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Concussions: the cost of competition

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Concussions: the cost of competition

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Recent research on concussions has illuminated the dangers of repeated head trauma. Now, high school football programs have to find new ways to combat the dangerous consequences of the sport.

Written by Noah Parker
Photos by Thomas Forman

Senior Pablo Gaeta came out of the huddle eager for the chance to get his team a much-needed win. The call: an outside pitch to Gaeta, who would turn and run the ball upfield. The Tigers adjusted their positioning and snapped the ball. Gaeta started moving laterally, watching the ball drop into his hands. A split-second later, he found himself on the ground, dazed and disoriented, having just been leveled by the opposing defensive end. Gaeta had just suffered a concussion.

This would be his fourth concussion in his first two years of playing high school football. The migraines that resulted caused him to quit playing during his junior year for fear of further injuries.

“I had developed a bad migraine problem which prevented me from physically going out to play,” Gaeta said. “I didn’t want to make it any worse by getting hit again.”

Gaeta is not alone in his struggles with concussions. Millions of teenagers suffer devastating hits leading to concussions while playing sports, including various student-athletes at SPHS. The effects of a concussion can be worse for teens than it would be for a fully developed brain. Based on research from Dave Ellemberg and the Journal Brain Injury, a traumatic hit can cause prolonged short-term memory loss, which can last for over six months in younger brains and severely affect a student-athlete’s ability to perform in class.

These concussions aren’t just happening during the heated competition of games. In fact, high school football players are more likely to suffer a concussion during practice than in a game. According to a 2015 study, 58% of high school football concussions occur at practice, an alarming rate considering the avoidability of head injuries on the practice field. Practice is supposed to be an important time for players to develop skills and learn proper tackling techniques, such as tackling with their heads up to avoid injury. Yet for many players, these lessons aren’t doing enough to prevent head impact.

“They always teach you to lead with your shoulders and keep your head up,” Gaeta said. “I would just sometimes get carried away and do my own thing.”

For senior Chandler Bullock, the time to work on proper tackling was also the time when many of the unnecessary and dangerous hits occur. Bullock suffered his first and only concussion of his high school football career during practice his junior year. Not only did Bullock sustain the concussion outside of an actual game, but the hit that caused the concussion came from one of his own teammates.

“I just think it could have been prevented,” Bullock said. “I felt different about football after that.”

Anthony, who requested not to have his real name used, also received a concussion at practice during a hitting drill during his sophomore year. Instructed and supervised by two junior varsity coaches, he paired up with another teammate; the two players ran at each other and collided headfirst. Immediately after, Anthony’s vision went black, and he started to see white dots. He knew right away that he got a concussion.

“At first I didn’t know what was happening… But when you get your bell rung, you kinda tell,” Anthony said, standing outside of the weight training room.

Anthony took a short break, threw up, and soon after returned to practice. He didn’t seek a diagnosis from a professional, instead recognizing the signs of a concussion himself. Over-the-counter pills helped relieve Anthony’s excruciating pain while he sat out of practice for a few days. Soon enough, he recovered, keeping the injury under wraps.

 

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A looming threat

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Although never diagnosed with a concussion, senior Matthew Walker has seen the dangers of football first-hand. Playing the positions of linebacker and tight end, Walker both causes and receives the kind of collisions that cause concussions. From his time on the front lines, Walker recognized the brutality of the sport and the risk that comes with playing.

“A lot, hundreds of times, people take hits to the head every play,” Walker said.

To many, this estimation may seem inflated. Yet the nature of football encourages pain; its foundation rests on a player’s ability to dish out bone-breaking hits, and studies back this unwritten verdict. According to the journal Neurology, the average high school football player will receive 500 hits to the head in a single season. Most of these hits will be sub-concussive and go unnoticed by players, coaches, and parents. However, the combination of all these hits, plus the appearance of a couple of concussions, can have deadly effects.

The short-term effects of concussions are both identifiable and treatable, but it is the long-term consequences that are the most damaging. Depending on the severity of the collision, a concussion can induce headaches, memory loss, dizziness, nausea, and may prompt a trip to the hospital. Especially for a developing, adolescent brain, the hard-to-notice long term effects are what is most concerning.

Chronic Traumatic Encephalopathy, or CTE, is the culmination of hits to the head over the course of an athlete’s career, regardless the level. A recent study published on Wednesday, January 18 by Neurology found that even routine hits to the head can cause CTE. The brain trauma caused by these collisions result in the degeneration of the brain tissue and abnormal protein and calcium deposits, causing memory loss, confusion, aggression, depression, impaired judgement, and dementia. Of the 111 former NFL players that have been evaluated for CTE postmortem, 110 have tested positive for the degenerative disease.

CTE has also been found in players who haven’t logged as many hours on the field as professional athletes. Michael King and Peter Grant, who only participated in contact football in high school in their midwestern towns, both committed suicide after slowly deteriorating following a couple of concussions and countless hits as a teenager. They are among the 20% of former high school football athletes who have been found to have CTE after death in studies conducted by the Journal of American Medical Association.

Despite the increasing spotlight of the dangers of football, high school organizations have done little to update protocols. Diemha Hoang, a rehabilitation and brain injury medicine specialist based in Long Beach, says it can take up to six weeks to fully recover from a concussion. Yet California Interscholastic Federation Southern Section protocol states that high school athletes may return to practice six days after showing no symptoms. But sending players back to practice prematurely can further compromise their health, as secondary concussions can cause even more damage to young brains.

Bullock, who suffered his concussion at practice, continued to partake in drills following the head-to-to head hit. Any subsequent head collision—even a small nick or congratulatory pat of the head—could have amplified the effects of the concussion and prolonged his recovery time.

“I took my helmet off and that’s when I started feeling sick,” Bullock said. “I practiced for a little bit [afterwards],” he added. “I knew something was wrong [so] I avoided getting hit in the head again.”

On-field protocols are just as vague. CIF SS standards state that a player may only return to play after being cleared by a “certified adult.” However, even loosely trained coaches are recognized as “concussion monitors.” In sports such as football, coaches are relatively well-versed in identifying concussions because of their abundance in the game.

“We do have that training in place and we take the side of being cautious over ‘they’re OK, let’s try to put them back in the game,” Jeff Chi, South Pas head football coach, said.

However, in other sports were concussions are less numerous or are not considered an issue, coaches may be unable to provide the necessary medical attention that a concussed athlete needs. This presents many problems, one of which is the coaches’ ability to identify concussions given a limited knowledge of the injury.

“Coaches have received training as far as identifying some of those symptoms,” SPHS Athletic Director Gregorio Luna said. “But, they are not qualified to diagnose.”

Another issue with coaches assessing their athletes is their possible bias, not wanting to lose important players from the game— a rampant problem in the NFL. The NFL has a on-field “concussion protocol” in which a player who is showing signs of head trauma must be cleared by a neurotrauma specialist on the sidelines before being allowed to return to play. However, many teams shrug these protocols and send their players back into important games with little to no repercussions from the league. In a time where winning means everything to many organizations and schools, some coaches take it upon themselves to keep their starting players in the game. And with an even more flexible protocol in high school sports, high school coaches have the ability to send concussed teenagers back into games.

Despite the continual occurrence of concussions from South Pas football players, coaches maintain that they keep player safety at the forefront of their concerns. At SPHS, coaches value player’s immediate safety over the final result of a game or a winning record.

[aesop_quote type=”block” background=”#2e2e2e” text=”#ffffff” width=”750px” height=”auto” align=”left” size=”2″ quote=”“This game is temporary…Your life and your head in not,” Chi said. “We as a coaching staff have to make a proper decision for these young guys in a time of emotional attachment to the game”” parallax=”off” direction=”left” revealfx=”off”]

 

 

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Finding a solution

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As the dangers of concussions are more understood, professional and collegiate organizations are have to deal with the unfamiliar player backlash. Professional players have followed the same path as Gaeta, quitting the sport entirely in fear of injury. For example, ex-San Francisco 49er Chris Borland, one of the NFL’s top rookies retired at the age of 24 in 2015, citing the long term effects of repetitive brain trauma as the main reason. Borland, who was scheduled to make $540,000 the next season, said that his love of the game was not worth the risk of effects of brain injury later on in life.

However, there was one major difference between the two cases of Borland and Gaeta. Borland felt educated enough on the issue to make his life-altering decision. Gaeta, on the other hand, feels as if they isn’t enough discussion of the topic on the high school level.

“I feel like [concussions] should be discussed in a more open and serious way because a lot of the players might not know the long-lasting effects that these hits can make,” Gaeta said.

Luna agrees with Gaeta on finding more ways to educate the South Pasadena community and SPHS students on the dangers of head injuries in sports.

“I think that we can never do enough to inform people,” Luna said.

Beyond education, there are multiple strategies that SPHS can implement to help protect their athletes from the dangerous effects of brain injuries. New advances in technology and medicine have spurred the development of strategies that can be implemented to mitigate the damages of head to head contact. Technologically savvy helmets are now able to detect concussions, removing the human error in trying to determine if a player has a concussion. This can help coaches and trainers better identify concussions in athletes, while also removing the ambiguity of in-game protocols. It can also give the school more reliable data on football concussions at the school. Although the athletic department keeps track of the number of concussions, many players go without telling their coaches and trainers, similar to the unnamed player did. Advanced helmets can eliminate players’ dishonesty and get them the treatment they need to fully recover.

Other schools and organizations are also beginning to use smart robots on the practice field in an attempt to limit player to player contact in drills. Tackling robots serve mimic players as they move down the field, allowing players to train in near-game time conditions. These robots take a lot of the danger out of practicing, while also teaching them the necessary skills to stay safe during games.

Off the field, SPHS can apply new “cognitive tests” to help evaluate for concussions. As Hoang explained, all players would take an exam testing for basic memory and motor skills before the season begins. If a player is feared to have suffered a concussion during the season, they would be evaluated with the same test. The results would be compared with their previous test to see if they had suffered a concussion. This strategy is much more accurate than a mere visual evaluation.

All these things cost money, though. Money that the district doesn’t have, or is spending on other activities or amenities.

“It’s an unfortunate first question,” Luna said. “But it’s a question of budget.”

Luna and Hoang agree on this: the only way you can protect yourself is to not engage in contact. And in a sport that is built on big hits and toughness, that can be near impossible to do. The culture of football promotes injury-causing collisions and congratulates players for “dropping the hammer” on other athletes.

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Now a junior, Anthony looks back on why he hid the second concussion he received, this one during a game. “[It’s] more of like a confidence thing you don’t want the other team to see you as weaker,” one of the players said. “You wanna show them that you’re the bigger guy so you just play through it.”

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