Concussions in School Sports by Megan Fisher

The final 10 seconds of the game; you have time for one more play. The ball is snapped; the quarterback throws you the most beautiful spiral of his life. Then nothing. You wake up slowly. People are hovering around you, asking you questions you cannot remember the answers to. You have just received your first concussion. Head trauma, swelling of the brain, concussion- none of these are phrases an athlete wants to hear. Sports concussions are an epidemic in the athletic world, especially in high school. Concussions are plaguing the halls of high schools around the country, and staff and administration are unaware of how to properly care for and educate a person suffering from a concussion. Not only is the occurrence of concussions an epidemic, but the ignorance of a high school’s staff on the effects and problems associated with concussions is also an epidemic.

Football History and Example:

When most Americans think about sport related concussions, their thoughts immediately zero in on good old fashion American football. As one of the most popular and well televised athletic season of the year, even people who are not sports fans know at least a small part of what football is. The love of football can be seen across all age groups, from pee wee teams to middle and high school, all the way to the professionals in the NFL, the National Football League. In the south especially, football is not a sport but a religion. During the fall of the school year, high schools will limit events on Friday nights in order to showcase football’s Friday Night Lights. Every Friday, the stands fill with friends, family, and school mates. The stands creak in the student section from row after row of the school’s students. Among high school sports, football has the highest number of sport related concussions. "Men's football had a 6.71 rate of SRCs, but with an estimated 3,417 SRC incidents annually, it took the position as the sport that produced the most SRCs overall" (Concussion Rates among NCAA Sports). While due to the sheer number of participants on a team, football does not have the highest rate of concussions, it tops the list of actual number of concussions. According to an article in the Journal of Athletic Training, “Based on the national estimate, the majority of concussions resulted from participation in football at 40.5%” (Gessel et. al). That means that out of all the high school and collegiate sports the researchers looked at, football was responsible for almost half of all concussions. Keep in mind, this only includes the concussions that were severe enough to be reported to a healthcare professional. For a full contact sport, physicality is a necessity. In the Athletic Journal of Athletic Training, an article titled, "Concussions Among United States High School and Collegiate Athletes" reports that:

The highest proportion of concussion injuries occurred during running plays (Table 2) and resulted from contact with another person (Figure 3). More specifically, tackling and being tackled were responsible for 67.6% (n = 37 113) of the concussions in football. Linebackers suffered 40.9% (n = 9464) of all concussions among defensive players, and concussions represented a higher proportion of their total injuries (13.1%, n = 9464) than for all other defensive positions combined (10.8%, n = 13649) (PR = 1.21, 95% CI = 1.18, 1.24, P < .01). Running backs sustained 29.4% (n = 6785) of concussions suffered by players in offensive positions. (Gessel et. al)

Football is a dangerous sport that kids and young adults all across the nation play. Depending on the position, a child may be more or less at risk for head trauma, but concussions can happen to anyone. Most people know how violent football can become, but what most people don’t know is that right behind football is girls soccer.

Nicholas Fisher played football throughout middle school and into high school. Within his first two year playing high school football, he received two major concussions and one minor one. One of his major concussions and his minor one were received when playing teams that were not good. When players do not know how to play a game correctly and safely, it puts themselves and their opponents in serious danger. With a sport like football, there are many opportunities for contact that would result in a concussion. As a full contact sport, players such as Nicholas, are more likely to have major concussions with long term effects.

Soccer History and Example:

After football, girls soccer has the highest number of concussions in high school and collegiate players. An article titled "Epidemiology of Concussions Among United States High School Athletes in 20 Sports," published in The Journal of Athletic Training, states that, "The majority of concussions resulted from participation in football (47.1%, n = 912), followed by girls’ soccer (8.2%, n = 159)" (Marar et. al), meaning that nearly 10% of concussions in athletes come from girls soccer. Girls are biologically and physically predisposed to concussions. When adding this information to that fact that girls soccer is an aggressive sport that is played without pads or helmets, it is a miracle that more female soccer players do not have substantial brain damage. When playing, girls "head" balls that were kicked with all of someone's strength, go one on one with other girls, and are often kicked. If you are a goal keeper, your head is quite often low to the ground in the midst of other players, which increases your exposure to opportunities for being kicked in the head.

Hailey Burke is one player who has had three major concussions in a year. If she receives one more concussion, she will not be allowed to return to play. For this reason, she wears a full protective concussion helmet. She used to wear a preventative concussion band, yet she still received a concussion while wearing it. She has recently committed to play soccer at the collegiate level where she will continue to be exposed to dangerous situations. She received all of her concussions playing soccer at the high school level. Girls soccer is very violent and full contact which is extremely dangerous for all of the players.

Schools and Example:

When returning to school after a major concussion, the injured person may have serious symptoms, which include, "headache, dizziness, nausea, trouble thinking clearly, difficulty thinking clearly, and difficulty remembering new information" (CDC). When returning to school from a concussion, a student may have one or all of these symptoms. Upon returning to school, there are a few requirements that teachers must follow when dealing with concussed students. There are papers, signed by a doctor, that state that teachers are supposed to give extra time on test and quizzes, reduced or shortened assignments, and giving the student paper assignments instead of requiring work on the computer. In CCISD, there is a distinct lack of accordance to these guidelines. When these rules, which are put in place to aid the students, are ignored, the health and grades of the student will pay the price.

When Randi Benefield had her first concussion, her teachers were unwilling to edit their assignments so that Randi would be able to do at least part of the assignment. This unwillingness from the teachers worsened her symptoms due to stress of the brain, which at the time had major trauma done to it. She also failed her human geography class first semester because her concussed brain could not handle the work load. When Randi had returned to school, a copy of the guidelines were sent to and acknowledged by every one of her teachers. The administration did nothing to help Randi and her parents convince the teachers to follow the guidelines established by the district and signed off on by her doctor. What happened to Randi happens with many students returning to school after a major concussion. There are many long and short term effects that teachers are unaware of; therefore, they do not handle the situation to the benefit of the concussed student.

Effects on Society:

Studies have shown that, "players with a history of previous concussions are more likely to have future concussive injuries than those with no history; 1 in 15 players with a concussion may have additional concussions in the same playing season; and previous concussions may be associated with slower recovery of neurological function" (Guskiewick et. al). 

This means that in schools where students play an increased amount of football, there is a greater chance of receiving another concussion. So when students are unable to complete their work due to a concussion, there is a greater chance that they will have a repeat incident and therefore will have an even greater recovery time after the next concussion. This could cause a decline in grades and overall performance standing of the school.

The return to play protocol for athletes who have suffered a concussion is a mainly athlete response guided protocol. If a player is experiencing symptoms during the protocol, they are supposed to wait a few more days then start over. An athlete could easily lie and pretend that they are not experiencing symptoms in order to return to play sooner rather than later. Studies have shown that, "Caution and systematic evaluation should be undertaken before returning athletes with concussion to competition. Sole reliance on the self-report of the athlete may be inadequate. Preliminary data may suggest a more protracted recovery from concussion in high school athletes" (Field et. al).

In regions where there are increased incidence of concussions in high school and collegiate sports, there is a greater need for concussion doctors, brain specialists, and physical therapy establishments. This is because when a person receives multiple concussions, the effects are worse each time and they are more susceptible to receiving another concussion. With concussions, you need to have doctors to diagnose you, specialists to take scans your brain to make sure that you won't go into a coma, and physical therapists to rehabilitate you and strengthen the muscled in your back and neck to relieve symptoms and reduce the likelihood of another concussion. If a person such as Hailey Burke receives another concussion, she will need all three of these things like she did last time.

According to a study in the New England Journal of Medicine, "Severe single-incident injuries, with or without skull fracture, may lead to permanent brain damage, with incomplete recovery and residual sensory, motor, and cognitive deficits. If consciousness is lost for more than 30 minutes, the risk of Alzheimer's disease is increased, even if there is substantial recovery from the initial trauma" (DeKosky et. al). This means that there will be a need for a greater demand for care facilities that can take care of people with neurological disabilities. This also means that the age at which retirement should be will need to be lower because people could start showing symptoms of these disabilities earlier than ever.

Concussions are a plague in themselves. They infest schools from coast to coast and boarder to boarder, especially in sports such as football and girls soccer. "An estimated 136 000 concussions occur per academic year in high schools alone" (Meehan).  The occurrence of concussions is increasing among players in nearly every sport and affects more people than teachers and administration realize. Not only are there many short term effects, but there are also many long lasting effects that can bring about mental decline.

Solutions:

Concussions have been plaguing student athletes for as long as sports have been a part of schools.  The administrations in high schools either refuse to acknowledge, or are unaware of, the effects of concussions on their students. Some people will argue that concussions have already been reduced an immense amount since football was first being played. However, the fact is that athletes are still in danger of traumatic brain traumas today. One way to reduce the number of concussions in football is to make stricter penalties for infractions such as helmet to helmet contact, thus eliminating the high occurrence of these impacts.  For concussions in girls soccer, one way to reduce concussions would be to have a concussion band or helmet be a mandatory part of the uniform for all players. In regards to school administrations, teachers and administration should be required to take a course every year on the effects of concussions on a person's ability to function in a given environment and to learn how to properly help a student who is returning to school after a concussion.

Since football is a full contact sport, concussions are almost a certainty. However, the number and intensity of these traumatic brain injuries can be reduced. When players step on the field, they are counting on the other team to be careful and not injure them. The sport is a combination of trust and competition. Athletes trust that the other players will follow the rules, yet maintain a healthy amount of competition. Although helmets have improved from the leather ones that players used when the game first became popular, there is always room for improvement. Working on better, more reliable, helmets should always be a priority- not just for the NFL but for students and children alike. Another way to help reduce the number of concussions is to make stricter contact regulations and be sure that referees are following the guidelines when infractions occur. If referees do not uphold the standing regulations that are in place to protect the player, they are putting the young, healthy athletes at risk for serious brain injury.

Girls soccer is one sport where players are expected to go head to head without any sort of protection. The only protective equipment the players have are shin guards. Players often head the ball numerous times during a game. This means that a player is expected to make contact with the ball with her head, while the ball is in the air. Most of the time, these headers do not go uncontested. Two girls both jump up to head the ball, meaning two heads are trying to occupy the same space. When this happens, players' heads tend to collide while the ball is simultaneously contacting one or both of the players' heads. This causes the brain to bounce around in the skull, resulting in a concussion; in fact, "Physicist's initial assumption is that damage to the brain is a consequence, direct or indirect, of the movements, forces and deformations at each point in the brain" (Holbourn).  This is a similar to the way athletes receive concussions in football. In football, the players are required to wear a helmet as part of their standard uniform, hoping to decrease brain trauma.  Many wonder why soccer players shouldn't also be required to wear helmets. A way to reduce traumatic brain injury in female soccer players is to require them to wear a concussion headband or helmet as part of their standard uniform. These protective headgears could potentially save many players from losing copious brain cells. Football players protect their heads; soccer players should do the same.

School administrations and teachers often fail to recognize the severity of a student's concussion symptoms. Players are often allowed to return to school just days after they sustain a severe brain injury. When teachers do not follow the doctor's orders to give a student paper instead of online work, shortened assignments, and extended time on tests and quizzes, teachers are forcing a traumatized brain to work overtime. Without these accommodations, the teachers are forcing a student to complete work similar to writing an essay with their eyes closed and their fingers broken. After a concussion, the brain cells that are needed to complete the required assignments are damaged and are not working at their full potential. Teachers and administrators should be required to take a yearly course where they learn about how concussions effect the students and their brains and how to help students return to a learning environment with the least amount of disruption to their education. This raised awareness could prevent teachers from exacerbating a student's suffering after his or her traumatic brain injury. Knowledge is power, especially when it comes to the future of brain traumatized students.

Camus and Absurdity:

 Albert Camus would agree that concussions are absurd in their own way. When playing a sport, there is no rhyme or reason to when you get hit and why one player might suffer a concussion while another may not. In soccer, a girl might sweep a player's feet, causing the player to end up one hundred and eighty degrees from upright. Sometimes when a player comes down, she might get a concussion, but in a similar situation, the player may just receive a bump on the head. The circumstances that lead up to a concussion are random and coincidental.

Conclusion:

Traumatic brain injuries, also known as concussions, are prevalent in sports throughout all age groups. However, they are especially prevalent at the high school and collegiate level. Football has always been seen as a dangerous sport, therefore, steps are taken to make sure the players are well protected. Football players wear head to toe protection while soccer players are left exposed to the dangerous game that leads to too many concussions. Concussions are an epidemic that run rampant through sports and affect many players. Administrators are uneducated about the effects concussions have on the education of their students. This epidemic could be solved by having better protective equipment for both football and soccer.  However, the biggest change needs to be in the way school districts teach the administration and teachers how to help students who are returning to school after a concussion. After all, it is clear that concussions are bound to happen to at least one of their students. It is important to protect the brains of those who will eventually be corporate bosses, teachers, engineers, President, and other people who run the world.

Works Cited

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Meehan, William P., Pierre D'Hemecourt, and Dawn R. Comstock. "Sign In: Registered Users." The American Journal of Sports Medicine. SAGE Journals, 17 Aug. 2010. Web. 10 Mar. 2017.

"Study Looks at Concussion Rates Among NCAA Sports." APTA. PT in Motion, 7 Oct. 2015. Web. 10 Mar. 2017.

"What Are the Signs and Symptoms of Concussion?" Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 22 Jan. 2016. Web. 10 Mar. 2017.