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Concussions in high school

By Mike Ciarochi mciarochi@heraldstandard.Com 5 min read
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Roberto M. Esquivel|Herald-Standard

Mark Pohlot, athletic trainer at Connellsville Area High School, says his school treats athletes for concussions even if the injury occurred outside the sports arena. “Some were from car accidents, some were from other non-sports issues, like bumping your head,” Pohlot said. “If they are an athlete here, we treat them regardless of how the concussion occurred.

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Roberto M. Esquivel|Herald-Standard

Mark Pohlot, athletic trainer, poses for a photograph in the newly constructed athletic training room of Connellsville Area High School.

Editor’s note: This the first in a three-part series.

Concussion is defined by the Oxford American Dictionary as “an injury to the brain caused by a hard blow.”

But that is from the 1980 edition. In October 2012, the American Medical Society for Sports Medicine issued a position statement that defined concussion as “traumatically induced transient disturbance of brain function and involves a complex pathopsychological process. Concussion is a subset of mild traumatic brain injury which is generally self-limited and at the less-severe end of the brain injury spectrum.”

To the layman, a concussion is a brain bruise. Most of us know how long it takes for a bruised arm to heal and recognize the discoloration of skin as a sign of healing. But a brain bruise? What do we look for, if anything?

To athletic trainers, coaches, athletic directors, parents and athletes, the definition can’t begin to explain what happens next.

Symptoms can vary, but almost all concussions come with headaches, blurred vision and nausea. These symptoms may diminish over time, but they also may return or intensify if the athlete is not treated medically.

Even then, there are no guarantees.

Also, there is no way to prevent a sports concussion, short of not playing. Even not playing a sport can’t guarantee one will remain concussion-free.

“A large number of concussions are not sports-related,” said Dr. James Gyurke, chief marketing and sales officer of imPACT Applications, Inc. “Living will produce concussions, be it from a car accident, a fall at home, anything that involves the head or brain. The body is not built to sustain hits to the head.”

In fact, many athletic trainers treat athletes who have suffered concussions away from their sport or sports.

Mark Pohlot has been the full-time athletic trainer at the Connellsville Area School District since 2000. He estimates that he treated close to a dozen athletes for concussions incurred during sporting events in the recently completed 2013-14 school year. In the same time frame, he estimates that as many as 20 athletes were treated for concussion symptoms not caused by athletic activity.

“Some were from car accidents, some were from other non-sports issues, like bumping your head,” Pohlot said. “If they are an athlete here, we treat them regardless of how the concussion occurred.”

Recently, a new helmet for football was released by a company called Simpson-Ganassi Helmets that claims to “help reduce concussions” and thus, “revolutionize the sport.” The helmets are making their rounds and may even show up on a few high school sidelines, but by and large, neither Gyurke nor other experts in the field are willing to endorse this or any helmet that claims to reduce the instance of concussion.

“Today, we haven’t seen any technology in helmets or mouth guards that prevent concussions,” Gyurke said.

Ah, yes, the treatment.

The first step is removal from the field or court. Next, an athlete must go to a doctor and be cleared by the doctor before returning to his or her sport.

In most cases, once a doctor gives an athlete clearance, it will be at least three or four days before the athlete returns to play in a game. There is a protocol that needs to be followed by the trainer before they can allow the athlete to resume play.

But this treatment is part of a relatively new pattern in concussion treatment. It involves baseline tests that school districts must purchase and administer to athletes prior to their seasons.

Tina Haky was the athletic trainer at Geibel Catholic High School for 17 years and routinely administered baseline tests there since 2004.

“It’s all on a computer,” she said. “We test every athlete on every team from seventh through 12th grade. The test has a two-year life span, so we would give the baseline tests in seventh, ninth and 11th grades. It’s basically a test of memory and reaction time.”

“No one’s ever the same,” said Duane Dupont, Albert Gallatin’s athletic director and wrestling coach. “We give them the test. Once they suffer a concussion and they are cleared by a doctor, they have to take the test over again and the trainers can tell where they are in their recovery.”

“The biggest thing is to make the public aware,” said Mike Hill, athletic trainer at Albert Gallatin. “Everyone has to recognize the symptoms so we can get athletes healthy before they return to play.”

“It’s hard to imagine, but what we did 10-15 years ago is contrary to what we are trained to do today,” said Phil Pergola, athletic director at California High School and boys basketball coach at Ringgold. “They used to tell us to keep them awake, but now we’re supposed to keep them calm and in a dark place.”

The headaches can be excruciating, similar to migraines, but more intense and not as predictable. Physical exertion can trigger a headache, but the headaches are not triggered only by physical exertion.

It is believed that the theory of keeping concussed athletes awake kept them from going into a coma, but now calming the athlete helps him or her relax and begin the process of getting back to normal. If you have ever experienced a migraine, you know the benefits of darkness over bright light.

Most school districts in the area, but not all of them, incorporate baseline testing into their concussion treatment. The next segment of this series will examine which ones do, which ones don’t and the cost involved in baseline testing.

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