Years ago, I was profoundly affected by the death of a high school football player in Idaho. I didn't know him, but the story of his death was all over the local news. The young man sustained what his coaches considered a mild blow while playing in a high school football game. After the hit, he jogged off the field and tried to shake it off. But he couldn't. He complained to his coaches that he was having trouble breathing. Sensing something was wrong, his coaches referred him immediately to the ambulance EMTs. Within a few minutes, this player, an otherwise healthy 17-year-old, was in full respiratory arrest. He was transported to an area hospital and was pronounced dead a short time later.
How could such a terrible thing happen? It was just a game, and he was just a kid. Someone close to the team said they believed he had gotten his bell rung the Friday before. Teachers at his school remembered him being a little lethargic in class the week of the game, and teammates said he had been complaining of headaches throughout the week. Apparently, however, he never told anyone else - not his coaches, not even his parents.
This young man was no different from most other young athletes who take their sport seriously. Nothing was going to keep him away from those Friday night lights.
Every year in the United States, more than 63,000 high school football players will sustain a concussion. That's one out of every six players. While it was never proven that concussion caused the death of that Idaho football player years ago, many of the signs that surrounded his death suggested a phenomenon known as second impact syndrome (SIS) could have been to blame. SIS occurs when an athlete who has sustained one head injury sustains a second one before the symptoms associated with the first blow have fully healed. And although it's relatively rare, it's fatal 50 percent of the time, and it's isolated to children under the age of 19.
Concussion symptoms will differ from person to person. The potential side effects can be long term. Concussed kids can suffer for months, even years, from headaches. Depression, mood swings and learning disabilities can also last. Even though symptoms may subside, researchers have been able to conclude that it takes much longer for the function of kids' brains to return to normal.
Last year I completed a study that investigated how much Idaho's high school football coaches knew about concussion. The study looked at how coaches evaluated and managed concussion and how they determined when it was safe to return athletes to play. What I found was that many of our coaches were not following research-based approaches to concussion management and were especially naive when it came to managing mild concussion, or "bell ringers." Their lack of understanding also clouded their judgment when making decisions about return to play.
Before we go placing blame, we need to understand that our coaches truly want to do the right thing. But we've got to give them the right tools to do it. Those first aid and CPR classes need to be supplemented with research-based training on current concussion management practices. It would be great if all schools could hire licensed athletic trainers. My study clearly showed that Idaho's largest high schools are managing concussion better most likely because of the presence of athletic trainers. But the simple truth is there just isn't enough money in Idaho's school system to pay for athletic trainers at every school, and even if there were, there aren't enough licensed athletic trainers out there to fill the necessary slots.
That's why we need to rely on education. Our coaches - and our kids - deserve it.
