They spend much of their time absorbing the fundamentals. All the while, athletes learn one important intangible about athletics from the time they first step onto a playing field: effort.
“You compete,” recent Oakdale graduate Jonathan Oden said. “You give 110 percent on and off the field.”
For some of the more competitive athletes accustomed to giving a maximum effort, leaving the playing field doesn’t sit too well — even if they’ve sustained a head injury.
Recent studies have shown that high school students often do not report concussions and either continue to play or rush back onto the field earlier than recommended. The Institute of Medicine and the National Research Council in October released a 306-page report that maintains athletes “profess 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.”
Frederick County Public Schools athletics supervisor Kevin Kendro maintains the empowerment of athletic trainers, coaches’ training in dealing with concussions and a cautious return-to-play policy after athletes are diagnosed have helped combat that issue in Frederick County.
“I believe we are leaders (in concussion management),” Kendro said.
In the past, Kendro said, coaches may have pushed for injured players to return and disregarded athletic trainers’ medical advice — something he says does not take place today.
“The days of a coach ever questioning an athletic trainer, those days have been gone,” Kendro said.
When athletes are suspected of sustaining a concussion, trainers perform on-field tests that gauge short-term memory and other cognitive functions.
Sam Weir, a recent Linganore graduate who played wide receiver for the Lancers’ football team, sustained one documented concussion during his freshman season and another the following season. In both cases, he said, the trainer essentially controlled his status for the remainder of those football games.
During the 2010 season, Weir caught a pass on a quick slant, and a linebacker immediately tackled him in a helmet-to-helmet collision.
Administering a post-collision evaluation following his first concussion, an athletic trainer rattled off five random words and asked him to repeat them in the same order. Weir could only remember two of the five words.
“She (told the coaching staff), ‘Yeah, he’s done,’” Weir said.
An athletic trainer determined Oden’s status after he sustained the second of his two concussions, and at the time, he didn’t particularly like the trainer’s assessment.
Oden, a catcher for the Bears’ baseball team, was involved in a home plate collision in a home game against Linganore, and the trainer concluded that Oden still seemed out of sorts.
“I ended up cussing her out on the bench,” Oden said. “I was in denial that I had (a concussion).”
Oden was in that state of denial because if anybody knew of concussion symptoms, it was him.
A year earlier, a Bethesda Chevy-Chase baserunner rammed his shoulder into Oden’s chest and drove his knee into the Oakdale catcher’s back.
Emergency room doctors found blood in his urine, and Oden said his doctor believed his brain was “bleeding” and that when he tried to return to school his “handwriting looked like a 3-year-old’s.”
The concussion resulted in headaches, hearing problems and trouble focusing in the classroom.
“I laid in bed for a week and a half and stared at the ceiling and slept,” he said.
Oden didn’t experience any of those symptoms during his game against Linganore, prompting his irritation with the trainer who decided he had to sit out the game. At the end of the season, however, he and other players saw pictures the Oakdale yearbook staff had taken of a game against Walkersville later in the season. For Oden’s teammates, the game triggered memories of a memorable win, and they reminisced about highlights Oden couldn’t recall.
“I have no recollection of what happened during that game,” Oden said.
Pivot Physical Therapy director of sports medicine operations Christy Denney, who enters her fifth school year as Urbana High’s athletic trainer, has dealt with players who have lobbied to re-enter games after sustaining injuries she believed needed immediate treatment. She said Hawks coaches have helped resolve any conflict by supporting her recommendations.
“Our coaches respect our decision, and we are the be-all, end-all,” Denney said.
While all 10 FCPS high schools have a certified athletic trainer, Kendro brought up the issue of having multiple athletic events at one site. He said the concussion education FCPS head coaches receive helps to address the problem.
The FCPS’ concussion protocol and procedures requires all coaches to take a National Federation of State High School Associations online course on concussion management every two years.
“Even when they can’t be at a field, we’re confident that our coaches can handle it until our (trainer) arrives,” Kendro said.
Denney said she has had “one or two” instances in which students have tried to conceal a concussion but that friends who had knowledge of the symptoms immediately informed her of the attempt to hide the injury.
Oden said classmates who competed in other sports approached him and revealed to him they thought they may have sustained a concussion. Those athletes did not report their symptoms to the school’s athletic trainer.
Leaning on his own concussion experiences, Oden peppered them with questions. Could they walk straight? Could they do their schoolwork? Did their coaches see a drop-off in the level of their play?
“If their play isn’t affected, I’m not going to go behind their back (and inform their coaches),” Oden said. “If they’re in the clouds, I’m going to mention something.”
Despite experiencing a concussion and knowing the dangers associated with head injuries, Oden understands why athletes still might want to hide a head injury.
“They want to play, and they don’t want to let their teammates down,” Oden said. “At that same time, you need to realize if it’s a serious concussion. You have to admire the heart and the competitiveness, but you have to be smart.”
Weir said the motivation for concealing a concussion derives from both personal and team goals.
“If you’re a leader on the team and you have a starting position and you’re having a great season, and you have a concussion, that could affect your starting spot,” said Weir, who experienced nausea, headaches and dizziness after his concussions. “They want to make sure they have their starting spot or they (may) have a record they’re trying to beat.”
That doesn’t mean Weir advocates playing through a concussion.
“Definitely do not try and rush and get back on the field,” Weir said when asked what kind of advice he’d give to others who suffer concussions. “If you lie about it and go back on the field, it can make that concussion three times as worse, and you can actually lose memory.”
Weir alluded to the risk of second-impact syndrome, which happens to athletes who suffer a second concussion before their brains have fully healed from previous concussions. Then, symptoms become much more severe, ranging from dementia to death.
While reducing the number of concussions has always been a goal of FCPS, Kendro said athletes healing properly remains the No. 1 priority.
“We want to prevent the second and the third (concussions),” Kendro said.
“If they say they’re OK, that doesn’t mean they’re going to be put back into the game,” Kendro said.
“We do our best, and we feel we do a good job and try not to let anything slip by.”
According to the Institute of Medicine and National Research Council study, the number of reported concussions has increased significantly since 2005. The study provided statistics from the Center for Disease Control, which estimated that the number of athletes age 19 and younger who were treated for concussions and other sports- and recreation-related traumatic brain injuries increased from 150,000 in 2001 to 250,000 in 2009.
The IOM and NRC concluded that “increased awareness and recognition of such injuries” may have contributed to the increase in the number of reported concussions.
Despite the increased emphasis on concussion awareness in schools, Thomas Johnson athletic director Steve Nibbs said some students may still attempt to conceal concussions and play through head injuries.
“They want to play that bad,” Nibbs said. “They know that if (a concussion) evolves, that if there’s something wrong, they won’t play for a while. That’s the passion. They don’t want to not play. That’s an overriding thought.”