News From Terre Haute, Indiana

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December 4, 2013

Study looks at effects of concussions

FORT WAYNE — Austen Cummings sits in class and can’t remember what he’s supposed to focus on.

He doesn’t have a learning disability or an attention disorder. The Homestead High School sophomore suffered two concussions in the span of two months while playing football. The concussions have caused Cummings to blank out in class, at times for almost a half-hour.

“I’ll sit there for 20 minutes and realize ‘what am I supposed to be doing?’” Cummings said. “Those are the moments when I start to freak out about if I get another one.”

Precise numbers are hard to come by, but estimates considered reliable by those who treat sports trauma suggest between 43,000 and 67,000 high school football players in the United States are diagnosed with a concussion each year.

Concussion numbers may reach more than 130,000 when accounting for both diagnosed and undiagnosed cases, according to the Journal of Neurotrauma. A separate study by the Journal of Athletic Training revealed that about 53 percent of high school football players don’t report concussion-like symptoms.

The Indiana General Assembly passed a bill two years ago designed to better protect young athletes. In the next session that begins in January, Sen. Travis Holdman, R-Markle, plans to offer a bill to do even more.

But even those measures can’t protect athletes unless the players, coaches and parents work together to change a culture that celebrates hard contact and those who continue to play while hurt, health experts say.

The national conversation over the health of athletes was fueled by the NFL settlement in August, when the league agreed to pay a total $765 million to more than 4,500 former players. The deal provides benefits and compensation for players who developed brain-related health problems caused from football contact.

State-level data on football concussions can be difficult to find. The Indiana State Department of Health, Indiana Medical Association, Indiana Department of Education and Indiana High School Athletic Association do not record the number of concussions that occur in Indiana’s high school athletics, officials said.

“It is virtually an impossible task to track every concussive event, determine whether a concussion was actually sustained by the athlete, then record it in some fashion,” IHSAA Commissioner Bob Cox said.

Even without exact numbers, some say more needs to be done to protect young athletes.

In next year’s session, Holdman is sponsoring SB 372, which would require football coaches at the youth level to be certified in recognizing concussion symptoms and to know how to handle a child with a suspected concussion.

“The problem we have in Indiana is when you try to enforce the protocol at every level, you have to have a government agency or entity that is subject to the legislature to enforce the rule,” Holdman said. “With the concussion protocol the past two years, we can only control what is overseen by the IHSAA.”

Once a player is suspected of having a head injury, he or she must pass a battery of tests in accordance with the IHSAA protocol to re-enter the game.

IHSAA protocol states: “Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health care professional.”

If an athlete is diagnosed with a concussion, IHSAA protocol requires the person to sit out until receiving a written clearance, which is also requited by the Indiana law passed in July 2012.

The clearance must come from a licensed health-care provider who is trained at evaluating concussions and head injuries.

“The way the Indiana law is written, it is possible to have a same-day return,” said John Doherty, Munster Community Hospital concussion clinic director and Munster High School athletic trainer. “They’re trying to fix and expand that law now.”

Holdman’s law would require coaches who use taxpayer-funded facilities to be certified through USA Football’s “Heads Up Football” program. USA Football is a nonprofit educational and training program for youth football, supported by the NFL.

If Holdman’s bill passes, Indiana would become the first state to require coaches to be certified through USA Football. The certification would train coaches to teach their players how to prevent injuries.

“Parents that sign kids up [for sports] are given warnings that I feel are adequate,” Doherty said. “If you think that you’re going to play football and there’s no risk of serious injury, you’re fooling yourself.”

Cummings, 16, plays on Homestead’s offensive and defensive line and suffered his first concussion came at a football camp last summer.

The most recent one came at a practice on Aug. 14. Cummings ran downfield when he was blindsided by a teammate during a drill and was knocked out.

“They took me off the field and ran me through some tests,” he said.

“They look at your pupils, see how sound and light affects you. They check for dizziness and ask a few questions like what’s the date and where you’re at. They give you three words to remember and they come back like 10 minutes later and you have to repeat the three words.”

Cummings was out three weeks after suffering his second concussion. This time he and his mother, Brooke Haver, were more prepared to handle it. After his first concussion, Cummings waited a week before telling his mother about the injury. His second was diagnosed immediately, which enabled him to undergo rehabilitation right away.

His headaches and inability to focus in class continued to stress him out, and he missed several days of school. His grades slipped and he nearly flunked off the football team. At home, he spent most of his time in his room watching Harry Potter movies.

“He wasn’t his normal self after when he was at home,” Haver said. “He’s usually pretty active and he would only engage in things that were non-stimuli.”

His family spent about $3,500 on tests that Cummings had to undergo following his second concussion, his mother said.

Homestead football head coach Chad Zolman understands the serious nature of concussions and remains cautious with players even after medical clearance.

“We assume the doctor knows what he’s talking about, but we don’t want to put him back in blindly,” Zolman said. “We have to be careful not to put him back in too soon.”

Cummings’ desire to play is alive, but he can’t help buy worry about his future if he gets another concussion.

“It does worry me, especially when I read about what it can do later in life,” he said.

“There are some people that go on to be fine, but some people have serious long-term side effects. It worries me and I still feel like it could happen, but I go on trying not to think about it.”

D’Ambra, Henson and Mikesell are members of the Ball State Student Media.

 

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