Protecting players
PUSD and LHS take IMPACT test
“If in doubt, sit it out.” That’s the slogan that researchers at the American Academy of Neurology, doctors and others in the medical field are pushing to parents, players and coaches in regards to concussions and head injuries caused by athletics.
With the passing of new laws and heightened efforts to protect players against the possible long-term effects of concussions, Porterville Unified School District and Lindsay High School are taking preemptive steps toward the safety of their players.
Starting last week, all levels of PUSD football teams began taking the IMPACT Baseline Test. Lindsay teams are setting up dates to also take the test.
IMPACT stands for Immediate Post-concussion Assessment Cognitive Testing and “is a computerized neurocognitive assessment tool to help licensed healthcare providers evaluate and manage a suspected concussion,” according to the company’s website.
Dr. Abel Ojeda Jr., the clinical director at the PRO-PT branch in Porterville, said that the major reason behind all this advanced testing is because players return to play too early and with a still-developing brain that can lead to second-impact syndrome if they’re hit in the right spot.
“That is the one that can cause brain damage,” he said. “That is the one where they actually have a sub[dural] hematoma, so they have a brain lesion and their brain is bleeding. Because their brain did not go back to working normally.”
In 2013, PRO-PT made the tests and return-toplay protocol available to all Tulare County schools free of charge, and are now expanding to Kings County.
“We’re excited about the opportunity to work with people at PRO-PT. We think that they are very committed to keeping our athletes safe and we look forward to learning from them on improving the way that we monitor our athletes’ safety,” Rich Rankin, PUSD’S athletic director said.
The baseline test is a neuropsychological test that assess brain function at a normally functioning rate in all aspects including: Memory, reaction time, and sensitivity, said Ojeda. It is followed by the Post-injury Test that is taken if a concussion is suspected.
“We had a poor retest when we did it a few years back,” Ojeda said. “We tested an entire squad as well, kind of sort of like what we’re doing now and we rested one athlete. And the reality, 10-15 percent of all athletic injuries are concussions. So if they have 100 injuries, they should have roughly 10 concussions right? We only had one retest. So they’re not getting reported.” Although Ojeda did not say what school the tests were done at, it’s well-documented that many numbers for concussions are conservative because of under reporting.
Earlier this month, California was ranked 50th out of all 50 states and the District of Columbia in regards to sports safety policy implementation by the University of Connecticut’s Korey Stringer Institute. Parterned with the NFL, Gatorade and other organizations, one of KSI’S main goals is to increase education and safety of the game while maximizing performance.
The CIF Executive Director Roger Blake disputed the report saying, “The Korey Stringer Institute (KSI) has chosen to shine a light on certain areas, but it has left others in the dark. Thus, the information provided presented an inaccurate and incomplete assessment of what is occurring throughout California.”
A major issue for schools in California is that 80 percent of schools do not have full-time trainers and none are licensed in California, according to a 2015 story from CBS Sacramento. California is the only state in the nation to not recognize athletic trainers as licensed health-care practitioners and lacks regulation in the field.
According to the San Diego Union Tribune since the mid-1980s, the California Athletic Trainers’ Association has been lobbying the state to require certification and licensing for people to call themselves an athletic trainer. They came close in 2015 when a bill requiring such received unanimous support. But Governor Jerry Brown vetoed it saying the “burden” of certifying athletic trainers exceeded the possible danger of having unlicensed ones.
Although neither PUSD or Lindsay has trainers for their athletic programs, Lindsay does have a doctor, Joel Ramirez, that volunteers with their football team. Both PUSD and Lindsay’s athletic directors said that they are working to get trainers for their programs, and Ojeda said PRO-PT is willing to work with the schools.
Under CIF and state law, all coaches must receive training on concussions every two years and are required to remove a player if a concussion is suspected. That player must also sit out for a minimum of seven days, however Ojeda said that recovery is not always as short as 10 days.
Parents also have the right to remove their child if they believe a concussion has occurred. As mandated also by state law, parents are given and required to sign a concussion information sheet.
The sheet, available on the CIF’S website, states that a concussion “can be caused by a bump or hit to the head, or by a blow to another part of the body with the force that shakes the head” and that “most concussions occur without being knocked out.”
Players with suspected concussions can go to Ojeda and PRO-PT who will conduct the second form of the test. Results from both tests are compared and then sent to the player’s primary physician.
“It takes several domains to diagnose, like the neuropsychological test, mental, physical exam and a clinical interview. Those three or five things there kind of help diagnose the concussion, but this [baseline test] is just one step for that,” Ojeda said.
PRO-PT’S return-toprotcol occurs in five stages, or days, before PRO-PT and the player’s physician will sign a return-to-play sheet.
Day one is the postinjury test while day two is light exercise, like biking, that gets the heart rate up. On day three, the athlete runs, talks and answers questions followed by reading while strength training on day four.
An athlete returns to practice on day five and does about 90 percent of activities, while on day six they can do a full practice. After each day questions are asked about how the player is doing, if the player responds in the negative, a day will be repeated until that player can go through it with no problems.