A Heads up on Concussions

As concussion awareness is increasing, there have been changes in both attitudes and policies on how to deal with the risk of concussions

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Julianne Berry-Stoelzle

While helmets can help prevent more serious brain injuries, they do not help prevent concussions.

By Julianne Berry-Stoelzle, Iowa City High School

Everyone only has one brain, and protecting that brain can be a challenge. According to a study published in the journal Pediatrics, football is the sport with the highest concussion rates followed by girls soccer and boys ice hockey.

Nathan Bradford ‘23 has had three concussions from playing football—one each year from seventh grade to ninth grade. After his first two concussions, Bradford took about a week off from playing football before returning to the game he loved.

“I had a lot of people pushing me to [continue playing]. I enjoyed the game a lot, and I was getting better,” Bradford said.

However, after suffering from another concussion the following year, Bradford decided to stop playing football at the end of the season.

“It was a tough decision, but I valued my own brain over the game that I was playing,” Bradford said. “Playing this year would just not be worth the risk.”

It was a tough decision, but I valued my own brain over the game that I was playing. Playing this year would just not be worth the risk.”

— Bradford

A concussion is generally started by a blow to the head or whiplash that creates a bruise in the brain. That leads to swelling, and since the brain is contained within the skull, there is nowhere for the swelling to go, and the resulting pressure affects the brain. Symptoms can include trouble concentrating, feeling off-balance, blurry vision, seeing double, sensitivity to light, neck pain, fatigue, and trouble remembering things.

The Director of Primary Sports Medicine at the University of Iowa, Andrew Peterson, is also the head team physician of the Iowa Hawkeyes. He goes to football games with the Iowa Hawkeyes so that he can be ready to intervene if a player gets a concussion.

The main tool used to identify concussions is the SCAT 5, the fifth version of the Sideline Concussion Assessment Tool. It is included in an international consensus statement on concussion evaluation and management.

“Pretty much everyone uses [the SCAT 5] as their sideline concussion tool,” Peterson said. “It involves the symptom scores, balance test, some memory and concentration tests. You use that to really fully evaluate [if someone has a concussion].”

Concussion diagnosis is largely based on the symptoms of the athlete, and how they act during the testing. In the fall 2019 football session alone, the City High football team had 12 diagnosed concussions. The coaches are very aware of this issue and have measures in place to deal with both the risk of concussions and their treatment.

“All coaches are educated thoroughly. Every year the state requires us to watch more videos so we all know what to look for,” football coach Dan Sabers said. “The kids are [also] very well informed.”

Over the past few years, there have been multiple rule changes in the sport to help prevent concussions. One of them includes not allowing a player to use their head to strike another player. 

“There’s just been a lot of changes through my years of coaching,” Sabers said. “One of the more significant changes that I’ve witnessed is how we teach the game, how the rules have changed.”

The implementation of new rules preventing players from using their heads to attack other players requires new techniques for tackling and blocking. 

“You tackle with your shoulder,” Sabers said. “You keep your head out of the game, so that it’s never there when you block. Back when I was first coaching, the facemask was part of the block strategy that we taught.”

Another change is a state policy that limits the number of contact days for the football team during practice. This is to prevent multiple smaller hits, called sub-concussive forces, that can also add up to a concussion.

“Concussions can happen in any sport,” City High Athletic Director Philip Hansen said. “We’ve really done a good job of reducing that not only here at City High but also at the state level.”

General concussion awareness enables players to recognize when they have a concussion as well as notice the symptoms in their teammates. 

“[Dealing with concussions] is not just on one person. It’s on everybody,” Hansen said. “It’s the coach working with the trainer, working with other coaches, [and] other athletes just to make sure everybody’s on the same page.”

[Dealing with concussions] is not just on one person. It’s on everybody.”

— Hansen

Jen McHenry, the athletic trainer for City High, works closely with teams with high concussion rates such as football, but is also available for anyone who has a concussion.

“I think [the] kids overall do a pretty darn good job of taking themselves over to see Jen,” Saber said. “She’s something that is part of the game now. They know they can go see Jen at any time.”

When someone comes to McHenry about a concussion, the first thing she does is check the signs and symptoms of her pacient to see how severe the concussion is.

“Sometimes if you get hit in the head, you get a headache, no matter what, but that’s not necessarily a concussion,” McHenry said. “So we try to determine if there’s other signs and symptoms that are consistent with a concussion. And if there are, then we remove them from the game or practice.”

State law requires any student who has received a concussion to be removed from play for at least a day. In order to begin the Return-to-play process, an athlete has to receive a written medical clearance from a licensed care provider and be symptom free for 24 hours.

“It’s really hard because I can’t take an X-ray like I can on your broken arm. A concussion really relies upon the reporting of the person who got the hit, and how they’re acting, behaving, and seeming to the people around them,” McHenry said.

When something seems to be wrong, McHenry tends to err on the side of caution rather than have an athlete get injured further.

“Everyone wants our kids to be as safe as possible,” McHenry said. “We’re going to be very, very careful because you only have one brain.”

This story was originally published on The Little Hawk on February 26, 2020.