By Marilynn Nash
The Eau Claire Area School District is ahead of the game in concussion policies. Even before the National Federation of State High School Associations (NFSHS)concussion rule went into effect for the 2010-2011 school year, the district held high standards.
Under the old rule, athletes were removed from a game if they appeared unconscious. The new rule requires removal from a game if any signs of concussion are present. Permission from a health care professional must be given in order to return to a game.
Eau Claire Area School District concussion procedures
“We have been on the leading edge of concussion care for several years for high school athletes,” said Lynn Reuss, licensed athletic trainer at Chippewa Valley Orthopedics and Sports Medicine and head athletic trainer at Memorial High School.
The district has used ImPACT testing since 2002, Reuss said, and was one of the first in the state to utilize it at the high school level.
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is a 20-minute test used to evaluate brain health before sports participation to establish a baseline and after an injury, according to the ImPACT website. Sports medicine centers, doctors, professional teams, colleges and universities, and high schools are clients of ImPACT.
A licensed athletic trainer is available at most practices and events, Reuss said.
“The athletes are evaluated by the athletic trainer and if it is determined that they have a possible concussion, they are removed from the game,” Reuss said. “They are then referred for further evaluation at a concussion clinic where a follow-up ImPACT test is done…They will be put through a progressive activity program and they must be symptom free before returning, in addition to [receiving] written permission from the physician.”
Since the stricter rule went into effect, there has been an increase in the number of concussions, Reuss said.
“Is it more awareness and better education of all involved in sports? Most athletes, especially high school athletes do not report that they have symptoms of a concussion when they actually do,” Reuss said. ”It’s [the increase] not necessarily due to the rules, but due to increased public awareness generated from higher profile athletes that is trickling down to the younger athletes. In our area and Wisconsin, in general, education about concussions has increased and that has helped athletes, parents, [and] coaches take more notice [about] the consequences of not reporting them.”
Over-reliance on protective equipment
Athletes tend to become careless when wearing extra protective gear, said Zorba Paster, Dean Care family physician, clinical professor in the Department of Family Medicine at the University of Wisconsin-Madison, author, and Wisconsin Public Radio show host of Zorba Paster On Your Health.
“My bottom line spin is that concussions are a serious problem,” Paster said. “Headgear reduces it but does not eliminate it. The real problem is soccer where no head gear is worn. Parents should be aware of this when their kids have symptoms.”
Reuss advises a balanced approach.
“There is no way to completely prevent concussions. They will occur in any sport at any given time,” Reuss said. “There are many factors that help, including wearing appropriate equipment that is in good condition, good neck and body strength, teaching the proper techniques for each sport, etc.”
The Centers for Disease Control and Prevention (CDC) reports that “as many as 3.8 million sports-and-recreation-related concussions occur in the United States each year.”
The CDC defines a concussion as “an injury that changes how the cells in the brain normally work.” The CDC advises coaches to watch for “a forceful blow to the head or body that results in rapid movement of the head” combined with a change in “behavior, thinking, or physical functioning.”
Another import term is Second impact syndrome, which is if a second concussion occurs without enough recovery time from the first concussion, brain swelling, permanent brain damage, and death can result.
Concussions affect young people more severely. They get concussions more often and take longer to heal than adults, according to the WIAA.
An Ohio State University study showed that the highest rates of concussions occurred in football and soccer. The study also found that the concussion rate for high school girls was higher than the boys. In soccer, girls received concussions from the ground or the ball more often than boys. Researchers suggest that girls have higher concussion rates because boys have stronger necks, and girls have a smaller head to ball ratio.
Keith Muchow said he was pulled from a high school basketball game when he was kid after receiving a concussion and chin laceration. Muchow said he felt lightheaded, couldn’t focus, and didn’t feel like his normal self. Muchow said he had two later concussions that he knows of, with no known lasting effects.
Muchow said that as a parent of a toddler he welcomes increased concussion awareness and stricter rules. He works as the assistant basketball coach and strength coordinator at the University of Wisconsin-Eau Claire.
“New information and awareness has caused more players to be willing to sit out games,” Muchow said. “It used to be that you were considered tough if you went back in the game. Now it’s considered dumb.”
Reuss adds that the well-being of the athlete has priority over any difficulty the team has when a valuable player is not allowed to play due to a concussion.
“Which is the bigger problem?” Reuss asked. “Having a star athlete participating with a concussion or concussive symptoms with a risk of sustaining second impact syndrome, which can be fatal, or the athlete missing the appropriate number of games to ensure his or her health for his or her lifetime?”