A recent study by the National Academy of Sciences, partially funded by the NFL, found scholastic athletes face a significant risk of concussion as they play, more so than their collegiate counterparts. In Delaware, some efforts have been made to address the issue though new Delaware Interscholastic Athletic Assoc. (DIAA) rules and a 2010 state law. But those changes can’t keep concussions from happening, so some schools are looking to do more as WDDE News Director Tom discovered when he visited Wilmington’s all-boys Catholic high school Salesianum.
[audio:http://www.wdde.org/wp-content/uploads/2013/11/ConcussionFeature.mp3|titles= WDDE's Tom Byrne visits Salesianum to learn about their baseline testing program for concussions.]
"It was towards the end of practice, probably a 5-7 yard shot. Took it right to the forehead. There was a bright flash and everything was slow motion. I couldn’t hear anything., I took a knee . It was probably about 20 seconds after I got hit that I could start to hear and then my coach asked me if I was alright. I don't remember this but he told me I said no.”
That’s Salesianum’s junior lacrosse goalie Josh Croney - describing the concussion he suffered last spring.
A scary moment, but he says what happened the next day was even scarier.
“I was in chemistry class and I was looking at the board. I couldn’t follow anything. It was sort of like it was a different language," said Croney. "I couldn’t really connect anything and what the teacher was saying, it just didn’t really make any sense to me. I just didn’t feel like I was there.”
The school called Josh’s parents, John and Bonnie, to take him home. It was a shock. John, a Wilmington youth lacrosse coach, had been part of concussion clinics, but it was only when it was his own son involved that what he’d heard in those clinics sank in.
“We took him out of practice, he slept at night, he was fine, woke up the next morning and all of a sudden he wasn’t fine," said the elder Croney. "That’s when I realized there was more required here, there was more attention to it required at the medical end.
That led the Croneys to the A.I Du Pont Hospital for Children’s Center for Sports Medicine, which treated Josh and guided his recovery. First, it shut him completely down for a couple of weeks, and not just athletically. No TV, no texting, no time with friends, just quietly resting and sleeping.
Slowly he worked his way back to a normal routine and eventually sports. But Josh and his family believe the process could have been been shorter, if they’d had extensive baseline tests to help set what Josh’s normal cognitive level was pre-concussion.
This year, Salesianum is starting obtain that additional information thanks to a new, and fairly ambitious baseline testing pilot program developed in a partnership with A.I’s Center for Sports Medicine.
Starting with the current winter sports season, Sallies is requiring extensive baseline testing for its highest risk sports. In the winter, that’s hockey, wrestling and basketball. They plan to continue to build the program from there based on its results.
The key to this program is it goes beyond the basic computer-based cognitive tests. It also measures balance and visual tracking that the Center’s supervisor for outpatient therapy Tim Duer says helps paint a more complete picture of each individual.
“We’re finding more and more that these are two of the big areas that are remnants when people are recovering from a concussion," said Duer. "As we’ve seen these kids, more and more of them do test out above or below normal. [So], when we’re relying purely on a normal for as for as a return to play clearance that’s not always an accurate assessment for these kids because normal isn’t always normal."
But that’s not all, Duer says the tests mean no longer relying completely on a young athlete to honestly report symptoms.
“Previously, you’d see a kid, do a couple of tests and see his balance wasn’t quite right, but they’d tell you I’m fine, I’m ready to play, I’m good. It becomes a challenge when you’re trying to explain to someone and you don’t have that hard fast piece to prove," sad Duer. "Now, with some of the equipment we have in the facility and the test we’re using, there’s no question asked any more.”
Sallies’ athletic trainer Joe Szczerba adds it also allows others dealing with the injured student to understand their limitations beyond the field.
“It is important that the guidance counselors, the teachers, are all on the same page and that they’re patient with the patient - no pun intended - knowing that you can’t see the concussion, you can’t see the brain, the injury of the brain like you could an ACL or something like that," said Szczerba. "So, a lot of times for the person that is dealing with the person with the concussion, it can be frustrating at times trying to understand why is that individual not in school, why does that individual have to go to the nurse’s whenever they start to have more symptoms."
So far, Salesianum principal Father Chris Beretta says the reception for the program has been good, despite the $50 per student that parents have to pay.
"For the battery of test that they’re getting, it’s really a great deal," said Fr. Beretta. "When you consider that people whose kids have been active playing sports for a number or years, lay out money for spirit packs, and gear, and clothing, and bags, and shirts, and shorts and all that kind of stuff, I think people realize this is far more important than any of that and most of our parents are certainly willing to pay that for the services that we’re getting."
But can this program and its services be taken beyond one school? Can it be replicated elsewhere?
Cape Henlopen High School trainer Sheryl Burris currently does the computer based cognitive baseline testing of athletes there. She likes the Salesianum program conceptually, but sees significant logistical hurdles exporting it statewide.
"I think the challenge is for something like that would simply be right now would be Sussex County versus New Castle County," said Burris. "It’s just not a reality for Sussex County students to have access to that type of program because they’d have to travel an hour and a half away to do so. Basically. it’s the personnel. We don’t have pediatric neurologists in those numbers that close to us."
But Father Baretta believes where there’s a will there’s a way to make it happen up and down the state.
"I think if we prioritize this as schools, as parents, as people who are generally concerned for young people and see this as really, especially those high risk sports, this is not really an option. This is something we need to consider as serious as the equipment that we’re providing them," said Fr. Beretta.
Though Josh Croney points out, even as programs like this try to take the guesswork out of diagnosing and treating concussion by adding data, and perhaps diminishing human guesswork, it's still up to individuals to do their part and take concussions seriously.
"I didn’t really accept the fact that I had a concussion. I didn’t really accept what I needed to do to get better," said Croney. "I would just recommend to help as soon as you can. You’ll be back on the field faster because I waited too long to get the help that I needed and it ended up hurting me in the long run."
