Two new mandates are changing the way concussions are treated in high school sports
By Lola Duffort
High school senior Michael Espinel, a defensive player for Belen Jesuit Preparatory’s football team, has suffered three concussions in two seasons.
In November 2009, Belen was practicing for the state championship semi-finals. Michael received a blow to the head during a drill, momentarily numbing half of his body.
“I felt like I was in a dark room, with a light shining in my face. My head hurt so badly,” said Espinel, then a sophomore.
He returned to the practice field anyway, and five minutes later he collapsed, unconscious.
Two pivotal new measures being rolled out in South Florida are intended to prevent scenarios like that.
The Florida High School Athletics Association (FHSAA), which governs high school sports throughout the state, is implementing new guidelines to keep athletes suspected of sustaining a concussion from returning to the field without a doctor’s OK.
In addition, high school students who play on interscholastic teams in Miami-Dade and Broward counties will take a baseline cognitive test in the pre-season to determine the extent of a concussion and monitor their recovery should they suffer a head injury.
Both changes are aimed at keeping injured players off the field until fully recovered, helping to prevent the cumulative effects of multiple concussions.
“Injuries on the brain, especially the ones that go untreated at a young age, have a much greater impact on society than we’ve been previously willing to admit,” said Dr. Kester Nedd, director of Neurological Rehabilitation at the University of Miami’s Sports Medicine Center.
“Beyond headaches and dizziness, any traumatic brain injury can potentially affect personality and interpersonal relationships.”
One such long-term consequence is Chronic Traumatic Encephalopathy (CTE), a degenerative brain disease, according to Dr. Ann McKee, head neuropathologist of a brain bank at the Bedford Veterans Administration Medical Center in Massachusetts.
“Multiple injuries on top of previously untreated injuries – that’s where the danger builds up,” McKee said.
Assessing a concussion’s severity and determining proper treatment can be difficult. When a kid takes a bump to the head, finer cognitive functions such as memory are usually the first to go and the last to come back, Nedd said.
The test being phased in for Miami-Dade high school athletes — called Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) — takes 30 minutes and is administered online. Test takers perform a series of tasks that measure cognitive functions such as memory recall, attention span, non-verbal problem solving and reaction time.
Once an athlete is suspected of suffering a concussion, an ImPACT retest is administered, and scores are compared. Along with a neurological exam, the results can aid a doctor in determining whether an athlete is fit to return to the playing field.
Nedd and his colleague Dr. Gillian Hotz, who run The Miami Project to Cure Paralysis Concussion Clinic at the University of Miami, have been pushing for years to have high school athletes tested.
The cost to individual schools — estimated at $600 annually — had stood in the way, but David Goldstein, an incoming junior at Ransom Everglades School in Coconut Grove, helped change that.
Goldstein, a soccer player, suffered his third concussion in four years in January 2010 in a head-to-head collision during district finals. He stayed in the game – and spent the next three months with incapacitating headaches and a loss of balance.
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