Sudden impact: The growing issue of youth concussions
By Rob Rossi
Published: Friday, Sept. 2, 2011
Haley Branovan's brain is stirred up.
She can't go to school at Culver Academy in Indiana or even send a text message without experiencing a headache, dizziness and nausea from a concussion she sustained while playing ice hockey.
On this day, though, Branovan, 16, of Wexford finally receives positive news.
"You will get better," Michael Collins, Ph.D., head of UPMC's Sports Concussion Program, tells her during an exam in Pittsburgh's South Side. "You will play hockey again."
As many as 3.8 million sports-related concussions occur annually in the United States -- an epidemic, according to the Centers for Disease Control and Prevention.
UPMC treats 10,000 concussion patients a year, or about 250 a week, and 70 percent to 80 percent are in high school or college, spokeswoman Susan Manko said.
As the high school football schedule gets under way tonight and other fall sports follow, it is the experiences of professional athletes like Penguins superstar Sidney Crosby that have shined a spotlight on concussions.
"It is the buzz word of sports," said Larry Cooper, a certified athletic trainer at Penn-Trafford High School and former member of the National Athletic Trainers' Association Secondary School Committee.
The increased attention might simply mean the public is becoming more educated about traumatic brain injuries, said Dr. Kevin Wong, president elect of the Pennsylvania Academy of Family Physicians.
"Scaring people with the term (brain injury), with all this information, isn't the worst thing," he said.
How states compare
The National Federation of State High School Associations (NFHS) which sets rules and guidelines for interscholastic sports and activities, recommends all high school athletes take a baseline cognitive test.
However, the Pennsylvania Interscholastic Athletic Association, the state's governing body for high school sports, does not mandate that its schools follow the recommendation.
Collins said patients are easier to treat if they have taken a baseline exam such as the locally developed ImPACT test. The 25-minute, computerized exam consists of six parts, relying on words, designs, shapes and colors to measure a person's normal brain activity. It costs $40, which parents -- not schools -- pay.
"The schools are responsible for the health and wellness of the students," said Tim O'Malley, executive director of the Western Pennsylvania Interscholastic Athletic League. "Most school districts, I do know, won't let their students participate without a baseline test."
Like Pennsylvania schools, athletic governing bodies in sports-minded Texas, Florida and Ohio told the Tribune-Review they also do not mandate baseline testing.
The PIAA and the WPIAL, a regional subsidiary, encourage but do not mandate that football coaches take the NFHS's 20-minute online concussion course.
Officials in Texas and Florida said coaches there must pass the NFHS test to coach this year. Ohio coaches, like those in the PIAA, do not have to meet such a requirement.
The PIAA and WPIAL are ahead of other states when it comes to having certified athletic trainers -- considered with coaches to be the first line in diagnosing concussions -- at school events.
Only six of 126 WPIAL football schools did not have an athletic trainer last fall, Cooper said, citing National Athletic Trainers' Association data. Eighty-two percent of PIAA schools used athletic trainers last year compared to 42 percent nationally, the data showed.
Dr. Jack Wilberger, chair of Allegheny General Hospital's neurosurgery department, said concussions will remain a health concern for athletes unless "you fundamentally change the way games are played."
The Pennsylvania Interscholastic Hockey League, which does not fall under the much larger PIAA's oversight, has begun tracking concussions and other injuries. The league of 64 boys hockey schools passed a requirement this summer that players get a baseline cognitive test. Coaches must pass a course, and coaches and on-ice officials must attend an seminar on how to look for and handle concussions.
The PIHL is working to reclassify "freshman" status in an effort to keep like-sized players facing off against each other. Currently, the PIHL allows a hockey player from sixth through ninth grades to play freshman hockey. By fall 2013, ninth-graders will be eligible for only junior varsity or varsity.
"We've seen information from doctors who say an 11-year-old brain cannot process carrying the puck and taking a body check at the same time," said PIHL commissioner Ed Sam, "so we don't want kids that age going against older, bigger players."
Branovan sustained her concussion in July after being hit by an older girl at a 21-team hockey tournament in Marlborough, Mass. Her Team Pittsburgh U16 squad was "playing up" against teams with players as old as 19, she said.
After her concussion and initial visit to UPMC, doctors prescribed Branovan with medications that helped her return to a regular sleeping schedule. Rehabilitation activities such as tossing a tennis ball from hand to hand and lining beads on a string she held out from her nose helped improve her orientation, she said.
"When (Collins) said right away he would keep her out of school for a couple of months if necessary, that sort of hit a pressure point for me," said Scott Branovan, Haley's father. "I was scared. But hearing him promise she'd get better and play again was a relief."
Four days after seeing Collins, Haley Branovan said she was thinking again about playing hockey in her No. 12 jersey.
"I'm feeling better," she said, "so I can think like that."Additional Information:
Concussion warning signs
Parents should take their children to the emergency room if they develop any of the following symptoms:
-- Headache, dizziness and/or unconsciousness
-- Confusion/disorientation, difficulty with memory and/or balance problems
-- Blurry vision, unequal pupil size and/or no pupil reaction to light
-- Drowsiness, slurred speech, tremors and/or convulsions
-- Nausea, vomiting and/or sensitivity to light or noise
Source: Allegheny General Hospital Sports Medicine
Children should follow these instructions to help recovery from a concussion:
-- Avoid texting, video games and MP3 player usage
-- Use only acetaminophen (Tylenol) to treat pain; avoid aspirin, ibuprofen and naproxen (Advil, Alleve)
-- Consume a light diet as tolerated
-- Get regular sleep
-- Avoid strenuous activity until receiving clearance from a medical professional
-- Place an ice pack on head/neck as needed for comfort
Source: Allegheny General Hospital Sports Medicine
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Ex-Colts executive Polian: Approach free agency with caution
- NFL notebook: Jaguars reunite DT Bryant with coach
- Former Steel Valley, Pitt star Ezell eyes WWE if NFL doesn’t work out
- NFL notebook: League may experiment with 42-yard PAT
- NFL notebook: Browns cut troubled WR Bess