Napa Valley Register - Message At Concussion Forum: ‘When In Doubt, Sit ‘Em Out

AMERICAN CANYON â€" For decades, the most common images of concussions have been of unconscious athletes wheeled away on stretchers, or helped off a field with shaky speech and gait.

But an increasing number of trainers and doctors are sounding the alarm about less obvious, but more common, collisions they say can turn young athletes' brains into ticking time bombs if not properly treated. On Wednesday night, three of them shared their message at American Canyon High School in a forum to foster awareness of sports-related brain trauma, and how to recognize and treat it.

The message speakers shared with the 40-person audience was unequivocal: treat any apparent head injury seriously, keep an injured athlete off the field until symptoms clear fully, and never dismiss head blows as mere “dings” or “bell ringings.”

“Know your kids; make the call. When in doubt, sit ‘em out,” said Rob Brandon, a co-owner of Napa Valley Physical Therapy Center. “Sports are a great thing for kids, but there are risks when you play. We're trying to eliminate the catastrophic situations.”

The community discussion was hosted by U.S. Rep. Mike Thompson, D-St. Helena, who has taken up the cause of ex-athletes and service members dealing with traumatic brain injuries.

“We need to do what we can, collectively, to prevent it, diagnose it, minimize it and treat it,” said Thompson, a Vietnam War veteran and onetime football player for St. Helena High School.

From 2001 to 2009, an average of 173,285 patients 19 and younger were treated for sports-related brain injuries, the Centers for Disease Control and Prevention reported in 2011.

Head injuries among children and teenagers also are an equal-opportunity risk, two studies in the American Journal of Sports Medicine indicate. While football led a list of 20 sports with 64 concussions per 100,000 “athletic exposures” (one player in one game or practice), overall concussion rates for girls were 70 percent higher than for boys in sports played by both genders, like basketball and soccer, the journal reported in April 2012.

Melissa Bartholomew, athletic trainer for Napa College's sports teams, said benching an athlete after an apparent blow to the head is especially critical for the young to spare still-developing brain cells and also to prevent so-called second-impact syndrome, in which a second concussion soon after the first can trigger brain swelling that results in death or permanent neurological damage.“Because these injuries happen so much in high school, we need to know that young people's brains are more susceptible and take longer to heal,” she said.

Bartholomew told parents and coaches to pay attention to the majority of concussions in which players endure symptoms subtler than blackouts but no less alarming â€" dizziness, forgetfulness, sleeping problems, light and sound sensitivity, and unusual fatigue.

Equally important, she added, is teaching players not to use their protective headgear as a weapon, and to remind them that sports helmets are designed to protect bone rather than brain tissue.

“The helmet is there to protect skull fractures; it does not prevent concussions,” she told an audience that included local youth football coaches and parents of student-athletes. “The helmet does not turn you into Superman.”

Since more than 90 percent of concussion victims remain conscious, testing athletes' brain function at the start of a season is a crucial tool to evaluate when they can safely return, said Brian Freeto, orthopedic surgeon at the Napa Valley Orthopaedic Medical Group. To that end, Brandon said Napa Valley Physical Therapy began offering Napa and Vintage high schools access to the computer-based ImPACT testing system last fall to reveal athletes' baseline functions in math, thinking and reaction-time drills, allowing trainers to measure how much impairment a head injury has caused.

Among the parents at the concussion forum was Beth Mattei, whose lacrosse-playing teenage son already has faced the choice between staying on the field and looking after his long-term health. Henry Mattei, a junior at Justin-Siena High School, gave up the sport earlier this month after suffering an on-field concussion one week after colliding with an opponent.

Despite problems concentrating and following conversations and even failing a school test, Henry needed a week to feel comfortable with the decision, his mother said.

“He loves lacrosse; he's played it a long time and this was going to be a big season for him,” she said. “Fortunately my husband and I read a Rolling Stone story on concussions, and we had him see a doctor. Enough people told him what the cognitive trade-offs would be for his entire life â€" and he's hoping to go to an Ivy League school.”

Even an alumnus of another prestigious university, however, admitted misunderstanding the nature of concussions until well after his football playing days, perhaps a sign of the hill brain safety advocates yet face.

“I'm a little embarrassed to admit I didn't know what a concussion was until after I retired,” said Ben Lynch, a center who played for Cal and then the San Francisco 49ers from 1999 to 2002. Only after reading a book by Chris Nowinski, a Harvard football player and professional wrestler who in 2007 co-founded the Sports Legacy Institute to coordinate research into sports-linked brain damage, did Lynch realize most concussions don't cause loss of consciousness. “I never knew what the symptoms were, and (only then) I realized how many concussions I suffered.”

“Two things I was praised for the most while playing football were knocking somebody unconscious and playing through injury,” he said. “That's exactly what we're trying to change.”

Hanging over the concussion problem for one speaker was the memory of a football teammate at Napa High School who once was its brightest gridiron star and later an NFL player, only to become a cautionary tale later.

Ryan Hill, a coach with the Napa Saints youth football team, recalled the talent and reckless energy of his Indians teammate Steve Hendrickson, a four-year linebacker and fullback in the early 1980s at Napa High who went on to play in the NFL from 1989 to 1995. But Hendrickson's all-out tackling, combined with players' scant awareness of head-trauma risks in the 1980s and early 1990s, has doomed him to a retirement marred by progressive cognitive decline and memory loss, Hill told the audience.

“The tragedy is he used his head as a battering ram, and he did everything at 110 percent,” he said of the 46-year-old Hendrickson, who shared his post-football troubles in a Napa Valley Register feature last June. “At our 20th high school reunion, he sat there like he didn't know anyone there anymore. It's a crying shame.”

Now a coach of boys age 12 to 14, Hill called himself aggressive at pulling young players to the sideline at the smallest hint of a head injury, even when having to fight their competitive desires.

“When you pull them, they get very upset,” he said. “But it's easier at our level (of the sport) because we have minimum-plays requirements; I can pull one kid so another can get his 10 plays in. You have to explain to the kids that it takes all of them to win a game, and it takes all of them to lose a game.”

Above all, Hill emphasized the need to let young athletes know that head trauma and its ills spare no ages.

“When we were teenagers, what did we all say?” he said. “We said, ‘Not us; we're indestructible.'”