WITH THE HEIGHTENED public awareness of head injuries in football serving as a backdrop, Dr. Bennet Omalu spoke candidly about concussions in youth football in late February at Beth El Synagogue in St. Louis Park.
Omalu is the doctor who dis-covered the connection between football concussions and the degenerative disease Chronic Traumatic Encephalopathy (CTE) while studying the brains of deceased National Football League players in the 2000s. Omalu, whose story was the focus of the 2015 film “Concussion,” starring Will Smith, pulled no punches.
“If you were out at a restaurant and a child at another table misbehaved, and his father repeatedly slammed the child’s head into the wall as a punishment, you would most likely call the police,” Dr. Omalu said to a packed house, drawing a connection to the dangers of youth football, when children slam their helmeted heads against one another.
Increased attention to the dangers of concussions in football has led to improved recognition and education for coaches and medical staff, according to a medical expert.
One local coach said the game is “probably the safest it has ever been.” However, some local medical professionals have called for the removal of football from schools, due to concussions.
Football concussions have been in the national spotlight recently. In April 2015, a judge approved the NFL’s $900 million settlement in a concussion lawsuit with thousands of former players. A top NFL official this year acknowledged a link between football and CTE, which the New York Times wrote for many “was an echo of big tobacco’s confession in 1997 that smoking causes cancer and heart disease.” And at the box office, “Concussion” documented Omalu’s struggle to bring to light the connection between football concussions and CTE, as well as the pushback he received from the NFL.
The concussion issue has carried over to youth and high school football as well. In high school, one in five athletes will sustain a sports concussion during the season, according to Head Case, a concussion awareness website. Forty-seven percent of all reported sports concussions occur during high school football. And 33 percent of high school athletes who have a sports concussion report two or more in the same year.
Dr. Nicholas Holmes, who specializes in sports medicine and concussion management at Twin Cities Orthopedics, said concussion recognition at the high school level has improved.
“Right now concussions get a lot of attention in the media and a lot of attention from coaches, so most people are better at recognizing it,” said Dr. Holmes, who also is the team physician for Park High School in Cottage Grove.
“Most places these days, the coaches have some kind of training and recognition,” Dr. Holmes also said. “I think that it’s certainly a lot better than it used to be. …”
New rules have been adopted in recent years for diagnosing concussions and protecting players who sustain them. In 2010, the Minnesota State High School League implemented a rule change from the National Federation of State High School Associations (NFHS), stating that athletes who show symptoms or behaviors of a concussion must be immediately removed from play and cannot return until cleared by a medical professional. In addition, the league’s protocol has a general rule: “When in doubt, sit them out.”
Baseline testing — which requires athletes to take an exam that measures their baseline brain functions — in high school sports also has become a more common concussion management technique. The MSHSL also recommends coaches, officials, students and parents take the NFHS 20-minute concussion course online.
But what happens once a player is diagnosed with a concussion?
According to the MSHSL policy, only a medical professional can diagnose a player with a concussion. If the player is diagnosed with a concussion, the player is removed from all competition for the remainder of the day.
The MSHSL policy also states that only a medical professional can clear the athlete to return to play. The policy includes guidelines for a step-by-step process for returning, in which the player must be symptom-free at each level to reach the next step. Each step requires a minimum of 24 hours.
Holmes said the average person takes one week to clear symptoms and get cleared to return.
Josh Zoucha, the head football coach at Minneapolis Southwest, said his team’s return-to-play protocol — which mirrors the MSHSL guidelines — includes a series of physical conditioning exercises “from very light to intense to see if they show any concussion symptoms over a series of four days.”
“If the athlete misses one day of the return-to-play protocol, it starts over,” Zoucha said. “If they show any symptoms during the testing, it stops until they show no signs and then starts over.”
Ian Baures, a senior at Minneapolis Southwest High School, is a former football player who quit the sport after suffering multiple concussions, he said. Baures said he felt pressure to return to play after his first concussion.
“There (were) a lot of ‘Are you ready yet?’ kinds of questions,” Baures said, “which pressured me into playing before I was ready.”
Zoucha said he could not speak about a specific situation involving a player, but said, “I trust our trainers to make good decisions about our players.”
Baures said he returned to play about three weeks after his concussion. When he suffered a second concussion, he decided to stop playing football, he said.
“Now that I look back on it, I’m very happy that I stopped playing,” he said.
Future of football?
Last fall, two University of Minnesota doctors recommended football be eliminated from schools across the nation, which would reduce pressure on students to play a sport in which many suffer from concussions, according to a Star Tribune article.
Not everyone agrees.
“I don’t think there is a need to get rid of high school football or sports at any particular level,” Holmes said, “as long as people understand the risks, and we have good education about what can happen and how you return to activity.”
Zoucha said the sport is “probably the safest it has ever been, especially compared to when I played, or even 10 years ago.”
“Safety has moved to the forefront of most sports,” he said.
Baures thinks differently about football.
“I think that it is a dying sport and should die soon,” he said. “Because no matter how much padding or new technology you put in a helmet, there is still a good chance that you can get hurt.”