If awareness of head injuries had been as focused six years ago as it is now, parent and tennis coach Brice Brenneman says he might have worried more about the three sports concussions his son suffered while in high school.
“The first one was a routine heading in soccer,” Brenneman said. “He came home, got sick, fell asleep. The first one the doctors treated as a fluke.”
The second and third concussions were treated more seriously, leading physicians to recommend he wear a foam padded helmet to play sports.
What the three incidents had in common was that heading a ball in soccer or colliding with a player in football are routine incidents in sports. Most players head a ball and never have a problem. Brenneman wonders now if physicians today would have recommended his son stop playing.
“Perhaps today we are more cautious than we were then,” Brenneman said.
Awareness of head injuries has increased to the point that three years ago, the Ohio High School Athletic Association began requiring students to have a physician’s permission to return to play or practice after showing symptoms of a concussion.
This year, the Ohio Legislature followed suit, passing House Bill 143, making it a law that coaches and referees are responsible for taking students out of games when they show signs of concussion.
The National Federation of High School Associations announced Monday that 700,000 coaches and others involved in high school athletics have taken their course for recognizing concussions in only two years.
According to the Center for Disease Control, concussions are among many traumatic brain injuries young athletes can experience and can lead to lifelong impairment in memory, behavior, learning and emotions.
During the last decade, emergency treatments for traumatic brain injuries for youth in sports has increased by 60 percent, mostly in bicycling, football, basketball and soccer — rates are highest per athlete in football and girls soccer.
Wapakoneta City Schools Athletic Director Brad Rex said not only does the state has safeguards they put into place when it comes to a student and a sports injury, but the school especially has safeguards they put into place, too.
One example is the software Wapakoneta City Schools has been using for the past three years.
“When a student comes in as an eighth-grader or freshman to play football, or another sport, we put them through software,” Rex said.
ImPACT software gives a baseline of a healthy student and was purchased by St. Rita’s Medical Center and donated to the school.
ImPACT provides computerized neurocognitive assessment tools and services that are used by physicians, psychologists, athletic trainers, and other licensed healthcare professionals to assist them in determining an athlete’s ability to return to play after suffering a concussion, according to impacttest.com.
The student will take the test before they begin their sports season, and if an injury occurs, such as a head injury or concussion, they must take the ImPACT software test again and have passing results to continuing playing.
“To be able to play again, they must be cleared by three things, a doctor, an athletic trainer and the software,” Rex said.
ImPACT software is used for players who participate in contact sports — including football, soccer and basketball — and is not used for participants in cross country or track.
Coaches along officials are trained to detect concussions and other sports related injuries.
“If an official believes the student has a concussion, they have to take them out of a game,” Rex said.
From here, the coach should advise the student to see the athletic trainer. The student must be cleared by either a physician or the athletic trainer to be able to play again, as they will have to sign off on the student.
Wapakoneta City Schools Athletic Trainer Robb Williams said that technology has advanced, and applications, such as ImPACT, can give immediate evidence of a concussion.
“We are more cognizant of clinical skills,” Robb Williams said. “Wapak has utilized ImPACT, which is the same system most colleges and major league teams test their players with.”
Williams said the test is composed of short- and long-term memory skills, colors, matching, letters and numerals used to assess the student.
With being able to diagnose a concussion through new techniques the OSHAA is mandating, there is less of a margin of error.
“Because of St. Rita’s and because of Wapak and their athletic trainers and coaches, we don’t have that margin of error,” Williams said when it comes to diagnosing a concussion.
Through the ImPACT software and the training the coaches and athletic trainers receive, this reflects on athletes, as they will learn and pick up the signs and symptoms of a concussion.
A few symptoms of a concussion that Williams said are especially evident after a hard hit to the head are a headache, sensitivity and postural sway — where a player looks like they are moving around, or swaying, because they cannot maintain posture.
Last year, the OHSAA began keeping track, giving Ohio as a state a look at where athletes are suffering injuries, OHSAA spokesman Tim Stried said.
What the numbers revealed was that, at least in Ohio, football is not the worst offender when it comes to concussions. Wrestling had the highest number of concussions at 111, and football came in second at 102. All other sports, statewide, had 25 or fewer head injuries.
As for why wrestling had so many head injuries, Stried said the cause was undetermined. It could be that wrestlers are getting bigger or stronger, he suggested, or they could be hitting the mat with a lot of force.
Stried said the key to preventing injuries going forward won’t be about legislation, it will be about coaches stressing the fundamentals.
In football, that means teaching students to keep their heads up when they tackle.
“We’re also trying to make everyone aware that student needs to come out immediately, whether or not they have a concussion,” Stried said, noting students should only continue play once they are cleared by medical personnel. “Sustaining one (concussion) is not typically life threatening.”
St. Marys Athletic Director Doug Spencer also brushed upon the topic of concussions.
“This is definitely an important topic that’s been generating a lot of interest with the increasing number of concussions,” Spencer said. “Some you just can’t prepare for.”
He said coaches are required to get their sports medicine certification and any new information that comes along, he forwards to those coaches.
In addition, the district goes through a lot of expense to prevent injury. Every helmet costs $200, and every year the district pays $5,000 to re-inspect and recondition the equipment.
One hurdle in tracking how prevalent the injuries are is the lack of a tracking system broken down by sport for how many concussions athletes face each year.
Amy Brown, St. Marys Memorial High School trainer, said school officials do everything they can, but not all concussions are preventable or life-threatening.
“When we were kids, they’d tell us, ‘Just shake it off,’” Brown said of the changing regulations. “Now, we know there’s greater risk of problems down the road.”
She said some of what appears to be an increase in concussions is actually probably because of increased awareness of the symptoms, and therefore, more students getting treatment.
Even with proper training, however, recognizing a concussion is difficult. In her time with the school, Brown said she witnessed multiple concussions, but for one softball player, the only symptom was a headache that persisted for weeks.
Other symptoms for players can include lightheadedness, dizziness, visual problems, and “seeing stars.”
As for what might be the next step in preventing concussions, Brown said she doesn’t know what that would be.
“Believe me, if a specific football helmet prevented concussions, everyone would have it,” Brown said.
Brown noted referees and coaches are doing a better job pulling students out of play when they show symptoms, but there’s no way to know when it will happen.
As for Brenneman, his son has no lasting effects despite three concussions, and he said he’s glad his son had the opportunity to play the sports he loved.
“He never did head a ball again, though,” Brenneman said.