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Concussions Taken Seriously at K-State

By Mark Janssen 

MANHATTAN, Kan. - Joe Paterno said it last month: "We used to have one single bar; now we have a weapon."

The 83-year-old Penn State coaching legend added, "I've been saying for 15 years we should get rid of the facemask and get back to shoulder tackling."

Paterno was speaking about helmet-to-helmet hits that have resulted in nearly $1 million worth of fines this fall in the National Football League. But the issue of high hits has also been a hot-topic in the college game where a similar hit is no more than a "personal foul - unnecessary roughness" 15-yard penalty. In the collegiate game, the penalty comes from hits above the shoulders and does not necessarily have to involve helmet-to-helmet contact.

In addition, Phil Laurie, an observer of Big 12 officials, explains, "If it's viewed as a player purposefully launching himself at a player and there is a hit above the shoulder, there can be an ejection."

Kansas State coach Bill Snyder says he "... doesn't have an answer for the problem." He adds that it's the responsibility for the NCAA, coaches and players to be involved in playing the game safely. "It's still a contact game; you can't take that out of it."

But the Wildcat coach is very aware that when the game is taught, or played, without proper technique, the helmet can be a weapon, which can result in concussions no matter the level of play.

The most recent NCAA survey at the college level has concussions dropping from 3.4 of every 1,000 student-athletes in 2004, to not being higher than 2.8 in 1,000 players from 2005 through 2008.

At the high school level last year, there were a reported 55,000 concussions nationwide. Head injuries resulted in nine permanent injuries, and two deaths in 2009.

In October, a high school-aged player from Spring Hill, Kansas, died from a concussion suffered during a Friday night game.

THE HELMET: Kansas State equipment manager Chuck Hall says, "You're not going to stop concussions. It's like asking NASCAR to stop having wrecks. It's just not going to happen."

Hall says that today's helmet, which costs between $200 and $350, is every bit of a weapon when used as one. 

"When you dive head first into another helmet, that's violent," he said.

One of the concerns Hall has is the way today's player wears his football hat.

"With the long hair some players have today it's like putting a bucket on a mop. It's not going to stay on like it's designed to do for very long," he said. "Even with all the safety features of today's helmet, it's not going to lock down on the head when players have all that hair. That's not a manufacturing issue, but it's a society issue of wanting to be comfortable, which includes a loose chinstrap."

THE RESULT OF BIG HITS:  K-State head athletic trainer Matt Thomason understands how helmet-to-helmet hits are the talk of today, but he adds that helmet-to-turf hits are of an equal concern.

In layman's terms, Thomason defines a concussion - a traumatic brain injury - as blunt trauma to the brain caused by the shifting of the brain inside the skull.

"Often times it's not the initial hit that causes the concussion, but it's the rebounding to the opposite side of the skull that causes the injury," explained Thomason.

Confusion and amnesia are the two most prevalent signs of a concussion, which are followed by multiple symptoms.

"The main thing for us is to get to know the players. That's knowing their mannerisms and personalities so when a head injury does occur, we have a better feel if he's acting normal, or not," said Thomason. "We go out on the field and simply ask, 'What's wrong?' We're looking for a response that is normal, or not normal, to that player."

Each year, K-State gives a 30-point cognitive test that gives each athlete a preseason "baseline score." The questions are as simple as the day of the week, the year, time of day, plus short- and long-term verbal tests such as repeating five words - shoe, glove, hat, dog, football.

When a player has a head injury, the exact same test is repeated with the athlete having to be at least equal to the "baseline" score that was set prior to the season.

If not, Thomason says, "We take his helmet and lock it up in a trunk. It's not a coaching decision.  It is our sports medicine staff making a decision that is in the best interest of the athlete's health and safety."

The same test is taken again the next day, plus by NCAA guidelines, the player takes a "SCAT Card" follow-up assessment as to whether he has a headache, is dizzy, or has neck pain.

Thomason estimates that K-State has six to eight concussions a year, with over half of those coming in practice as opposed to games in a normal season.

A CONCERN IN BASKETBALL, AS WELL: It doesn't take a hit with a hard-shell helmet to force a concussion.

Kansas State's men's basketball trainer Brandon Yoder has treated two such injuries that have occurred in Wildcat practices this year.

"Most of the time it comes from someone hitting their head on the floor," said Yoder. "On occasion it can be from an inadvertent elbow, but more times than not it comes from a fall where the player suffers a hard hit against the floor."

Like in football, Yoder said, "We follow our protocol to a 't' and that starts with knowing our student-athletes and looking for the slightest thing that appears out of the norm."

For all K-State sports, that protocol includes the baseline testing prior to the start of the season, and the SCAT Card testing following an injury.
 
"On occasion, you'll find an athlete that tries to cheat with answers and get on the court too soon, but I'm a firm believer that the true nature of the injury will rise to the top," said Yoder.

TO PARENTS AND PREP COACHES:  Thomason and Yoder say there are classes available for parents and coaches to take on concussions, but nothing that is mandatory at the high school level.

Thomason's encouragement to a coach is to know the mannerisms of his athletes and avoid saying, "He just got his bell rung."

"Just like here, those high school offensive and defensive linemen hit helmets 100 times a day," said Thomason. "A concussion doesn't have to be a hard hit; it can be very subtle at just the right angle."

In any sport, he continues, "My advice is, 'When in doubt, take them out.' You should assume a concussion and the athlete should be evaluated by a physician as soon as possible. The consequences aren't worth taking a chance."

Yoder adds the same message: "At all times, error on the side of caution. You absolutely can't be too cautious with any type of head injury. We're talking about an injury that could be fatal."

Thomason said there are varying opinions on the subject of whether there are degrees of concussions, and he emphasizes that an individual does not have to lose consciousness to have a concussion.

To coaches and parents, Thomason adds that if symptoms such as dizziness, vomiting, and headaches persist more than three or four days, that a follow-up evaluation with their physician should occur. And, during the period of symptoms, there should be absolutely no activity in terms of lifting, running and physical contact.

"Even teammates should speak up," said Thomason. "If a player goes the wrong way on a play that has been practiced hundreds of times, or if a player asks a teammate what he needs to do on a play, he needs to go to the coach and say, 'Hey, something's wrong with Fred.' We only have so many athletic trainers on the field and we're trying to keep an eye on 125 guys."

Studies have shown that if a player has one concussion, his chances of having another are doubled.

"At K-State, once you have three concussions in the same season - fall or spring - you're done for that season," said Thomason. "The consequences are too severe to take a chance with a possible head injury."