I hope we will be able to build on this information to ensure young athletes in New Mexico and around the country are competing in the safest environments possible."

As a coach, Newcomb said he's never relied on helmets or equipment to fully protect his players. He said his program used Riddell helmets because Riddell is the "longest continuous helmet company around," and he trusts them. He added that it's not the helmets the parents or players need to trust, it's him, as a coach.

Which is why Newcomb recommends all football coaches educate themselves, their athletes and parents about the concussions and how to properly protect and tend to them.

"Educate yourself on it, what are the signs, what are the symptoms," he said. "Take all the proper precautions, take every injury seriously. Do your part as a professional to educate yourself of the safety issues surrounding concussions."

Because if you don't, you could end up with another Darrell Boling who thinks he is OK.

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