A head-hitting issue
Jul 21, 2015 at 11:53 AM
"I was watching from the stands, and I could tell something wasn't right," Becky said. "I could tell he was trying to avoid head balls.”
She immediately asked Spring Lake athletic trainer Adrienne Hubbard to check him out.
The first time Adam hit heads with the opposing player, he’d kept playing. The second time, he couldn't shake it off.
"I got a headache and started to feel a little nauseous," Adam said. "The headache started to get worse, and I told our trainer about it. She sent me to the emergency room that night and they pretty much said I have a regular concussion."
A concussion. For years, the word carried little weight, and people paid the injury little attention. But now, as people learn more and more about the terrible long-reaching effects of these brain injuries, parents, coaches and officials take concussions much more seriously.
No longer do coaches send their players back into the game moments after getting their proverbial bell rung. These days, the moment an athlete at the high school level suffers a head injury, they are immediately pulled out of the game and kept out until they clear an elaborate evaluation.
A HARD INJURY TO HANDLE
Adam has suffered countless injuries during his years of playing soccer, basketball and baseball.
Sprained ankles and broken bones are easy enough to understand. A concussion, the 18-year-old said, is different.
"Frustrating is the best word for it, because you're sitting out, and it's not like your ankle hurts and you can't play," he said. "It's a very serious injury, but it doesn't feel like it."
A concussion is defined as any minor traumatic brain injury. Athletes are especially susceptible to the injury in impact sports such as football, hockey and soccer.
Hubbard knows about concussions all too well. She suffered one in college — the result of a fall. Despite the fact that she was well into her athletic training studies, she didn't recognize her own symptoms.
"I just sat there stunned, then got up, said, 'I'm good,' and went to Chi-Chi's with my friends," she said. "Then I went home and promptly got sick. I had a headache for a few days.
"Six weeks later, I was in the hospital because I couldn't sleep and I was failing a class," Hubbard continued. "They asked the right questions and found out I fell on my head six weeks ago. I felt stupid. Here I'm an athletic trainer, and this is Concussions 101, but I never thought about it."
So now when her students suffer concussions, Hubbard doesn't mess around. She makes sure they're fully recovered before they return to action, and that they realize exactly why they're sitting on the sidelines, despite the fact that they "feel better."
"I try to tell them, 'Listen, kid, I know you don't think anything's wrong, but this is your brain. This is what's going to get you through life,'" she said. "This is two weeks out of your 75 years on the planet — or, with a player like Adam, who's going on to play soccer at the Division 1 level, two weeks out of your very long soccer career. You have to sit down and make sure you're healing correctly if you don't want to have permanent problems."
Hubbard uses examples of high-profile professional athletes to drive her point home.
"I go extreme," she said. "Look at Muhammad Ali. Articles state that the blows he took to his head have contributed to his condition now."
That's the biggest issue with concussions — if you suffer a second head injury while still recovering from the first, the results can be catastrophic.
"Especially when it's related to the NFL," Adam said. "I watched the movie they made about it, and these guys can't even talk anymore. I don't want to end up like that."
DIAGNOSING THE PROBLEM
Both Grand Haven and Spring Lake schools have come up with stringent guidelines as to what happens when a player suffers a head injury.
At Grand Haven, athletic trainer Patrick Wykes or a member of his staff is at every home athletic event, and he's always on the lookout for head injuries.
"If I'm at a football game and I see a big hit, and I see the classic symptoms — grabbing the head, shaking the head — we start talking with the athlete," he said. "The first thing I ask is orientation-wise. I'm asking them what's the score, who are we playing, what day of the week is it? Just to see if they're oriented. Then I'm looking at the neurological symptoms, where we're doing the finger tracking, the sobriety test, have them touch their nose."
Wykes explained that there are 12 cranial nerves that control certain functions such as eye movement, smiling and even smell.
"I'm testing to see if all of those things do what they're (supposed to be) doing, and also checking their pupils," he said. "That's when you see the flashlight, checking to see if the pupils are equal and reactive to light."
Wykes then tests the athlete’s basic balance and motor skills, such as standing with his or her feet together.
Further tests include cognitive questions — can you do the months of the year in reverse order? Count backward from 50 by sevens?
"I'll also do some short-term memory stuff,” he said. “I'll give you a list of words, then ask you to repeat them in five minutes.”
A player who's suffered a head injury of any kind can expect to miss, at a minimum, 20 minutes of action while Wykes checks them over.
"If their (eye) tracking is smooth, their balance has no problems, they remember who we played last week, what the score was, then you know they're OK," he said. "A handful of times, I've started an evaluation and said, 'Yeah, you're OK' — but I keep a close eye on them, and tell them every time they come off the field, come see me."
Wykes said he saw between 20 and 25 concussions at Grand Haven last year — an average number, he said, for a school with 400 student-athletes per season.
Hubbard — in her first year as Spring Lake's trainer — said she's seen six cases through the recently completed fall sports season.
A LONG ROAD BACK
If an athlete is diagnosed as having a concussion, game play is out of the question for at least a week or two. Adam sat out almost two weeks following his mild concussion.
Grand Haven senior Abby Cole, one of the top volleyball players in the state of Michigan, was knocked to the ground during a volleyball match this past fall and hit her head so badly that she can't recall details of the evening. She was prohibited from playing for about two weeks.
In order to get back into action, student-athletes at Grand Haven and Spring Lake first have to pass an online test. Grand Haven uses a program called HeadMinder; at Spring Lake, it's called Impact.
The grant-funded program costs about $750 a year.
"We log the kids in and they go through a six-piece test," Wykes said. "It tests their reaction time, short-term memory, pattern recognition, things like that. It's just looking at how the brain is firing. Every athlete at the varsity, JV and freshman level takes it — although we prioritize starting with high contact sports."
In the event that an athlete suffers a head injury, he or she re-takes the test after their symptoms have gone away.
Once an athlete passes their online test, they move on to the B.R.A.I.N. Protocol, which was developed at the University of Michigan. It stands for Bike, Run, Agility, In red and No restrictions.
"Passing HeadMinder is just one step in a series of steps to get back," Wykes said.
In the B.R.A.I.N. Protocol, an athlete starts with 10 minutes on a stationary bike. If he or she feels dizzy at all or if they develop a headache, they immediately stop and re-try that test the following day.
After passing the bike portion, athletes move on to 10 minutes of running, then agility work away from the team. If all goes well, they can return to the team "In red," which means they're held out of contact.
"Once they go through that with no issues, then they're released into full practice with no restrictions," Wykes said. "So you can see, it's normal for someone to sit at a minimum of five days. It's a process, and research shows the younger the patient, the longer it takes to recover."
Adam wore a piece of protective headgear when he returned to the field for the Lakers.
"I was a little apprehensive when I went back out there," he said. "I'd say I had it in the back of my mind for one to two games. The headgear gave me peace of mind. I felt like it did a good job of protecting my head.
"I've been lucky," he added. "I haven't had anything happen since then."
Some athletes aren't as fortunate. Wykes said he's dealt with youngsters who have taken six months or longer to recover from a concussion, and it affects much more than their athletic career.
"We've had kids take months and they're still symptomatic, having trouble concentrating in classes," he said. "It's just one of those things where everyone is different."
Wykes said that through improved education, he and other health care professionals are working hard to get people to realize just how serious concussions can be.
"There's no such thing as getting your bell rung,” he said. "That kind of old-school thinking is troublesome, and we're trying, through education, to show that if you have enough force and energy going through your brain, that causes those synapses to short circuit; that's not good. That's a head injury, and your body's going to respond to that."