| Hard Knocks Page 2 Testing team members in the pre-season is the ideal way to use the program, which puts the students through a series of words, letters, colors, shapes and symbols to gauge brain function. However, even if athletes are not �baselined,� Heinz said the program has been developed to the point where it will compare the injured student to normal levels. When dealing with concussed athletes, objective data is needed because, for several reasons, the teenagers themselves are not the best source of information. Young athletes are likely to misrepresent the way they are feeling because there is pressure, from themselves and others, to get back into the game. More than that, however, a concussion can affect a person�s judgment, so the injured athlete may believe that he or she is fine, even if that�s not the case. Another factor, which has only been understood in recent years, is that the concussion�s symptoms may take a couple of days to manifest. The old format of staying out of play for 15 minutes, or until the initial dizziness wears away, is not only unreliable. It�s dangerous. �Even those little things we thought were �dings� develop over the next several days into a functional impairment,� said Heinz. �And we can show that their memory, their processing speed, their reaction time are all decreased after a �ding.� And so the current thinking is that you no longer let anyone go back after any kind of brain injury.� The good news is that the average concussion usually clears up in a week or so. Throughout that time, Heinz works with athletic trainers and school nurses, who test the students � five to ten a week � and then confer via telephone with the doctor, who notes that it is important that the student not participate in any physical activity while his brain is healing. �They don�t go to the weight room, they don�t do cardio training, they don�t do anything. They focus on not falling behind in their studies,� he said. �And we do serial testing until their symptoms are gone and their numbers are back where they should be.� Even after that, Heinz and the trainer or nurse work out a return schedule so that the student eases himself back into action. For reasons that doctors aren�t sure of, those who sustain a concussion are at risk to have another. Whether it�s the way some people play a sport or the way individual brains are wired isn�t clear. What is clear is that a receiving a concussion while a previous one is still healing is extremely risky. So-called �second-impact syndrome� causes the brain to swell in a matter of minutes and the outcome can be fatal. When Jon Conant returned as goalkeeper just two weeks after being concussed in a collision with an opponent, it was clearly much too soon. In fact, having banged his head pretty good while bike riding at age 12 and suffering a concussion during the previous baseball season, it�s likely that the first soccer concussion should have ended his playing days. The last one certainly did. �The rest of my senior year was in a surreal fog,� he said. �I lived in that for the rest of high school.� For a while it wasn�t clear whether Conant would be able to graduate with his class. He did, but then needed to take a year off before he felt well enough to attend college. �I couldn�t stay awake. People might think you�re lazy and unmotivated, but it takes all your energy just to function. I wish I had a gaping flesh wound so people could see it, but it�s all internal.� Programs like ImPACT give school staff and healthcare professionals a window into the brain to see exactly how its function has been affected, and now that it�s clear that concussions aren�t to be handled casually, most are giving such injuries the attention they deserve. �Coaches have become much more receptive,� said Neil Carroll, the athletic trainer at Scarborough High School, where�s he�s seen four concussions so far this season. �You live and die by whatever the athletic trainer says,� Lake Region High School athletic director Todd Sampson said. �Under no circumstances can a coach influence what a trainer says. If the trainer says the kid is done, then that kid is done.� At Windham Christian Academy, Principal Roy Mickelson, noting that Jon Conant's return to the soccer field was approved by a doctor, said that today his school reacts with "more diligence and awareness" to such injuries. Dr. Heinz believes that the single most important step toward dealing with concussions properly is for schools to have a full-time trainer. In fact, copies of ImPACT were furnished to schools with the stipulation that they have a full-time trainer or nurse working directly with students. �Don�t spend money buying new uniforms every year,� said Heinz. �Spend the money and get an athletic trainer. More than anything that will help prevent these kinds of injuries and get them taken care of correctly.� As long as athletes participate in sports there is a risk of being injured, but a collision on the playing field should not be something that upends a young person�s life. �I feel mostly healed now,� said Conant, seven years later, �but I�m not allowed to play contact sports ever.� |