AVON — The Indiana legislature recently passed a law aimed at preventing concussions in student athletes, but many Hoosiers may be a bit confused about what the procedures require.
With that in mind, Dr. Mark Booher with the Hendricks Regional Health sports medicine department will present a program from 6 to 7:30 p.m. Aug. 16 at the Hendricks Regional Health YMCA in an attempt to clear up any misconceptions and inform the public of the new law.
”I think that the biggest thing overall is just that the general awareness of concussions has increased dramatically in the last decade, but in just the last four or five years alone,” Booher said. “It is parents, coaches, athletes, general public. People are taught about concussions and are getting a little more educated on it. The purpose of the talk is to just try to further that education.”
Booher will explain what a concussion is, how it is defined, and how it is dealt with on the sports medicine side. He will discuss the tests that they use with diagnosing concussions and treating them, including the ImPACT test -- a computerized neuropsychological test.
”One of the things with the ImPACT is that we’re getting baseline tests on all of the athletes, prior to their season starting,” Booher said. “During the season, if they unfortunately sustain a head injury, we’ll utilize that test as part of our return to play process. Their test must return to baseline for them to move onto the next step.”
The process for a student-athlete who sustains a concussion is evaluation and no activity with rest, then some lighter activity to see how they respond, then more sports-specific exercise, then to training drills and practice, before finally returning to game activity. Booher said some students are even taken out of class, depending on the severity of the concussion.
This process occurs to keep the athlete from enduring what is called “second impact syndrome.”
”When you do have that initial head injury, you have an increased risk of a subsequent head injury in that window of time as you are trying to heal,” Booher said. “Even when athletes are asymptomatic, we’re still finding that there is probably still a period of time where it can take up to three weeks from when they feel better to when they are really better.”
He said it’s much more dangerous in younger people.
”There’s a risk of second impact syndrome, where you get a second blow to the head and through other physiological forces, they basically lose control of the regulation of blood supply around the brain and it causes vascular engorgement and swelling of the vessels and swelling of the brain,” he explained. “The skull doesn’t grow and expand, so it basically chokes itself. There has been some death and paralysis from second impact syndrome. It’s something that is almost exclusive in young athletes, under 20 years old is almost where you find second impact syndrome. It’s not reported cases of professional athletes, it’s the young mind.”
Booher said catastrophic head injuries are three times more likely for high school football players than college football players.
Indiana passed legislation, which started July 1, in an attempt to cut down on head injuries for student athletes, and forces them to take the process in recovery.
”In the law, it requires the schools to distribute out information sheets to inform and educate coaches, athletes, and parents about the nature of head injuries and the risks involved with continued play after a concussion or head injury,” Booher said. “The students and parents will be given an information sheet to sign it and return it to the school. We keep that on file at the schools that we take care of on the west side.”
In addition, the legislation heavily monitors the recovery process.
”If an athlete is suspected of sustaining a head injury, whether that’s in practice or a game, they are to be removed at the time of the injury and they cannot return to play that game or practice,” Booher said. “One of the newer caveats is that they have to have written clearance from a licensed health care provider who is trained in the evaluation and management of concussions and head injuries.”
Booher said that won’t be a huge transition for HRH sports medicine, as they’ve been doing much of that in the past.
And, he said, while concussions are heavily linked to football injuries, other athletes are susceptible.
”I’ve noticed such an increase in headaches among female athletes,” he said. “It’s gotten to the point, for me, that football is the number one sport with head injuries, then girls’ soccer is right there at number two. That’s easy to overlook. We think about head injuries and mostly football, but girls’ soccer, girls’ basketball, lacrosse, wrestling, boys’ basketball. People can get head injuries from just playing around the house as well, but I’ve noticed an increase among female athletes.”
Booher said they really don’t know why females are more susceptible, but it could include weakness of the neck muscles, hormonal differences, or genetic predisposititions. He said they’re hoping that research will give them some answers over the next decade or so.
He also said they’re seeing more cases of head injuries, most likely as a result of more awareness.
”It may just be because people are more aware,” he said. “Coaches are more aware. Kids are more aware and they are more inclined to come in and get looked at, whereas in the past they might not have reported it. Even today, there is still under-reporting going on, where athletes are hesitant to say they’re hurt because they don’t want to get pulled out. That’s the part that we’re trying to educate them on, to try and realize that you could be doing yourself a serious disservice by not reporting symptoms of a head injury.”
The Hendricks Regional Health YMCA is just off of U.S. 36 at 301 Satori Parkway, Avon. All in the community are welcome to the program and no YMCA membership is required.