A report by the American Academy of
Pediatrics released in early June reports concussions have risen 200 percent
among teens aged 14 to 19 in the last decade.
Other reports indicate one in five high
school athletes will sustain a concussion.
With questions being raised about the
safety of sports, how have San Mateo County public high schools fared in
addressing the issue of safety and head trauma?
According to a report from the San Mateo
County Civil Grand Jury released June 29, schools comprising the Peninsula
Athletic League are well aware of the dangers and are doing a relatively good
job of diagnosing and treating head injuries.
“Our district was out in front of it,”
said Steve Sell, Aragon’s longtime football coach and athletic director.
The San Mateo Union High School District
has been the most proactive in protecting student-athletes at their member
schools, having instituted districtwide pre- and post-injury neurocognitive
testing, as well as the hiring of full-time certified athletic trainers — two
of the recommendations the grand jury concluded all districts should strive to
reach.
The grand jury’s third recommendation is
each district establish a database of all head injuries. That information would
then be turned over to the Peninsula Athletic League for analysis.
SMUHSD utilizes the Immediate
Postconcussion Assessment and Cognitive Thinking (ImPACT) test to establish a
baseline of all athletes at the beginning of the high school season. Following
any kind of head injuries, athletes re-take the test and have the results
judged against the baseline test. Until the athlete can equal or surpass their
baseline score, they are held out of competition.
According to the grand jury report,
SMUHSD and the Sequoia Union High School District are the only two in the
county that are doing neurocognitive testing. SUHSD conducts its testing through
a grant from Sequoia Hospital, while the San Mateo district pays for testing
through its general fund. Half Moon Bay High School did use ImPACT testing for
football for the 2012 season, but budget constraints have forced the school to
shutter the program the last two years.
The Cabrillo Unified, Jefferson High and
South San Francisco Unified school districts do not perform any kind of
neurocognitive testing, citing budget constraints, according to the report.
Jeff Cosico, El Camino High School
athletic director, said he has not heard from SSFUSD about implementing
neurocognitive testing, but he and South San Francisco High School athletic
director Matt Schaukowitch have been talking about implementing a test on their
own.
“We want to do it where we’re both
consistent,” Cosico said.
“One of our assistant trainers was kind
of pushing (for baseline testing). I said I wanted the district to make the
decision. But he showed me a test and I said this is something we could do on
our own,” Cosico continued. “Player safety is the number one concern. We have
the CIF baseline cognitive test, but it wasn’t district mandated.”
Sell cautions, however, that the testing
is only one of the protocol used in determining a concussion and when it is
safe to return.
“[Baseline testing is] part of the
evaluation. It’s not the biggest part. It’s not going to replace a doctor,”
Sell said. “It’s just another tool.”
In addition to testing, the state of
California and California Interscholastic Federation (CIF), the governing body
of high school athletics in the state, have enacted legislation to further
protect athletes. A couple years ago, CIF passed a law that says any athletes
who suffer a head injury can only return after clearance from a doctor. There
have also been new rules passed limiting the amount of live hitting football
players can do during the year.
“There have been some rules changes from
CIF and CCS about what you can and can’t do,” said John Philipopoulos,
Burlingame’s football coach and athletic director.
Assembly Bill 2127, which took effect
Jan. 1, forces players who suffer a head injury to sit out a minimum seven days
after having been evaluated and diagnosed by a physician.
All the testing and laws can’t replace
making an early diagnosis and taken the first initial steps in treating a
possible head injury. Matt Smith, head trainer at Burlingame High School, said
nothing is better than seeing firsthand how an injury occurred._And that’s
where things can get a bit muddy. While football games are required to have a
trainer present before the start of all games, other sports don’t have that
mandate. So during the basketball and soccer seasons, Smith, who has served as
the school’s trainer for the last 10 years, finds himself have to split time
between two different venues, which he said can have an impact on care.
“It can be a bit [hectic], going back and
forth,” Smith said. “When things like that are going on and there is a head
injury, it can make it a little harder because I may not have seen
it.”_Regardless, Smith will go through the protocol and always err on the side
of caution.
Sell said it’s important to have a
trainer who is more concerned with the health of a player than the result on
the scoreboard.
“You need, as best as you can, an
uninterested third party making the determination,” Sell said. “It’s good to
have someone there who says I don’t care if we win or lose, this kid is not
going back in.
“The coaches, in this district, put the
kids first, but it’s nice to have someone who has not prepared all week to win
a game.”
While the grand jury report focused
mainly on the safety of football, it did indicate that football is far from the
only sport that places athletes in danger. Girls’ soccer and lacrosse have seen
a spike in head injuries over the last several years.
“The pace of the game has really sped up.
The skill level has gotten better in the last decade,” said Jose Navarrete,
Woodside’s girls’ soccer coach and longtime youth coach.
“They do things in a higher gear than a
decade ago.”
That has also contributed to more head
trauma and it’s coming at an earlier age. There is a growing movement to ban
the youngest age groups from heading the ball and Navarrete is among the group.
“I know there has been a lot of education
done,” Navarrete said. “I think at the younger age groups, head gear should be
mandatory. They’re still not in control of their bodies.
“I don’t think the element of skill will
go away if 8- and 9-year-olds aren’t heading the ball.”
Therein lies the greatest way to counter
possible injuries — education. Sell believes the way the game is taught
needs to change, especially in football.
“No matter what sport, people coach the
way they were coached,” Sell said. “People who are coaching now were taught to
get your head across the ball.”
Now coaching staffs are realizing that
puts defensive players especially in harm’s way as it becomes very easy to take
a knee to the head by a running back.
Now Sell and the Menlo School coaching
staff are utilizing the rugby tackle, which stresses keeping a player’s head
from crossing the body of the attacking the player.
“It’s a shoulder tackle,” Sell said.
“It’s a tackle you should be able to make without a helmet on.”
Sell, who played football at Aragon and
rugby at St. Mary’s, said he was a better rugby tackler than football tackler
and, after looking at the safety ramifications, said he is a convert.
“I think [the rugby tackle] is easier. …
If you can hug and twist, you can make the tackle,” Sell said. “I’d rather give
up an extra yard if it means for sure [the ball carrier] will go to the ground
and the tackler won’t get injured and miss two weeks.’
Sometimes the biggest battle is simply
protecting the player from himself. Even at the high school level, an athlete
is willing to look past any potential injury to get back on the field. It’s up
to trainers like Smith to make sure that doesn’t happen.
“I can’t base my decision on how the kids
says he feels,” Smith said.
If there is a head injury, it’s almost
assured the player in done for the rest of that game and will be required to
see his or her doctor. But Smith has also devised his own cognitive testing to
make a quick evaluation on a player’s condition.
“I started doing baseline testing about
five years ago, before the district brought it into play,” Smith said. “I do my
own paper-pencil test. It takes about seven or eight minutes. I can add up the
scores and compare them to [the baseline scores]. Just the idea of … having
something tangible to go against when player comes out of a game. … Instead of
just going on what the kid was saying, now I say something that is a repeatable
test. … It’s not hard and fast, but it gives us info.”
Smith said he prefers his test over the
ImPACT test, simply because of the time restraints necessary to take the
district test.
“It’s time consuming,” Sell said.
Smith said the post-injury ImPACT test
can not be taken for 24 to 48 hours after a diagnosis by a doctor. Because the
test is so involved, Smith said it take up to 25 minutes, it could possibly
worsen symptoms if taken too soon after the injury.
“I would prefer (my test), in my opinion,
than the ImPACT test. It can be given quickly and gives you basic info to see
if something is there,” Smith said. “With my test, if they get an injury, I can
take them right in, re-administer the test and look at the baseline test. I
don’t have to wait 24, 48 hours.”
July 6, 2015
San
Mateo Daily Journal
By
Nathan Mollat
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