Illustration by Kenny Srivijittakar.
Illustration by Kenny Srivijittakar.
Illustration by Joe Lai & Kenneth Srivijittakar.
Illustration by Joe Lai & Kenneth Srivijittakar.

His head was spinning. It had all happened in what felt like a split second — one minute he was sprinting past defenders toward the end zone, and the next his helmet flew off and he was lying flat on his back in the grass. Panting heavily, he scrambled to stand up and try to recover the ball, but before he knew it he could feel himself falling again as his vision quickly blurred. He tried to regain control, but it was no use — he was slipping into the black abyss of unconsciousness.

This scenario has become a reality for a growing number of collegiate athletes nationwide who have suffered a concussion while playing a contact sport. According to the Sports Concussion Institute, 1 in 10 athletes participating in contact sports in the United States sustain a concussion annually, which amounts to roughly 1.6 to 3.8 million sports-related concussions.

Thanks to extensive media coverage on the much-debated issue of how to treat concussions and other serious head injuries in the National Football League (NFL), this topic has made its way onto the playing fields of high schools and colleges across the country, as well as into the halls of state assemblies and House judiciaries. That’s because for a student athlete who sustains a concussion, the severity of the injury and the way they address it can have a huge impact on their immediate health and the sustainability of their body and brain later on in life.

What Is A Concussion?

A concussion, otherwise known as a mild traumatic brain injury (MTBI), can be caused by a bump or blow to the head, neck or body that prompts the brain to move rapidly in the skull. There are different types of concussions ranging from grade one (which is considered mild) to grade three (the most severe, which is characterized by a loss of consciousness for at least a few seconds).

Depending on the severity of the blow, a concussion can be a significant injury — it can change the normal function of the brain and lead to serious long-term health problems if left untreated, or if enough time is not allowed to pass before the athlete goes back to his or her everyday activities.

Young athletes who return to play too soon — these make up 41 percent of all concussion cases, according to the American Academy of Neurology — put themselves at risk for additional concussions and even death in some cases, although this is a relatively rare occurrence.

Athletes who sustain multiple concussions throughout their playing careers also risk facing long-term health defects when they age. The Center for the Study of Retired Athletes at the University of North Carolina Chapel Hill conducted a study, released in June 2007, in which they found that NFL athletes with a history of three or more concussions are more likely to experience depression and cognizance issues, both of which are often precursors of Alzheimer’s disease.

UC Santa Cruz head athletic trainer Primrose Pisares says that concussions are not something to be taken lightly, as they can lead to health problems later in life.

“Concussions caused by a sports injury or otherwise can be serious because they can affect motor and cognitive skills depending on the severity of the injury, which can range from mild to severe and even death,” Pisares said. “If an athlete returns to play too quickly, his or her symptoms can worsen and lead to more permanent damage to the brain.”

The Trickle-Down Effect

While concussions and head trauma have always occurred in contact sports, it wasn’t until recently that they began to receive widespread recognition. It first began in 2007, when the NFL began a study on the long-term effects of concussions in retired players. This did not receive significant public attention until last year, when an Oct. 28 hearing before the House Judiciary Committee eventually led the NFL to suspend its survey after intense scrutiny of poor statistical sampling and accusations of possible bias.

Shortly thereafter, NFL Commissioner Roger Goodell implemented an overhaul of their previous concussion policies, which included a new rule that bans players from returning to a game or practice in which they have shown significant symptoms of a concussion. The policy now requires the player to receive clearance from a neurologist not associated with the team before he returns to play.

Pisares attributes the peak in concussion interest on the collegiate and high school levels to the recent NFL attention.

“Having the NFL in the news regarding concussions is a big thing, because people notice it,” Pisares said. “A lot of it has to do with the media, because otherwise how would people know this is coming up?”

Chuck Messimer, general manager of minor-league football team the Monterey Bay Vikings, believes the NFL’s actions have led the mass media to exaggerate the concussion issue.

“For lack of a better term, it’s a gore factor,” Messimer said. “People like to get hold of something that’s wrong with society and blow it up out of proportion.”

Jesse Trumbull spent nine years as assistant coach before becoming the head coach of the Santa Cruz High School Cardinals four years ago. He says the increase in concussion diagnoses can be attributed to a growing awareness of the injury.

“There have been head injuries in all contact sports since they started, but now that we have more information about it there’s obviously more concern over it,” Trumbull said. “It’s definitely a point of focus now for coaches. The medical staff has become more involved with the team and players.”

Concussion Commonality in Santa Cruz

Although UCSC doesn’t have a football team, concussions still occur in other high-contact sports on campus — particularly rugby, basketball, and soccer. Pisares said that one or two concussions usually occur per season for sports such as soccer and basketball. But for sports that involve more physical contact, such as rugby, concussions are even more prevalent.

“They’re definitely somewhat common, unfortunately, especially since there are no hard helmets like in football,” said Alex McKenzie, head coach of UCSC women’s rugby. “I’ve seen several a year, ranging in severity. … It’s relatively common compared to non-contact sports.”

When an athlete from one of the National Collegiate Athletic Association (NCAA)-sanctioned teams on campus does get a concussion, he or she usually gets a medical evaluation from a UCSC athletic trainer, who uses a template called the Sport Concussion Assessment Tool (SCAT) to determine the severity of the player’s injury.

The SCAT card comprises several different components that test the athlete’s memory, cognizance, physical symptoms and demeanor. Depending on the results, the trainer will then suggest a treatment plan, which usually includes sitting out for a week to 10 days from when the player has stopped showing concussion symptoms.

The NCAA has a few general guidelines, but no set of requirements that specifically dictates how to handle a concussion.

Pisares says that since it is difficult to prevent concussions altogether, what is most important is ensuring that an athlete receives proper treatment when they do sustain a head injury.

“We don’t have sports that require helmets like football, so it’s just about more vigilance when they do get a concussion,” Pisares said. “[It’s about] making sure coaches are following our guidelines, making sure athletes don’t do any physical activity, et cetera.”

Coaches such as Todd Kent, head coach of women’s basketball, fully put their trust in the UCSC training staff when it comes to handling serious injuries.

“As a head coach, I do whatever the trainers and doctors tell me,” Kent said. “If a trainer tells me they’re still symptomatic, I don’t let a player practice. I trust their opinion of what they tell me a player can and can’t do.”

Coaches at the high school level, in particular, are becoming more aware of the dangers of head injuries. Young athletes are especially vulnerable to serious injury from a blow to the head because their brains are not as developed as older athletes’.

The commonality of concussions in high school sports has been well-documented, especially when it comes to football. According to the National High School Sports-Related Injury Surveillance Study, roughly 68,000 concussions occurred during the 2008 high school football season. Although this may not sound like a very high number, concern arises from the very kids to play with good, safe technique to make sure everyone gets off the field healthy.”

Coaches and Congressmen Take Action

From Santa Cruz to Sacramento to Washington, D.C., various organizations are considering imposing more specific guidelines and requirements that outline how a concussed athlete should be treated and when they should be allowed to play again.

California Assemblyman Jerry Hill (D-San Mateo) recently co-authored a bill that, if passed, would require a high school athlete to provide a doctor’s note to the coach upon returning to the team after suffering a concussion. Several other states, such as Pennsylvania and Washington, either have similar bills pending or have already passed them.

Hill says his personal experience playing sports in high school inspired him to propose this bill.

“I played high school football, I was hit a number of times and I’ve got the scars to show it,” Hill said. “I know from a personal standpoint that head injuries are serious and that high school sports, especially contact sports, can be violent.”

Trumbull says he fully supports Hill’s bill, as he already requires a doctor’s approval for returning athletes who have been injured.

“If anyone, especially with a head injury, receives notice from medical personnel that they shouldn’t play, we don’t let them play again until they are cleared by that same medical personnel,” Trumbull said. “I would support that as something that should happen everywhere.”

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports is currently reviewing its set of standards on concussions, but has not yet made any specific recommendations for stricter guidelines. Head trainer Pisares believes any changes they make will not occur right away.

“I think the NCAA might look into their guidelines again and see if they can do anything from their end, [but] it’s going to take a while because they can’t just say, ‘You have to do this’ and put it in their handbook,” Pisares said. “They have to do research first.”

Women’s basketball coach Kent hopes that the widespread attention this issue is getting will lead to an increase in awareness, regardless of whether rules are changed.

“From this, I hope, will just come a better knowledge and understanding to treat each head injury as if it’s severe so [the athletes] can get the best possible care,” Kent said.

Meanwhile, Monterey Bay Vikings general manager Messimer summed up why concussions should be taken seriously when they occur:

“You can fix a broken arm, but you can’t fix a broken brain.”