According to a range of individuals at every level of contact with concussed young adults— from the neurosurgeons down to the athletes themselves— there has indeed been a palpable change in the culture surrounding head trauma in the sports world and, more specifically, in high school athletics.
“It’s definitely an awareness thing,” NorthWood girls soccer coach Phil Ummel said. “Even just five years ago, it wasn’t something anybody talked about… It wasn’t something that was on our radar to look for as coaches or players.”
One aspect of the concussion conversation that’s contributing to the rise in awareness of the extreme danger of the injury is, as Dr. Jim Gyurke explained, labeling a concussion for what it truly is.
“The seriousness of the injury has to permeate people’s thinking,” said the CMO of ImPACT Applications, a computerized concussion evaluation system. “One (part) is terminology— we talk about a ‘dinger,’ ‘getting your bell rung,’ ‘seeing stars’— none of it sounds terrible until you call it what it really is, which is a traumatic brain injury. That’s exactly what it is.”
When one thinks about identifying those most apt at avoiding calling concussions what they really are, the prototype of the super-intense, win-at-all-costs high school football coach is one of the first characters that comes to mind.
This coach, with his face red and spit/headset flying, has no qualms about putting his star player back in the game after “getting his bell rung” because, as the cutthroat culture of a bygone time calls for, winning is more important than the safety of a young adults.
But those sorts of coaches, as South Bend Clay football coach Joe Szajko explained, are outdated in today’s reformed climate.
“I think most of the coaches in the area… We’ve all kind of, I guess, changed in the sense that we all get that concussions are the big thing and they’re real and if you ignore it, you’re talking about hurting the kid,” Szajko said. “So many of us coaches, we have sons ourselves. I think if you go into it with the mindset of, ‘How would you want your son treated?’, (you realize) it’s really the right way to act.”
Whether it’s football, soccer or any other sport, athletes at all levels feel the competitive pressure to stay in the game following a concussion or the onset of concussion-like symptoms.
But more and more athletes, coaches and parents alike are beginning to realize that when it comes down to it, it’s just a game.
“There’s still a stigma to it of, ‘Well, I don’t want to let my team down,’ or, ‘I don’t want to seem like I’m not tough enough to play,’ that I get and it’s certainly understandable,” Ummel said. “But it’s the coach’s job, it’s the adult’s job in the situation to make the kids realize that we’re talking about lifelong consequences here and these dangers are much more important than high school sports and the short-term rewards that you may get.”
Athletes are certainly starting to understand this— an understanding that can, in certain unfortunate circumstances, force a player to make the toughest decision of an entire career and walk away from the game forever.
Take former Fort Wayne Carroll soccer standout Maddy Messmann, a four-year starter on defense for the Chargers from 2009-12. Messman was third-team All-State and MVP of her team her senior year, playing well enough to earn a spot on the D-III Hope College (Holland, Mich.) squad.
But the 18-year-old, who had her first concussion her junior season and then another one this past April that occurred due to repeated headers during a tournament, had her collegiate aspirations derailed by head trauma.
“I had a series of concussions,” Messman said. “I didn’t know I had one and I kept playing and ended up getting multiple concussions on top of one another.”
Messmann was diagnosed with Post Concussion Syndrome (PCS) after her April incident, which led to a nearly three-month hiatus from soccer. But even when she returned to the pitch in the summer and arrived in Holland this fall, eager to seize her dream of playing college soccer, she couldn’t shake the headaches, fatigue, lack of concentration and other PCS symptoms.
“We were running sprints (during the preseason) and all of a sudden I couldn't see anything,” Messmann said. “Everything was blurry and I felt so nauseous, like I was going to pass out. I talked to the trainer there and she told me that it was in my best interest to no longer play soccer or any serious contact sport otherwise I would face permanent brain damage.”
When it came down to it, Messmann did the hardest thing an athlete can do— walk away from the game she loved with so much left on the table— but the logic of choosing her health over soccer, she says, is something she can live with.
“I didn’t want permanent brain damage because I have plans for a career and a family in the future, so I made the decision to not play anymore,” said Messmann, who is now a freshman at IPFW, “which was a really tough decision and one I’m still dealing with.”
It was a gut-wrenching process for Messmann’s parents as well, but they also knew Maddy was making the best possible choice for her long-term well-being.
"It’s a hard thing to do, because we’ve worked at this thing since she was nine years old,” said Messmann’s father Robert, who is a goalie coach for the girl’s team at Carroll. “This was the love of her life… For it to end like that, it’s not how you plan it to end.”
Robert went on to say that because of what’s happened with his daughter, he “can’t consciously tell a girl to head the ball while coaching.” This sort of intelligently cautious attitude— an attitude that clearly emphasizes long-term health over short-term athletic reward— epitomizes the trend in increasing awareness that Dr. Gyurke and other head trauma experts are noticing.
“I think that parents almost have to have a shift in their thinking about the injury,” Dr. Gyurke said. “But let’s put it this way— it’s a multi-generational effort to educate and raise awareness about the injury and its effects.”
Awareness does not begin in the stands where the parents sit, however— it begins on the sidelines. And that’s where, according to neurosurgeon, Colts medical team staff member and 43-year sideline veteran Dr. Hank Feuer, the most tangible shift in thinking has occurred.
“The biggest issue is recognition of the concussion,” Dr. Feuer said. “For years it was like, ‘Well, he didn’t lose consciousness so he didn’t have a concussion.' But we know in sports only five percent lose consciousness when they’ve had a concussion, and 95 percent don’t. So you’re basically missing 95 percent of concussions with (that mindset).”
Dr. Feuer, who serves as Co-Director of the Indiana Sports Concussion Network, also stressed that the importance of an actual exam (such as checking cognitive abilities, pupil dilation and reaction time and comparing those results to preseason baseline tests) when a concussion is suspected.
Dr. Feuer also believes the last part of the exam should be some sort of “stress-related exercise,” whether that be running in place or jumping jacks, as a way to obtain the most honest diagnosis of how the athlete is feeling.
“The biggest change that’s occurring now is… (trainers) have got to get beyond the, you know, ‘What’s your grandmother’s name?’ or ‘How do you feel?’ because every player says the same thing: ‘I’m great, I’m fine,’" Dr. Feuer said.
In 2011, Indiana lawmakers set forth legal guidelines for dealing with concussions and head injuries in IHSAA sporting events. The law says every high school athlete and parent must sign a waiver stating they understand they’re at risk for a concussion.
In addition, it requires “a high school student athlete who is suspected of sustaining a concussion or head injury in a practice or game” to be removed from play immediately and not return to play until he/she is evaluated and cleared “by a licensed health care provider trained in the evaluation and management of concussions and head injuries.”
“Now, it’s cut and dry— if there’s any symptoms, they’re done,” said Penn High School trainer Tricia Irvin, who’s been working sidelines for over 25 years at the prep and college level. “It’s actually kind of a relief that we don’t have to make that decision anymore as to whether they’re okay to play or not.”
Further concussion legislation will be passing through the capitol soon, too, as Indiana State Senator Travis Holdman (R, District 19) is sponsoring a bill for the upcoming January session that calls for concussion certification.
As Holdman explained, the law “would require that there be annual certification of all paid coaches, as well as volunteers, that are using any publicly funded facility.”
While the bill is initially focused on football, Holdman, who says he’s received nothing but positive feedback on the legislation, hopes to eventually expand the certification to coaches in other sports.
“Our hope is that we would be able to (implement it) to start next football season,” Holdman said. “If we get no push back from anybody, we certainly want to get this thing going as quickly as we can.”
And as Dr. Gyurke emphasized, as long as coaches, trainers, parents and athletes stay in the know about head trauma and its life-altering ramifications, the culture of athletes and concussions will only continue to improve.
“I think it’s a cultural shift and a greater understanding,” he said, “and that’s why (concussion) education plays so much of a role.
“When you talk about professional athletes, you really talk about returning to play (after a traumatic brain injury). When you talk about kids, the focus should be on return to life, return to school, because for the professional athlete, that is his or her job: to compete and to get paid for that. These kids… The reality is most of them will not become professional athletes… They have to take care of themselves in such a way that they can be functional, contributing adults.”