Written by Joanna Chartrand
This post is a follow-up to the article Confused About Concussions? written by Joanna Chartrand.
In April of 2010, the University of Pennsylvania campus was rocked with the news that Owen Thomas, a popular junior and lineman on the football team, had committed suicide. A seemingly well-adjusted, driven, and successful student suffered what was described as “a sudden and uncharacteristic emotional collapse” (Schwarz, 2010).
Autopsy results revealed he was suffering from early stages of chronic traumatic encephalopathy, or C.T.E., a form of brain neurodegeneration linked to diminishing cognitive function, depression, and suicidal behavior, among other behavioral dysfunctions (Institute of Medicine and National Research Council [IOM and NRC], 2014).
It seemed that Thomas, so driven by competition, had sustained an unknown number of unreported concussions during his football career, enough to develop the disease by the early age of 21.
Consider why this story made national headlines.
If you’ve read the first installment on concussions (see Confused About Concussions?), you’ll recall how serious brain injuries can be. From staggering statistics to short- and long-term impairments, the research can be overwhelming. But in the end, where should it lead us?
One answer is to the school. Think of everyone tied to the school setting: educators, coaches, athletic trainers, parents, the athletes themselves. Each of them play a role in the athletic culture of their institution, and prioritizing the health of our athletes means that each role warrants scrutiny.
Where to begin?
The most frequently proposed recommendation throughout the literature is awareness. Time after time, authors state its importance, many echoing the following:
Future efforts should focus on educating athletes, coaches, and parents on the signs and symptoms of concussions and the dangers associated with withholding these symptoms from sports medicine professionals. (Covassin & Elbin, 2010, p. 59)
Continued education and awareness of potential problems associated with premature return to play are essential for the health and welfare of athletes. (Covassin et al., 2009, p. 642)
. . . the vast majority of young athletes practice and play in circumstances where trained personnel are not routinely available to make sideline injury assessments, and the responsibility for determining whether to remove an athlete from play falls on coaches, parents, players, and, perhaps, officials. (IOM and NRC, 2014)
For the educator . . .
Understand the cognitive functions that can be compromised after a head injury, especially memory and concentration. Be prepared to make appropriate academic adjustments for each individual case. Consider playing a preventative role by ensuring your school’s P. E. curriculum is designed to develop your students’ body awareness and control.
For coaches and parents . . .
Online awareness and training tools are available to help you understand how concussions occur as well as how to respond when they do. The HEADS UP campaign by the CDC offers online training and resources for concussion management targeted toward coaches, parents, athletes, and even sports officials.
For the athlete . . .
Understand what a concussion is. Research conducted by Robbins et al (2014) found that athletes were twice as likely to report suffering a concussion when they were informed about the injury. They also point out that a simple 30-minute concussion education program could help athletes better recognize the symptoms.
When evaluating our school culture, we all must ask a simple question: How important is winning?
Consider surveys in which youth admit that “the game and the team are more important than their individual health and that they may play through a concussion to avoid letting down their teammates, coaches, schools, and parents.”
Think about anecdotal reports of athletes “tanking” the baseline neurocognitive test so that in the event of a concussion, they could return to play faster, though still not actually recovered (IOM and NRC, 2014).
How important is winning?
Ask your athletic trainers. In a 2009 assessment of ImPACT testing practices, Covassin et al (2009) found that a number of athletic trainers would return an athlete to play who was symptom-free but still scored below their baseline neurocognitive scores. Those who were on the fence claimed that it “depended on the importance of the competition” (p. 639).
Again, how important is winning?
Stories like that of Owen Thomas are sobering, and his is one of many that should provoke us to action. Think about your own students, and consider this vehement directive from the Institute of Medicine and the National Research Council (2014):
Culture is created by the sum of beliefs and behaviors within a group. And it is clear to us that currently, in many settings, the seriousness of the threat to the health of an athlete, both acute and long term, from suffering a concussion is not fully appreciated or acted upon. Too many times the committee read or heard first-person accounts of young athletes being encouraged by coaches or peers to “play through it.” This attitude is an insidious influence that can cause athletes to feel that they should jeopardize their own individual health as a sign of commitment to their teams. (p. 7)
In the end, perhaps one simple fact can drive you to action: The body does not accept the excuse, “I didn’t know.”
Joanna Chartrand (’11) serves at Luther Preparatory School-Watertown WI.
References
Chartrand, J. (2020, March 3). Confused About Concussions? Issues in Lutheran Education. https://blogs.mlc-wels.edu/wels-educator/2020/03/03/confused-about-concussions/?fbclid=IwAR1yTQs8TrnHLirWhGt-XxXg0ls2w6rHFNPUQTS0vng0ZPTSpsquvGkklls
Covassin, T., & Elbin, R. J. (2010). The cognitive effects and decrements following concussion. Open access journal of sports medicine, 1, 55-61. doi: 10.2147/oajsm.s6919
Covassin, T., Elbin III, R. J., Stiller-Ostrowski, J. L., & Kontos, A. P. (2009). Immediate post-concussion assessment and cognitive testing (ImPACT) practices of sports medicine professionals. Journal of athletic training, 44(6), 639-644. Retrieved from https://www.natajournals.org/doi/pdf/10.4085/1062-6050-44.6.639
Heads Up to Brain Injury Awareness (n.d.) Retrieved December 10, 2019 from https://www.cdc.gov/headsup/index.html
Institute of Medicine and National Research Council (2014). Sports-Related Concussions in youth: Improving the science, changing the culture. Washington, DC: The National Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK169016/
Robbins, C. A., Daneshvar, D. H., Picano, J. D., Gavett, B. E., Baugh, C. M., Riley, D. O., … Stern, R. A. (2014). Self-reported concussion history: impact of providing a definition of concussion. Open access journal of sports medicine, 5, 99–103. doi:10.2147/OAJSM.S58005
Schwarz, A. (2010, September 13). Suicide reveals signs of a disease seen in N.F.L The New York Times. Retrieved from https://www.nytimes.com/2010/09/14/sports/14football.html