News and Opinion from Sisters, Oregon
Football is a contact sport, and injuries are always a possibility. Over the past few years, more and more concern has been raised over the immediate and long-term effects of concussions on the health and well-being of players.
At a recent Outlaw Ladies Football Clinic, Dr. Robert Collins of Sisters offered up two key points: It is critical to be alert to concussions and operate a good protocol to deal with them; and, with proper care and attention, high school football and other sports can be safe.
"First, it is important to understand that the increasing number of NFL football players developing chronic traumatic encephalopathy (CTE) does not relate to sports in high school per se," Collins told The Nugget last week. "The youngest pathologically documented case of CTE was a 25-year-old. However, he had played tackle football starting at age six, had his first concussion at age eight, and approximately every year thereafter. CTE is caused by repetitive head trauma over 15 years. Coach Neil Fendall has led an effort to eliminate tackle football in Central Oregon before seventh grade, and his coaching staff teaches safe methods for tackling."
While football has the highest profile when it comes to injury, other sports carry risks, too.
"Concussions occur in all high school sports including soccer, basketball, volleyball and even cheerleading," Collins noted. Twenty-five percent of graduating student athletes will have had a sports injury removing them from the game, the majority being trauma to an arm or leg. Five to eight percent will have had a concussion.
"But here's the rub: it's easy to recognize a twisted ankle - pain, disability and swelling. Injury to the brain causes no pain or swelling, and disability requires special testing of cognition and memory. The athlete sustaining a brief concussion is often unaware anything has happened."
When an athlete sustains a concussion, Collins notes, "head trauma causes the pathways in the brain's white matter to stretch, twist and turn.The electrical fibers in these pathways simply 'short circuit' and turn off. In most cases the circuits turn back on in a few seconds, except for the most vulnerable circuits that serve attention, cognition and memory."
The key to preventing long-term harm from a concussion lies in vigilance. Players, coaches and parents all need to be aware of symptoms and alert to the potential of injury. The great danger with concussion is that a concussion goes unrecognized, an athlete continues to play, and suffers a second concussion in quick succession. That, Collins says, can be "catastrophic," leading to the potential for significant long-term effects.
"For parents, a student athlete may come home after practice and say nothing, but seem subdued, dizzy, skipping dinner and homework," Collins said. "These can be warning signs, and the student needs to be tested."
The Outlaws have a concussion protocol as is required by state law. Recognizing that a concussion has occurred should be a priority for everyone associated with the sport. If a possible concussion has occurred, the coach must remove the player and a trainer administer a test to determine if a concussion has occurred. If a player has sustained a concussion, family and the whole school community must help that athlete to rest - cognitively, physically and emotionally - and recover. The athlete can follow a gradual return-to-play protocol and return to activity once a health professional signs off.
"Every student's concussion is different," Dr. Collins noted. "Many will be back to normal by two weeks where full exertion produces no symptoms. A minority will have symptoms that last months - called the post-concussion syndrome. This can alarm parents, but the treatment is the same: rest by reducing work load. The protocol is the same as for a twisted ankle. The brain needs protected time to rewire its circuits - and eventually it will."
At the recent football clinic, members of the Bend Rugby Club - who play that sport with no helmets - demonstrated tackling techniques that are designed to minimize head-to-head contact. Such tackling techniques - avoiding the use of the head - are being adopted in football, which is also imposing strict rules against helmet-to-helmet contact.
"New designs in helmets, tougher rules against 'heading,' new coaching techniques will all continue to change how sports will be played," Collins said.
"Should a student play a sport, or return to play after an injury? These questions can only be answered by parents and family. It is a risk vs. benefit analysis. It's important to stay informed year by year of the risks. And it is important to fully appreciate the benefits. In Sisters schools, the coaching attitude is that athletics are simply a subject that is taught in special classrooms - gyms and fields. The lessons are in physical conditioning, work ethic, teamwork, obeying rules, dealing with adversity, celebrating success with exuberance and grace. In these classrooms students make lifelong memories and friends."
Each year, the Sisters School District steps up its efforts to educate and train coaches, athletes and parents to minimize the risks of participating in sports so that the student athletes can maximize the social and academic benefits associated with participation.
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