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Athletic Trainers, Coaching Staffs Take On More Responsibility

February 28, 2013
By ART LIMANN and TYLER REYNARD - Staff Writers , The Intelligencer / Wheeling News-Register

WHEELING - Injuries in sports have always been a concern. Most recently concussions, associated with the high-impact hits that can take place in football and other sports, have evoked a much higher level of concern - even drawing comment from President Obama that, if he had a son, he would have to think about allowing him to play the game.

"The game of football is a great game. There are a lot of great life lessons," Chris Daugherty, head football coach at Wheeling Park High School, said. "Parents are getting scared about concussions because they hear so much about them now. I'm not sure if there are more now than in the past, or if people are becoming more aware of them and you are hearing more about them."

He said the West Virginia Secondary Schools Activities Commission addresses the concussion issue every year. In fact, he said it is one of the major topics discussed. Coaches must also pass a computerized test on concussions before they are permitted to coach.

"Our biggest thing is not to put kids in danger until we have a diagnosis," Daugherty said, referring to youngsters injured during a game. "I would say football coaches in today's arena are removing kids from play whenever we see any of the warning signs. If they do have a concussion we have a standard return to play program that has to be followed."

He continued, "The most important thing I'm hearing from health professionals is we have to allow the brain to rest and heal before we return them to play. Studies are showing if you do that and allow the healing, the effects of a concussion are minimal. The problem is when you send them out to play too early. High school athletes are probably safer now than they have ever been because we have better equipment and better training."

In the future, Daugherty said he could see the game being "adjusted" with some rule changes to eliminate "some of the more scary situations" such as kickoffs.

Wheeling Park Athletic Trainer Pete Chacalos agreed that the WVSSAC has added concussion diagnosis and safety as a point of emphasis. He also noted all Wheeling Park players do "baseline testing" or "impact pre-test" prior to the season at Wheeling Hospital to give doctors a basis for diagnosis later. Concussion protocol at the school requires players to ease back into playing even after they have been approved by doctors to play again.

He said his job is to put the athletes through the testing and monitor how they respond. If there are any indications things are not right, they are not permitted to play and they go back to the doctor for a re-evaluation.

Dr. Derrick Eddy, director of Wheeling Hospital's Sports Medicine program, added, "Athletic trainers have to do more continuing education. There have been rule changes and coaches have to get more training. Coaches get it now. People realize this is real. Basically the word is getting out. It's not going away and everyone is pretty much on board."

Eddy describes a concussion as a "disruption of brain function." The injury does not appear on any type of scan, he noted, forcing doctors to diagnose it clinically. They look for a concussion to manifest itself through recognizeable symptoms like headaches, dizziness, loss of memory and sensitivity to light or sound, among others.

"Every case is treated individually," Eddy said. "There's no handbook when it comes to concussions."

Wheeling Hospital conducts preseason testing to document an athlete's baseline brain function. Immediate Post-Concussion Assessment and Cognitive Testing, referred to as IMPACT, is a computer program that tests athletes' verbal and visual memory, processing speed and reaction time. Athletes suspected of having suffered a concussion undergo the test to compare their results with their baseline scores to see how much brain function has suffered.

In the past year, Wheeling Hospital staff administered the test to 1,500 Ohio Valley student-athletes. Of those athletes, 250 - mostly football players - returned with suspected concussions to be tested again.

"It's objective data, so we don't have to rely on patients reporting symptoms," Eddy said of the IMPACT test. "Some athletes want to get back in the game so they might not be more forthcoming."

Athletes that return to action before concussion symptoms have subsided are more vulnerable to a second concussion, Eddy said. The condition, which is seen mostly in the immature brains of young people, occurs when a hit causes the brain to lose its ability to regulate blood pressure. Almost all athletes that experience "second impact syndrome" suffer permanent neurological damage and, in some cases, the condition can result in death.

"Kids in this country do die every year from concussions," Eddy asserted. "It's not a lot, but it does happen and it's usually the second impact that causes it. And a lot of times it's not a big hit."

John DeBlasis, head of physical therapy at Wheeling Hospital and senior administrator at Belmont Community Hospital in Bellaire, explained the concern and treatment of concussions has come a long way - to the point where what coaches and athletic trainers are required to learn and what there responsibilities are will be dictated by state law. Several states such as Ohio already have laws outlining coach's responsibilities.

"In the past it was common to rest seven to 10 days and you'll be OK, but there were no statistics to compare. No accepted model," DeBlasis said, noting the impact test now allows professional to evaluate a player's overall brain health. "Doctors have developed tests and now have data to use for evaluations. As research comes out it will get better."

Some state legislatures are now weighing in on the matter.

In Ohio, lawmakers late last year passed a measure requiring coaches and referees to remove a player from a game or practice who is showing symptoms of a concussion or head injury. According to the law, the player must sit out from action until being cleared by a medical professional.

The new law would apply to student-athletes and participants in a youth sports organization. All coaches and referees would be required to complete an education course every three years, the same as in West Virginia.

Tennessee lawmakers this month also proposed concussion-related legislation, the Associated Press reported.

Schools and other organizations with youth athletic programs would be required to adopt concussion policies under the measure.

The legislation is similar to laws passed in 42 other states and the District of Columbia that include provisions requiring students to be removed from an event if they show concussion symptoms, such as headaches, dilated eyes or vomiting.

The Tennessee proposal in particular would require schools to adopt guidelines to educate coaches, school administrators, athletes and their parents about the symptoms and dangers of concussions and head injuries. Under the measure, injured students wouldn't be able to resume the sport until a medical professional clears their return.

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