Jeb Wallace-Brodeur / Staff File Photo
Players collide during a high school football game between Spaulding and St. Johnsbury last season.
This is the first in a Sunday series on concussion injuries in Vermont school sports. Next Sunday’s article will focus on the shortage of athletic trainers in Vermont schools.
By Anna Grearson
As an assistant for his son’s high school football team, he was troubled by the lack of protocol when players came off the field woozy, stumbling and glassy-eyed after likely sustaining a concussion.
The confusion only deepened on the practice field when there was no concrete process to follow for safe return to play.
Now Sen. Dick Sears of Bennington and his son, Montpelier High School football coach John Murphy, are hoping a new bill aimed at establishing a clear protocol for concussion-related injuries will soon make its final swing through the Vermont House and onto the desk of Gov. Peter Shumlin. It has already cleared the Vermont Senate.
“The more we investigated, the more we found confusion,” Sears said. “For example, the (athletic) trainer said she thought a kid had a concussion, and a doctor came out of the stands and said, ‘No, he doesn’t.’ It’s pretty risky, there’s no clear direction in our laws.”
Concussions are a result of a sudden, hard blow to the head, causing the brain to smash into the skull. That jarring can lead to mental lapses or decreased function, headaches, nausea, dizziness, double vision and concentration or memory problems.
In recent published findings, the brains of former NFL players have been studied and linked to chemical changes from concussions related to severe personality variances, chronic depression and even suicide.
The new legislation, Senate Bill No. 4, or S.4. improves upon current legislation by more clearly defining who can clear a student-athlete for return to play, requiring referees to be trained in recognizing concussion symptoms, and establishing an action plan to be completed by each school to use when a concussion is suffered.
The bill also separates collision sports from contact sports. It flags football, boys’ and girls’ hockey, boys’ lacrosse and wrestling as collision sports in which concussions are most likely to occur. Should rugby ever be deemed a varsity rather than club sport, it will be classified as a collision sport as well.
The bill also requires a health care provider to be present at any collision-sport event. It defines that person — the only one who can clear a student-athlete to return to play — as “an athletic trainer or other health care provider ... who has within the preceding five years been specifically trained in the evaluation and management of concussions and other head injuries.”
“When the Legislature wrote the law last year and the year before, there was a lot of lobbying going on from a bunch of different medical professions,” Sears said.
“You had technically chiropractors who could say the kid was cleared,” he said. “You had no requirement that they have any recent training in concussion management.”
Under previous legislation, he said, anyone defined as a medical professional could clear a student athlete to return to action. Current legislation is more specific.
“Should an obstetrician, who’s never done anything in the way of concussion management, be able to determine that a kid can play?” Sears asked.
Murphy, whose Montpelier football team was plagued by injuries that prompted the forfeiture of two games, was directly affected by the confusion surrounding when his players could return and who could give the official green light.
“I felt restricted in my coaching ability,” Murphy said. “In the last decade, usually a doctor’s note is all I need. But (having that note) and a trainer, another professional I respect and trust, say ‘no,’ it’s extremely frustrating.”
He added, “We had low numbers, but it was the concussion law that crippled us the most. Whatever (the trainer’s) protocol was for the kids to get back into play was exactly correct, the steps were awesome, but when they make the kids wait for three or four weeks to even begin the process, in a nine-week schedule, it’s frustrating.”
The Vermont Principals Association requires concussion education for all interscholastic coaches. Murphy described it as a 45-minute online course on symptom recognition. Upon completion, a coach can administer a concussion test if he or she suspects a player has suffered that injury.
That puts increased demands on already-busy coaches to watch players not only for their skills on the field but also for sometimes subtle signs of brain injury. That’s where the additional referee training comes in, providing many extra sets of eyes on the field, and the requirement of a health care professional on the sidelines.
But it also leaves a measure of accountability on the part of the student athletes themselves.
Colin O’Meara, a Montpelier senior football and lacrosse player who also testified along with classmate Alex Dickinson in Senate committee meetings on the bill, admitted he hid what were likely symptoms of a concussion last fall.
“If I got hit hard in the game, I just kept it to myself,” he said. “You gotta worry about playing in the next game and the game after that.”
He’d heard about the concussion debate regarding NFL and collegiate players, but didn’t feel it related to him.
“I figured they’ve been doing that their whole lives, getting concussions,” O’Meara said. “It’s your senior year, you want to play. If you don’t play, you look back on it and think you didn’t give it everything.”
O’Meara said players receive very little information on concussions and are required to simply sign a form agreeing to tell coaches about suspected symptoms.
Spaulding athletic trainer Jason Carriveau, who works with athletes who play collision sports, said it’s vital to limit the motives for hiding symptoms.
“You want to make it as hard as possible for a kid to cover it up,” he said. “It’s about education, letting them know what can happen if they hide it and go back out and play. They have to know the long-lasting effects, that it’s affecting their brain and their ability to do things outside of sports.”
O’Meara, who admitted he should have spoken up after absorbing big hits, said if he knew the exact steps needed to return to play, he would have reported his symptoms.
“If I knew I could get back, I would definitely tell,” he said.
The current law has no guidelines for returning to play.
“That’s how this law started,” Sears said. “When we talked to the guys, we found out many of them didn’t tell because they were afraid they’d never get back to play.”
The new bill invokes a law passed in Oregon in 2011 called Max’s Law, named for a student-athlete who suffered a concussion during a football game in 2001. He returned to play in the next game despite not being cleared by a medical professional and collapsed at halftime with a massive brain bleed.
He survived three brain surgeries and a three-month coma, but now lives in a group home for people with brain injuries in Salem, Ore. Max’s Law requires an action plan like Vermont’s S.4 uses the alliterative checklist of “Recognize, Remove, Refer, Return.”
The removal prevents a student athlete, suspected of and then diagnosed with a concussive injury, from participating in games or practices. The injured athlete must see a health care provider as defined by S.4, take proper rehabilitative steps and be cleared of all concussion symptoms before being allowed to return, slowly, to active play.
The return also has implications in the classroom.
“We had a couple kids not be able to go to school for a couple days after they got concussions,” Murphy said.
Further inspiration for the revamped Vermont bill stemmed from the 2012 career-ending injury to Montpelier football player Dylan Mercadante.
He was hit on a first-quarter kickoff return, snapping his neck back and pinching off blood flow to his brain. He passed a sideline concussion test and continued to play until he collapsed on the bench in the second half with a whiplash-like injury more often suffered by skiers than football players. He later suffered multiple strokes, but survived and was told he could never play contact sports again.
The injury and aftermath had a profound impact on Murphy.
“I knew I had to be more vigilant of athletes under my care,” he said. “It put my job in perspective, that I needed to make sure that as a coach, I needed to have the tools for player safety.”
The newest tool, S.4, sailed through the Vermont Senate on a rare 26-0 vote after being introduced in January. Last week the bill moved through the House Education Committee, which heard testimony from Murphy, South Burlington athletic trainer Denise Alosa and Trevor Squirrell, executive director of The Brain Injury Association of Vermont, who also supported the bill.
Murphy and Sears hope the bill will become law and take effect July 1. The requirement for a health care provider at collision sporting events, if adopted, will take effect July 1, 2014.
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