Colby Koontz can’t remember much of what happened during Northwestern State’s basketball practice Oct. 12, just two days after he returned to the court following a foot injury.
Teammates and coaches told him guard Zeek Woodley tried to evade the 6-foot-9 freshman forward while driving to the basket and ended up unintentionally elbowing Koontz in the mouth. A significant gash required 13 stitches on his lip, but that paled in comparison to a much more serious injury.
Coach Mike McConathy said Koontz never lost consciousness but looked “dazed” when he got up, and team doctors soon diagnosed him with a grade-one concussion, the mildest form of the traumatic brain injury. Over the next few days, he would experience some of the worst symptoms, including constant headaches and sensitivity to light and sound.
“It kind of sucked there for a while,” Koontz said while watching his teammates warm up for their game against ULM on Nov. 19. “It was awful.”
Even low contact sports put players at risk, and protecting the brain isn’t always as simple as wrapping it in armor and hitting the field.
Concussions aren’t just for football
Concussions are most common in football, according to NCAA reports.
The organization commissioned a study that showed the rate of 3.1 concussions per game per 1,000 athletes from 2004-2009 put football above all other sports, and NSU head trainer Jason Drury said the sport accounts for the majority of concussions for the school’s athletes over the last five years.
But the number of concussions occurring in other sports isn’t insignificant. Softball leads the way with more than double the concussions of any non-football sport at NSU, and one McGill University study even found 60 percent of college soccer players reported concussion symptoms during the season.
Specific NCAA numbers are hard to find and some concussions aren’t publicly reported, but the University of Pittsburgh Brain Trauma Research Center estimates more than 300,000 sports-related concussions occur annually in the United States. Northwestern State’s concussion policy notes, “there is a considerable amount of inherent risk in all athletics, not just football” and Drury said the protocol for returning to play doesn’t really differ.
“Obviously, it changes a little bit with the sport-specific stuff,” Drury said, referring to drills athletes go through before they’re fully cleared. “But pretty much everybody goes through the same thing. We don’t try to single them out.”
Awareness of brain injuries in other sports is growing, said Julian Bailes, the chairman of the Department of Neurosurgery at Northshore University HealthSystem Foundation and a Natchitoches native. He earned national renown for his work with Bennet Omalu on brain damage suffered by professional football players and will be portrayed by Alec Baldwin in the upcoming Sony film, “Concussion.” Omalu, played by Will Smith, is the central character of the movie.
Trainers must maintain constant vigilance since, Bailes said, they often stand “on the front lines” when it comes to protecting players. Some brutal hits or collisions leave no doubt, but it’s not always easy to tell if an athlete has suffered a concussion.
“People really don’t understand how subtle and unobvious a concussion can be,” said Bailes, who has been researching brain injuries for more than 20 years. “It’s not an injury that anybody can see. It’s what somebody feels. It’s subjective many times.”
Education is key
Bailes hopes unlocking some of the mysteries surrounding concussions could lead to more effective treatment, even though he said doctors have made more progress over the last 10 years in understanding brain injuries than they ever knew before.
The NCAA and NSU’s policies both state more than42 working definitions of concussion exist, and no two concussions are identical. NSU athletics director Greg Burke said in recent years they’ve taken a spot at or near the top of the list when it comes to “hot button sports medicine/student-athlete welfare issues.”
In May 2014, the NCAA and Department of Defense announced the launch of a $30 million, three-year study to track an estimated 37,000 college athletes. Its goals include finding out more about what causes concussions, why they affect people so differently and which treatment techniques are most effective.
Added emphasis began in 2010 when the NCAA made it a requirement for every school to establish a written concussion policy, and Burke said brain injuries were a “non-discussion point” as recently as 10 years ago. Today, they come up at nearly every meeting and rules have been changed to mitigate the risk, most notably in football, but also in sports such as hockey and lacrosse.
Earlier this month, the U.S. soccer federation issued new guidelines to ban heading, or hitting the ball with the upper part of the head, for players less than 11 years old and placed limits on headers in practice up to the age of 13. McConathy said he’s thought about what could be done for basketball, only to conclude it would be tough to make the game safer outside of wearing helmets.
Another key for the NCAA and medical professionals is ensuring players understand the risks, symptoms and consequences, which is why 25 percent of the funding for the study will be used for educational purposes. Drury and Burke said Northwestern State emphasizes concussions at virtually every team meeting, and their policy requires players to acknowledge they’ve read a fact sheet.
“A lot of times it’s teammates saying, ‘Hey, this person needs (to be) checked out,'” Drury said. “Or it’s that person that gets injured saying, ‘I’ve got a headache, I can’t focus, I’m dizzy,’ that kind of stuff.”
He works with administrators to ensure NSU’s concussion policies stay up to date, checking them against the latest research, NCAA recommendations, and peer institutions. Trainers are required to obtain 50 continuing education units over two years, and Drury said concussions always come up quite often at national meetings.
Keeping players safe the top priority
Competitive players and coaches always want to do whatever they can to help their team win, sometimes at the risk of an athlete’s health.
A study performed by the Chronicle of Higher Education in 2013 revealed nearly half of major college football athletic trainers have felt pressure from coaches to return concussed players to action. That’s why even though Bailes and Burke believe the growing awareness of the dangers of brain injuries make such pushback less likely, it’s still critical to have a concrete policy in place to ensure athletes don’t rush back into action.
“Don’t deviate for any reason,” Burke said. “No competition, no win is more important than the welfare and safety of the student-athletes.”
McConathy agrees and he’s happy to let the trainers handle health issues at NSU, which has been ahead of the curve on concussions since doctors Chris Rich, Jim Knecht and head trainer Ed Evans created the athletic department’s first written policy in 1996. Burke makes it a priority to ensure everyone involved clearly understands a policy that has become much “meatier” in recent years.
Education and baseline testing for every new athlete begin the process, making it easier for team trainers to diagnose concussions and determine when symptoms have subsided. If the staff diagnoses a player with a concussion, he or she cannot return to action that day and won’t be cleared until a series of six steps has been completed.
The six steps are: 1) no activity, 2) light aerobic exercise, 3) sports specific exercise, 4) non-contact training drills, 5) full-contact practice and 6) normal game play. Renewed tests shall follow every step, and each one should take 24 hours with athletes required to go back to the previous step should any symptoms occur.
Changes made to the policy in September include a “return-to-learn” protocol, since Drury said research shows simple tasks such as listening to a lecture or focusing on a screen can be detrimental to recovery. Koontz said he missed a full week of classes following his concussion and didn’t return to his regular academic schedule until almost two weeks after the injury.
For most concussions, the NCAA and Drury agree symptoms will clear up in between seven and 10 days. Other times athletes can return sooner, or as Koontz found out, recovery can take quite a bit longer.
He made slow progress at first before symptoms started to get noticeably better, but he wasn’t cleared for non-contact basketball activities until Nov. 20, more than a month after the initial injury. Koontz said he’s eager to get back on the court once he’s fully cleared after a long, harrowing process, though he acknowledged it would have been much scarier without the constant support of trainer Devin Thulin, as well as his teammates, coaches and teachers.
“They were supporting me all the way,” Koontz said. “They understand that the trainers and doctors know what they’re doing. We’ve been working to get better every day.”
When he finally makes his Demons’ debut, it will represent another small but meaningful victory in one of sports’ most urgent ongoing battles.
The most recent addition to NSU’s concussion policy, made in September, includes a ‘return-to-learn’ policy to guide when athletes may return to class. The policy requires them to follow these five steps:
1. Gradual reintroduction of cognitive activities (5-15 minute increments)
2. Homework at home (20-30 minute increments)
3. School re-entry (partial day and homework)
4. Full day of classes
5. Resumption of full cognitive workload
The most recent addition to NSU’s concussion policy, made in September, includes a ‘return-to-learn’ policy to guide when athletes may return to class. The policy requires them to follow these five steps:
1. Gradual reintroduction of cognitive activities (5-15 minute increments)
2. Homework at home (20-30 minute increments)
3. School re-entry (partial day and homework)
4. Full day of classes
5. Resumption of full cognitive workload
ORIGINAL ARTICLE:
http://www.shreveporttimes.com/story/sports/2015/11/27/i-dont-know-what-this-is/76312428/