New tool helps screen young athletes for concussions

 

10-year old Blaine Dyer is getting a checkup of his brain.

Gwinnett Medical Center pediatric neuropsychologist Dr. Adam Shunk wants to know how the Dacula fourth-grader is doing after Dyer took a hard hit during a youth football scrimmage game a couple of months ago.

“When I play football, I don’t cry unless I’m really hurt,” says the Gwinnett fourth-grader.

But, this time, Dyer did cry, for good reason.

“This kid grabbed my legs and then another kid came beside me and hit me right on my head,” he says. “It was hurting my head, because my helmet was squishing my head a little.”

Dyer was taken out of the game, suspected of having a concussion.

That hit may have jarred or shaken his brain inside his skull.

Sometimes there are symptoms, but sometimes not.

And while it’s dangerous to return to play too soon, before the brain has had time to heal,  Dr. Shunk says many young athletes may be reluctant to admit they’re hurting.

“I mean every kid wants to get back on the field as quick as possible,” says Shunk.  “So they’re not always going to tell you when they’re having symptoms.”

Dyer says he wanted back on the field.

“And I was kind of mad, because I really wanted to play my game, because I’d been waiting for it,” he says.

But a new screening tool could take the guesswork out of screening children as young as 5 for concussion.

It’s called ImPACT Pediatric.

“It evaluates areas that are sensitive to a concussion: such as speed of processing, their learning and memory abilities and general attention, that can be disrupted when you’re recovering from a concussion,” says Dr. Shunk.

Many high school and college athletes already get baseline ImPACT screenings before their season begins.
Then, they retake the test to look for changes in their performance after a suspected concussion.

Now, Dr Shunk says, they can do the same before and after screening for athletes between the ages of 5 and 11.

Blaine Dyer, who is now happily back in the game, recently scored his first touchdown of the season.

It’s really exciting,” he says.  “When you first go out there, and you have a concussion.  And then you  go back on the field and score a touchdown, it’s really cool.”

 

Galvin, Beth. “New Tool Helps Screen Young Athletes for Concussion.” WAGA. FoxATL, 28 Sept. 2016. Web. 29 Sept. 2016.

 


Concussion safety: A parent’s guide to the fall sports season

Football season has kicked off, and Friday night lights are shining for parents around the nation. Unfortunately, with football comes injuries, and the most common injuries discussed today are concussions. Even if your child doesn’t play football but is involved in another sport, you should know the definition of a concussion and what this means for your child.

A concussion is caused by a bump, blow or jolt to the body, with a force transmitted to the head, causing an injury to the brain. Because kids are not fully physically developed, having thinner skulls and weaker neck muscles, they are more susceptible to concussions.

Concussions have been estimated to account for 9 percent of all high school athletic injuries. However, it is estimated that 50 percent to 75 percent of concussions among high school athletes go unreported. What is most alarming in youth sports is that those 13 and younger are more likely to receive a concussion, and most of those are not reported.

Before your children get involved in sports, it’s important that you and your kids are properly educated and know what to do if a concussion is suspected. This should start with a checklist of the basics:

▪ Does your child know how to recognize and report a suspected head injury?

▪ Does your child know how to express a head injury to a coach, parent or teammate?

▪ Does your child’s team or league have a concussion protocol?

▪ What type of physician (neurologist, family medicine or pediatrician) would you take your child to for the evaluation and treatment of a concussion?

Once your child has started playing, become vigilant about head injuries. If you suspect your child has suffered a hit to the head, watch for these common symptoms of a concussion:

▪ Headaches.

▪ Confusion or the feeling of being “in a fog.”

▪ Dizziness or balance problems.

▪ Fatigue or drowsiness.

▪ Nausea and/or vomiting.

▪ Sensitivity to light and noise.

▪ Irritability or nervousness.

▪ Trouble concentrating.

If you think your child or adolescent has a concussion, there are a number of dos and don’ts to follow:

▪ Do stop playing – immediately!

▪ Do tell a coach, trainer, teammate, friend or parent.

▪ Do consult a physician.

▪ Do keep hydrated.

▪ Do get some rest.

▪ Don’t continue playing.

▪ Don’t return to sports activities without medical clearance.

▪ Don’t consume alcohol.

▪ Don’t drive.

The nation’s growing awareness of concussions in the last decade has helped pass legislation to improve the treatment and management of concussions, especially in young athletes. State law requires parents, coaches, athletic trainers and, in some states, athletes to provide education about the symptoms and risks of a concussion. During athletic events, an athlete exhibiting concussive symptoms must be immediately taken out of play and is not allowed to return until they have received clearance from a medical professional.

As a result of legislation and research findings, the “6 Steps to Safe Play” were developed. Of particular significance are the tests now available to test your child’s brain function before and after injury. If your teen participates in a school sport, the following “6 Steps to Safe Play” are recommended:

1. Your child should have a preseason baseline, which is completed with ImPACT, a neurocognitive computerized test for kids 13 and older.

2. Sideline testing with SCAT 3, King Devick or BESS should be available.

3. If your child is injured while playing, he or she should be re-tested with ImPACT.

4. If concussion symptoms and ImPACT indicate a possible concussion, immediately seek medical treatment at a concussion clinic.

5. Once cleared by the doctor, your child can return to play and return to learn.

6. The team’s athletic trainers should have access to the Concussion Injury Surveillance System, a tool used to track concussions.

If a concussion is left untreated or an athlete sustains multiple concussions, your child could suffer permanent brain injury. The inherent competitive nature of sports and culture to win at all costs may sometimes overshadow the need to call attention to reporting injuries. As a coach, parent, athlete and even a fan, we must encourage the reporting of head injuries within the sports culture. An athlete’s awareness of the signs, symptoms, and effects of a concussion can only improve the safety of our athletes. Educating all parties, particularly our youth athletes, has shown to increase concussion awareness and reporting, making it a vital component of sports safety this school year.

For more information, visit UConcussion.com.

Gillian Hotz, Ph.D., is the director of the Kidz Neuroscience Center at UHealth – the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.

Read more here: http://www.miamiherald.com/living/health-fitness/article101433897.html#storylink=cpy
 Hotz Ph.D, Gillian. “Concussion Safety: A Parent’s Guide to the Fall Sports Season.” Miamiherald. Miami Herald, 12 Sept. 2016. Web. 13 September 2016

Concussions: Don’t let children return to sports too soon

School is back in session and along with it the fall sports season. Youth sports promote physical activity and camaraderie, and the lessons of team sports can last a lifetime.

But injuries are a reality with youth sports, and kids are especially vulnerable to head injuries and concussions. There has been a lot written about sports-related head injuries in the last few years, yet kids and parents alike often downplay symptoms of concussions and rush too quickly to get back to the field or court.

There has been a lot written about sports-related head injuries in the last few years, yet kids and parents alike often downplay symptoms of concussions and rush too quickly to get back to the field or court.

A new study points out the risk involved with returning to sports too soon after a head injury. Researchers from Arkansas followed 70 young athletes who came to a medical facility for treatment of a sports related concussion. The average age was 15½. Half of the young men and women were removed immediately from play, while the other half were allowed to continue playing. Neurocognitive testing as well as assessment of symptoms such as headache were done a week later then again a few weeks after the first assesment.

The group that was allowed to continuing playing despite concussion symptoms took twice as long to recover compared to the group that was removed from play immediately (44 days versus 22 days). Kids who were allowed to continue playing were also more likely to have a long recovery from concussion symptoms (more than three weeks) including headache, dizziness, impaired cognition, academic, and psychosocial problems. The authors concluded that kids recover from concussions significantly faster if they are removed from participation immediately after their injury compared to those who were allowed to continue playing.

The findings from this study are not surprising. More than 3 million sports or recreation-related concussions occur in the U.S. annually. Adolescents are at the greatest risk for sports-related concussions and recover much more slowly than adults for unknown reasons, but possibly because their brains are still growing and developing.

Research has shown that the injured brain loses its ability to protect itself from a second injury, making the risk of a short-term second impact potentially catastrophic, and the risk is amplified is children and adolescents.

The danger period after a first concussion is unknown but it is likely at least 10 days. But even weeks later, kids can have subtle effects of a concussion, including emotional and mental symptoms including irritability and frustration. The psychological effects of a concussion may even start weeks after the physical effects have resolved.

In 2013, The American Academy of Neurology released guidelines on the evaluation and management of sports concussions. The first recommendation of the guideline is that an athlete suspected of having a concussion should immediately be removed from play and should not be allowed to return to play until evaluated by a trained health-care professional with training in both the diagnosis and management of concussions.

The guideline further recommends that high-school age or younger athletes should be treated much more “conservatively” than college or adult athletes, acknowledging that growing children and adolescents are at much higher risk of serious brain injury.

There is no evidence that any medications or other treatments hasten recovery over simple rest.

For boys, the risk of sports concussion is greatest with football and rugby, followed by hockey and soccer, while for girls the risk is highest with soccer and basketball.

Most sports injuries, such as a sprained ankle or broken wrist, are easily diagnosed and treated. But concussions may represent a far greater and longer-term risk. As a parent or coach, always put the player’s well being first and treat any head injury as a potentially serious injury.

 

Correspondent, Bill Elliott IJ. “Concussions: Don’t Let Children Return to Sports Too Soon.” Concussions: Don’t Let Children Return to Sports Too Soon. Mariniji, 04 Sept. 2016. Web. 06 Sept. 2016.

Playing it safe in the heat!

In case you haven’t noticed — it is hot! With participation in outdoor fall sports beginning, schools and coaching staffs are taking extra precautions to keep their athletes safe from heat-related issues. In recent visits to both area high schools, coaches and staff members were following strict guidelines to help ensure the safety of their players.
According to the National Weather Service, heat is a leading weather-related issue in the United States that results in fatalities or illnesses. With heat advisories popping up throughout the state, it is important to monitor the heat index, a measure of how hot it really feels when relative humidity is factored together with the actual air temperature. During extremely hot and humid weather, the body’s ability to cool itself is challenged, which can result in heat cramps, heat exhaustion or even a heat stroke.

Cortney Bowers, certified athletic trainer for Colleton County High School, is cranked up for football season – meaning she’s on-duty during practice to help ensure the players’ safety. According to Bowers, South Carolina does not have actual heat regulations, but most athletic trainers within the state use a work/rest/water and continuous work/water consumption guideline made available by Fort Jackson.

“The guidelines are a way for us to categorize the temperature-vs.-work ratio to gauge when we should stop practice due to temperatures,” explained Bowers. “Athletes often don’t realize the toll heat takes on their bodies until they are suffering from a heat-related condition. As temps hit the high notes, I hit the water bottles and get out the Kestrel,” said Bowers. “The Kestrel is a dry-bulb/wet-bulb globe thermometer which measures temperature, humidity and heat index. It will work standing in the middle of a football field.”

Bowers is also charged with helping keep the players hydrated during practice. “I try to keep every player as hydrated as possible throughout practice, with plenty of water on the practice field,” said Bowers. “I have 18-20 sets of water bottles, so each coach has two sets of their own in groups. I have two 20-gallon water boys that I use on opposite sides of the practice field. The linemen, who tend to be bigger, have 4-to-5 sets of bottles and a 20-gallon water boy to help keep them hydrated. Last year, we had a continuous feed water boy purchased for us, which enables me to put ice in the chest and plug it up to a water hose for a continuous flow. On standby, I have 7-8 ten-gallon coolers filled with just ice to replenish the smaller water boys as needed and keep a seven-gallon cooler with towels, ice, water and ice bags in it for emergency.”

The Cougars will go full gear on Wednesday, which means Bowers will be going a step further in her preparation. “Once we put pads on, I will have a tent on the sidelines,” said Bowers. “I’ll keep the water under the tent and have tubs set up for emergency cold soaks or just for the guys to take a nice dip after practice. I also have the whirlpool inside that is ready to go if needed.”

According to Bowers, part of staying safe in the dangerous heat begins before athletes step on the field. “I preach to these kids to drink lots and lots and lots of water,” she said. “Although some Gatorade is acceptable, nothing beats water. Gatorade, which is heavy in sugar, can actually cause cramping. So, I always tell players if they drink Gatorade, fill the empty bottle back up with water. It is also very important to eat in the mornings before practice — whether it’s eggs and bacon or a peanut butter sandwich, it gives them the necessary energy for practice and helps reduce overheating. Dressing in loose fitting, comfortable clothing or heat gear, is another component to staying cool.”

The State of South Carolina has mandated that all coaches take an annual test through the National Federation of State High Schools on heat illness prevention, concussions and sudden cardiac arrest. This precaution allows coaches to know the signs and symptoms and to both stay educated and help educate.
“With coaches and athletic trainers understanding what to watch for, it means more eyes to watch for signs and symptoms, which is better for our athletes,” said Bowers.

 

Crosby, Cindy. “Playing It Safe in the Heat!” Walterboro Live. Walterboro Live, 12 Aug. 2016. Web. 23 Aug. 2016.

 

 


High schools must adopt guidelines to prevent sudden deaths of athletes

The death of 14-year-old Lewis Simpkins has once again raised questions about whether we are doing enough to prevent sudden deaths in sports.

The sophomore defensive tackle at River Bluff High School stumbled through the end of a 2-hour, 15-minute football practice before collapsing in the locker room on Aug. 10. Coaches gave him CPR and used a defibrillator. Paramedics took him to Lexington Medical Center, where he was pronounced dead.

Over a recent 20-year period, 243 deaths occurred during high school and college football practices and games. That’s about 12 per season. The most common causes were heart failure, brain injury and heat illness. The cause of Simpkins’ death has not yet been determined.

A recent article in The State newspaper pointed out that South Carolina high schools show poor compliance with guidelines to prevent sudden death. These guidelines come from the Korey Stringer Institute, a leader in research and education to improve safety and prevent sudden deaths for athletes and the military.

In the article, South Carolina High School League commissioner Jerome Singleton noted that he wasn’t familiar with the Institute or its guidelines. He did point out that coaches in this state must complete online courses regarding heat acclimatization and concussions. He also emphasized that the SCHSL reviews its medical policies annually.

Korey Stringer was an NFL offensive lineman for the Minnesota Vikings. He died from exertional heat stroke after an August practice in 2001. His wife Kelci partnered with heat stroke expert Dr. Douglas Casa at the University of Connecticut to create the Korey Stringer Institute. The NFL, Gatorade and other companies and organizations contribute to the Institute’s efforts.

One area of concern for football teams in the South is the heat, with 63 percent of deaths from heat stroke in football occurring in the South. Fortunately, these deaths are largely preventable. Unfortunately, South Carolina does a poor job complying with guidelines that can prevent these deaths.

While North Carolina and Georgia, as well as Alabama, Mississippi, Arkansas and Texas, meet the minimum best practice guidelines for heat acclimatization, South Carolina only meets one of the seven KSI guidelines. These guidelines include limits to the number and length of practices in the first weeks of summer football and recommendations for gradually adding protective equipment.

South Carolina schools also meet none of the guidelines regarding the use of Wet Bulb Globe Temperature (WBGT). The WBGT requires a special device to measure the outside environment for heat stress. It’s likely that the cost of the device plays a factor in our poor compliance, but Georgia meets all nine of the best practice guidelines for WBGT.

South Carolina does somewhat better with access to automated external defibrillators (AEDs) and training in CPR and AED use — meeting five to six of the Korey Stringer Institute’s eight best practice guidelines.

In terms of plans for emergencies like the tragedy at River Bluff, South Carolina again needs work. Of the 11 guidelines issued by KSI regarding emergency action plans — schools coordinating with local EMS, athletic trainers and physicians on-site to develop plans should a medical emergency occur — South Carolina meets none of them.

The South Carolina High School League needs to adopt these heat acclimatization and emergency action plan guidelines. It should work with its high schools and the state legislature to arrange funding for WBGT and certified athletic trainers for each school.

Schools, though, don’t have to wait for a statewide mandate to take action. Concerned parents of high school athletes can talk to the athletic directors and coaches to discuss plans to treat and prevent deaths from cardiac arrest, heat stroke and brain injury.

This isn’t about pointing blame at the SCHSL or the high school athletic directors and coaches around the state. My goal is to raise awareness and encourage change.

As tragic as the sudden death of a high school athlete is, it creates a perfect time to take steps to prevent another one.

Geier, Dr. “High Schools Must Adopt Guidelines to Prevent Sudden Deaths of Athletes.” Post and Courier. Post and Courier, 19 Aug. 2016. Web. 22 Aug. 2016.

How do I know if my younger child has a concussion?

We often hear concussion is a worry for parents whose tween or teen participates in sports. What usually gets less attention is that younger children also suffer from concussions and that their symptoms may not have a typical manifestation.

Is there concern if your younger child has suffered a concussion and you missed it? Here is some information to help you answer these questions.

1. We depend on the child’s complaints, performance and behaviors to diagnose a concussion. Concussion is a brain injury caused by a forceful bump, blow, or shaking of the head. The head does not need to be hit for the brain to be injured as some concussions occur only with head shaking, especially if the shaking is sudden and forceful. The brain injury cannot be detected by taking CT or MRI pictures of the brain.

What causes the brain injury in concussion is a change in the way brain cells use energy, communicate with each other as well as leaking of blood chemicals into the brain rather than physical changes in the brain. The doctor will know if a child has suffered a concussion based on the child’s complaints, level of functioning, and behaviors that imply that the brain is not functioning normally.

Credit: JAMA Pediatrics

2. Concussions are becoming more common in younger children. A recent article describing 8,000 concussions occurring in the Children’s Hospital of Philadelphia health system between 2010 and 2014 reported thatone-third of all concussions occurred in children under the age of 12. Many of these concussions were first treated by the primary care provider and not the emergency room showing that pediatricians are the ones that handle most concussions in younger children. While this is anecdotal, I can say that as a pediatrician, I have noticed in my practice that I am seeing more concussions and those occurring at an earlier age than perhaps 10 years ago.

3. The child’s complaints, performance, and behaviors that doctors use to diagnose concussion differ with the child’s age. Typically, concussion in a child 12 years or older is spotted by the coach or parent after a sports injury when he or she shows typical symptoms of fainting, nausea, headache, memory or concentration problems, balance problems or vision problems immediately following the injury. This is often suspected after a positive “sideline” assessment using a standard concussion questionnaire. In a younger child, the symptoms may be different.

A younger child might injure his or her head at home, playground, school or day care. The parent might not be aware of the circumstances or even that the injury occurred. A child may underreport symptoms to avoid getting in trouble or to go back to play. A child may also over report symptoms to skip school. A younger child should be suspected of having a concussion if there is a head injury AND the child has symptoms such as irritability, sudden mood changes, appetite change or sleep problems. These symptoms may be alone or in addition to the typical symptoms of loss of consciousness, nausea and vomiting, headaches, balance problems, and concentration difficulty seen in older children.

What if I missed a concussion in my child? Are there future consequences? We know that head injuries cause worse concussion symptoms if the child has had a previous concussion. Children having multiple concussion are at increased risk for prolonged recovery.  Here is what you can do to avoid missing a concussion and to prevent long term consequences:

Read up on signs and symptoms of concussion. Then you will be less likely to miss one. One of the best places to read about concussion in children is the Centers for Disease Control and Prevention website called HEADSUP.

When in doubt, see the doctor. If you suspect a concussion, then go to your child’s doctor as soon as possible. An emergency room visit is warranted if your child has any of these symptoms: progressively worsening headache, vomiting, difficulty waking up or paying attention, seizures, slurred speech or balance problem on standing up.

Rest is always the first step. If you suspect a concussion, having your child rest physically and mentally, and removing her from sports is always a safe bet until you can see or talk to your doctor. This is important since treatment of concussion starts with this kind of rest. Your doctor will recommend the ultimate duration of this rest and if any additional treatment is needed.

 

FAAP, Amer Kechli M.D. “How Do I Know If My Younger Child Has a Concussion?” Philly.com. Philly.com, 21 July 2016. Web. 28 July 2016.

Preventing Heat Stroke in Young Athletes

Staying hydrated throughout the day is best for teen athletes.

Conditioning for fall sports, like football, cross country and even marching band, has started but research shows that heat-related deaths are behind most indirect deaths in high school sports. Parents need to make their athlete take it slow when starting outdoor workouts and be aware of the dangers.

Heat exhaustion happens when the body’s natural cooling system gets tired from working too hard. Symptoms include fatigue, profuse sweating, dizziness and decreased exercise performance.

“When an athlete notices these symptoms, it is time for a break to cool off,” says Dr. Lora Scott, medical director of sports medicine at Dayton Children’s Hospital. “Sometimes ten minutes at the water cooler is enough. Other times, they may need shade or air-conditioning for several hours. They are at higher risk of getting sick again for 24 hours.”

Heat stroke happens when the body starts to shut down because it is too hot. If nothing is done, the person will die. An athlete with heat stroke may look like they have heat exhaustion, but they also start to have nervous system symptoms. These could be mild, like confusion or a short temper. They could be more serious, like seizures or loss of consciousness.

“Cooling within 30 minutes is the best predictor of life or death, in this situation,” says Dr. Scott. “Call 911 and do whatever it takes to cool them off fast.”

Heat stroke prevention day is July 31, one day before official practices for many sports begin. It’s a good time to review these tips.

Allow time to adapt. “Let kids start with easy outdoor training sessions to give the body time to adapt,” says Dr. Scott. “They may not be able to do their usual workouts when they move from the indoors to the outdoors. That is OK. Give it time.”

Stay hydrated. “Elite athletes can sweat up to four liters per hour!,” says Dr. Scott. “It is not practical to drink four liters in an hour, so practicing good hydration all day is important.” Drink until urine is colorless or very light yellow.

Listen to your body. If you feel overworked, it means your body is not ready for this level of exercise in this level of heat. You either need to cool off, or ease up on the exercise, or both. Take the time to condition safely.

Educate coaches. Make practice easier on the hottest days or move it indoors. Give the team unlimited access to water.

Take a collapsed athlete seriously. Make sure you are following the American College of SportsMedicine’s guidelines on length, intensity and frequency of practice.

Treat suspected heat stroke.

If an athlete acts strangely, think heat stroke. “Call 911 and cool them off immediately,” says Dr. Scott.

“Place them in a tub of ice water, pour water from a cooler over them, put ice packs on their neck, armpits and groin, use a garden hose if you have to. This is a life-or-death situation, and treatment is easily available and free.”

 

Dayton Children Hospital. “Preventing Heat Stroke in Young Athletes – Athletic Business.” Athletic Business. Athletic Business, 27 July 2016. Web. 28 July 2016.

USA Football program aims to lesson impacts of youth concussions

It’s a violent game that makes a lot of parents uneasy, but numbers for Pee Wee football continue to grow in the Miami Valley.

Safety is a major concern for the estimated 15,000 kids who will suit up for teams around the Dayton area this fall. Concussions are a constant concern no matter if the athlete is 6 years old or 16. The idea is to teach the proper techniques at an early age.

That’s why several local coaches spent a morning recently at Beavercreek High School learning how to teach youngsters to play the game the right way and educating adults on keeping the players safe.

It’s part of a program called “Heads Up Football,” which was developed by USA Football to help lessen the impact of concussions.

“The most important thing is having a controlled environment for practice to get them ready for games,” said Pee Wee coach Darrin Roth. “That way they know how to tackle, they know how to fall and they know the proper form when it’s time time to go full speed.”

Roth is the player-safety coach for the Western Ohio Junior Football Conference. He admits the game at the youth level has changed in the last decade to reflect problems that could persist as players get older, faster, and stronger.

“The kids health is more important to me than winning,” he said. “I’m going to make sure that if that kid tells me he has a headache and he doesn’t feel good, he’s not playing again until he gets checked out by a doctor.”

The clinic also focused on providing the proper equipment and making sure a child doesn’t take the field with a helmet or shoulder pads that doesn’t fit.

“We have to make sure that players are comfortable in their gear and not afraid to hit,” Roth said. “Just because we’re wearing equipment doesn’t mean we’re invincible, but we’re trying to teach a new way of football and make sure the kids are safer and most important, having fun.”

 

Hartsock, Mike. “USA Football Program Aims to Lesson Impacts of Youth Concussions.” Dayton Daily News. DDN, 20 July 2016. Web. 28 July 2016.

A heady subject: Local youth coaches participate in USA Football safety training

Alex D'Agostino, center, leads a clinic at Hannibal High School on Saturday.

As a football referee, Alex D’Agostino began to observe a game that in many ways was becoming more dangerous.

He decided to do something about that.

D’Agostino teams up with USA Football to serve as a master trainer who travels the country putting on coaching clinics that emphasize safety on the gridiron.

On Saturday, D’Agostino led a “player safety coach clinic” for local youth football coaches from Hannibal, Palmyra and other surrounding areas — all who coach teams younger than the high school level.

“We want to start the kids out right with safety about heat and hydration, sudden cardiac arrest and concussion awareness, while also teaching the fundamentals of blocking and tackling,” D’Agostino said. “We want them to start out correctly in their youth levels and make sure their coaches are certified.”

The four-hour session was split into two segments. For the first two hours, the coaches gathered for a meeting at Fiddlestiks Food and Spirits, where D’Agostino talked about the importance of USA Football’s Heads Up football program.

The rest of the time was spent on the field at Hannibal High School, where the youth coaches endured the heat to practice tackling and blocking drills they will soon implement with their own teams. Each drill focused on players keeping their heads up, which statistics indicate lowers the chance of injury.

The training also extends beyond the field, D’Agostino said. Coaches who completed the clinic were instructed on proper equipment fitting, especially when it comes to helmets.

“We see the need to enhance the safety practices,” Hannibal youth coach Jason Ross said. “We know what we’re doing here in Hannibal, but it’s just to make sure everybody is on the same page.”

For many local leagues, USA Football’s Heads Up training is nothing new. The clinic was a “refreshing course,” Palmyra youth coach Ben West said.

“You’re always learning something new,” he said. “What we try to do as coaches is teach fundamentals. Safety is a huge process. Watch out for the kids, make sure they’re learning and having fun. That’s what my main goal is.”

According to USA Football, more than 1,100 high schools and nearly 70 percent of all U.S. youth leagues enrolled in Heads Up Football in 2015. The program is endorsed by a combined total of 26 state high school athletic associations and high school football coaches associations spanning 21 states.

The lessons learned at the training were not supposed to be left on the field Saturday. Each coach plans to tell their fellow coaches about what they learned and monitor practices and games throughout the rest of the year.

“We’re going to make sure every level is doing this,” West said.

 Ross said he’s fortunate to have only seen one concussion injury in his four years as a coach. The training, though, is to “improve the culture.” The local coaches agreed the program should ease concerns of the danger of football, especially when it comes to parents uncertain whether they want their children to play. “We’re trying to make a better, safer game,” D’Agostino said. What would he say to those who still think football isn’t a safe game? “My son played for nine years,” he said. “I was the coach. That should answer.” The turnout of about 10 coaches on Saturday was smaller than most of USA Football’s clinics. That, though, does not make it any less important, D’Agostino said. “It’s a great group of volunteers coming out to make sure they’re trained the right way, that they can go back and train their coaches,” he said. “Hopefully, the conversations we’ve had with them, they’ll bring it back to their programs.”

Graeler, Kevin. “A Heady Subject: Local Youth Coaches Participate in USA Football Safety Training.” Hannibal Post. Hannibal Post, 18 July 2016. Web. 20 July 2016.

Soccer collaboration tries to get ahead on youth concussions

Toronto FC and Holland Bloorview are working to give youth baseline testing and concussion education.

Remy Cattell, 14. suffered a concussion playing soccer two years ago, but she was fortunate to have had baseline testing done at the Holland Bloorview concussion centre before the incident. Youth in the TFC academy will get the same testing in a joint program with the hospital that will also include concussion education.
Remy Cattell, 14. suffered a concussion playing soccer two years ago, but she was fortunate to have had baseline testing done at the Holland Bloorview concussion centre before the incident. Youth in the TFC academy will get the same testing in a joint program with the hospital that will also include concussion education.  (RICHARD LAUTENS / TORONTO STAR) | ORDER THIS PHOTO  

Remy Cattell took a baseline concussion test with her hockey team ― she was a random participant in a study by the concussion centre at Holland Bloorview Kids Rehabilitation Hospital ― but an incident on the soccer field landed her back at the centre, tired and dizzy.

Cattell had just started the eighth grade when a fellow player on her Leaside Tigers competitive soccer team cleared a ball from the team’s defensive end.

The ball hit Cattell, about five metres away, in the head.

She was knocked to the ground. The ringing in her ears kept her from hearing anything properly. She left the game but tried returning, ultimately for just a few minutes, once the ringing stopped.

Two years on, Cattell, 14, knows she suffered a concussion, the blow to her head enough to jiggle her brain. But at the time, she wanted to play.

“I didn’t really know about concussions or that it could happen to me,” Cattell said. “It probably was made worse than it needed to be.”

Her mother Cory and their family doctor didn’t know what to do. It wasn’t until Cory remembered the baseline test that Cattell returned to Holland Bloorview for help.

“When it first happened, I was so lost,” Cory said. “Calling the doctor, trying to find out what do I do, who do I call, how do I get help, what kind of things am I supposed to look for?”

A lack of awareness about concussions and how to deal with them is not unusual in young athletes and their parents, said Dr. Nick Reed, co-director and clinician scientist in Holland Bloorview’s Concussion Centre.

And while soccer might not be the foremost sport associated with the brain injury, it is still a contact sport that sees a tremendous amount of head contact, according to Michael Rabasca, Toronto FC’s director of high performance.

That’s part of the reason why the two organizations have teamed up for a one-year collaboration. The joint effort will focus on youth players in Toronto FC’s Academy. They will participate in the same baseline testing program Cattell did, and they will receive concussion education and training.

Reed and Rabasca hope teaching the group about concussions, while studying their tests for research, will be a step toward a safer game, both at the professional level and in amateur athletes like Cattell.

To date, Reed said, what’s lacking in people’s understanding of concussions is not the physical symptoms, such as headaches, dizziness and nausea.

“The injury itself has a wide range of symptoms: physical, cognitive, emotional and behavioural symptoms,” he said.

Young people recover differently, and sometimes more slowly, from concussions than adults, Reed said.

Cattell considers herself “pretty lucky” that she was only out of school for about a month. Two years later, she still plays soccer but doesn’t head the ball.

Initially, though, the stress of people not understanding her “invisible” injury hindered her recovery.

“People were still expecting me to be fine. I told my teacher I had a concussion but he was still sending me homework and still expecting me to get assignments done,” she said.

At that time, Cory said, her daughter struggled to even read.

“I was scared people wouldn’t believe me, because you can’t even see it,” Cattell said.

In professional sports, Rabasca said, sometimes such invisible injuries go unacknowledged.

“There is this hunger, desire, the social norm says, ‘You play, you don’t sit.’ We have too many examples of that at the pro level,” he said.

While those players’ intentions might be good, they’re not examples Rabasca wants Toronto FC’s academy players to follow.

In a group of about 120 participants, Rabasca believes between eight and 12 per cent of players have concussion concerns each season.

With the help of Holland Bloorview’s assessment and follow-through protocols, Rabasca says there is much less subjectivity when dealing with head injuries.

Today, he’s confident he’s sending fully fit players back on the field after a concussion.

“We’re not taking a gamble. We’re not sending players back on the field saying, ‘Our best bet is you’re going to be okay.’ ”

Armstrong, Laura. “Soccer Collaboration Tries to Get Ahead on Youth Concussions | Toronto Star.” Thestar.com. The Star, 17 July 2016. Web. 20 July 2016.