Feb. 10--How much time on the sideline is enough time?
Although few people have definitive answers, concussions have become a hot topic throughout sports -- particularly in high school and youth sports, where the lasting effects of head injuries are under study.
The Centers for Disease Control and Prevention estimated that 135,000 children between the ages of 5 and 18 are treated each year for sports and recreation-related brain injuries. The concern is over the lasting effects of such injuries.
Dr. Bennet Omalu, a co-founder of the Brain Injury Research Institute at West Virginia University, testified before Congress last week that the brains of children are more likely to sustain permanent damage from concussions.
Omalu's recommendation is for young athletes to sit out for three months after a concussion before returning to action, which he says would lower the risk of irreversible brain damage.
Marty Trimmer, Central York High School athletic director, agrees that being overly cautious is a good thing, particularly with injuries and youth.
"All athletic directors, coaches and administrators are concerned with the safety of our kids first," Trimmer said.
One person who knows the effects of a concussion first-hand is former Eastern York High school star Jon Witman, who played football at Penn State and for the Pittsburgh Steelers.
Witman said he suffered two concussions while playing for the Nittany Lions and another while playing in Pittsburgh.
"I get headaches
and dizzy spells," he said. "I am 37 years old. I don't know if it is just because I am getting older. You can ask my wife, I don't remember things. I have been living with it for the last 10 years. It is something I just deal with."
Some, however, question the need for a steadfast three-month waiting period after concussions.
Some head injuries are worse than others and some athletes have more resiliency after sustaining a concussion.
Dr. Richard Daly of York is the team doctor for Red Lion Area Senior High School and is concerned that a three-month mandate, while well-intended, could be hard to implement because of the variables.
He recalled a patient who had hit her head and, a week later, said she still couldn't think right. On the other hand, he knows of people who get knocked out and a week later are back to normal.
Witman isn't sure that a three-month wait is the answer, either. But as a father of budding athletes, he likes the fact that researchers are looking into the issue.
"You can have symptoms for a couple of days or a couple of months. They need to study it more," he said. "I don't understand. Where do they draw the line? There are different severities. How are they putting that three-month statute on that?"
Trimmer has another legitimate worry about a potential three-month wait.
"My concern is that kids will be very hesitant to go to the trainer, the coach, the doctor or even their parents," he said. "Kids are smart and, if they realize their season could be over, that could be a deterrent to kids acknowledging that something is wrong."
Daly agrees.
"Even professionals were saying they would not say anything because they wouldn't be able to play," Daly said. "It's a typical thing that all athletes are by nature competitive. That is a definite concern."
"When I was brought up, if you didn't have a headache, you played," Witman said. He is pleased that mentality has changed -- at least at the school-age levels.
One tool that has helped at the high school level and beyond is ImPACT testing, a program designed to help determine if an athlete is ready to return to the field after a concussion.
The program, developed at the University of Pittsburgh Medical Center, consists of a six-part computer test designed to gauge a player's memory, cognitive skills and reaction time.
Athletes are tested before their season begins. Their pre-evaluation scores are ranked as their baseline, which can be tested against and evaluated by a doctor in the event of a head injury.
Most area schools are using ImPACT testing for their athletes. Kevin Myers, Dallastown Area High School varsity football coach, said the test has taken some of the guesswork out of knowing if a kid is OK to play.
"Anytime there is a head injury we take it serious," he said. "I think that is a great tool. It's actually a doctor that clears them. ... The doctor is telling me he is good to go or has to sit out X amount of games. I will go with what they say. We are not big into rushing kids back."
And it's not just about football. Daly said cheerleading, basketball and other sports are risky, adding that, "a golfer can get hit by a golf ball and sustain a head injury."
Another person sold on the benefits of ImPACT testing is Bob Rhein, a youth lacrosse coach and former president of the York Lacrosse Club.
Rhein praised the ImPACT program, which is instituted by WellSpan Health. He recommends that other sports and clubs look into instituting the program because of the educational value to coaches and parents.
"As coaches, we tend to go by what the parents say and as a parent we tend to go by what our child says," Rhein said. "In some cases, if he says he is OK and a parent says he is OK, I might have let him go on the field and practice.
"So, the next time you hear your child say, 'I am fine' and you send them back to practice the next day, please be aware they could be one step away from a second head injury, which can lead to long-term brain damage or worse."
The lacrosse club applied for and received a grant from the state Department of Health that allows it to do ImPACT testing at the under-15, under-13 and, soon, the under-11 age groups.
"There are a lot of volunteer coaches that might not know what to look for," he said. "The result was priceless. Potentially one child or two could be saved from (severe brain injury). How do you put a price on a child?"
snavaroli@ydr.com; 771-2060
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