Understanding risk and protocols key to concussion management (USA Today Sports)

BALTIMORE — Former Pro Bowl running back Brian Westbrook doesn’t know where he’d be today without former Philadelphia Eagles athletic trainer Rick Burkholder.

On Oct. 26, 2009, Westbrook suffered his first concussion when he was hit in the back of the head and blacked out during the Eagles’ game against the Washington Redskins. Two days later, he wanted to practice again.

Burkholder stopped him.

“Burkholder said, ‘We’re not going to let you touch that football field until you’re absolutely ready,’” Westbrook said. “It was that decision and those words that changed my life dramatically for the better. It’s what allows me to go out there on the radio and TV and speak to young people today without worrying about head and brain disease.”

Westbrook spoke at the National Athletic Trainers’ Association Convention in Baltimore on Thursday, where a panel of athletic trainers gave tips on preventing concussions in youth and high school sports. NATA also unveiled new research and guidelines related to concussions, osteoarthritis and sudden cardiac death.

Among children, those ages 15 to 17 visit the emergency room the most often, while thousands of high school athletes have long-term complications resulting from injuries. Many youth athletes, their parents and coaches don’t understand the risk of severe injuries during competition. Westbrook, for example, didn’t even consider the thought of getting a concussion until he endured his first one.

Tamara McLeod, the director of athletic training programs at A.T. Still University’s Arizona School of Health Sciences, said most states have laws that require high schools to educate athletes about concussions, but usually these teachings are basic and don’t grasp the athletes’ full attention.

“Some of them just give a handout,” McLeod said. “The key is education before the injury happens.”

McLeod has studied and advocated for a collaborative approach to care that includes athletic trainers, school nurses, administrators, teachers and coaches when it comes to managing athletes’ care and preparing them to return to play.

According to NATA, only 12 states have a written emergency action plan; 16 states meet “minimum best practices” for heat acclimatization; and only 25 states have access to an “external defibrillator on a school property and at all school sanctioned athletic activities.”

By using video of professional athletes, McLeod said she’s had more success getting her message across, but she believes each age group should be targeted in a different way to emphasize concussion protocol. Heads Up Football, a USA Football education program, is another way to inform coaches and players on concussions, she said.

University of Connecticut kinesiology professor Douglas Casa cited a study recently done with Fairfax County High Schools in Virginia, and found that athletes playing under Heads Up Football certified coaches underwent 25 percent less injuries and 43 percent less concussions.

McLeod said that every school needs to have a policy for athletes who experience concussions, including treatment, how to ease athletes back into competition and when to allow them to play again. Having an athletic trainer helps this plan work, said Kristen Kucera, an assistant professor at the University of North Carolina at Chapel Hill’s Department of Exercise and Sport Science.

“Athletic trainers specialize in the prevention, recognition, management, treatment and rehabilitation of sport injuries and illness,” Kucera said.

Westbrook said athletes and their parents should be informed about the risk of concussions when they begin playing tackle football. The NFL has reduced the amount of physicality in practice since Westbrook began playing in the league, but he said it’s still difficult to manage injuries while coaches pressure their athletes to return to action.

“So many coaches expect you to be back on the field after two days,” Westbrook said.

The National Trainers’ Association launched a campaign called “At Your Own Risk” to educate, prevent and heal athletic injuries. The website AtYourOwnRisk.org includes an interactive map with the sports safety protocols for all 50 states.

According to the National Center for Catastrophic Sport Injury Research, there 80 catastrophic injuries and illnesses among high school and college athletes, with 78 percent at the high school level, from July 2013 to July 2014.

In 2015, 50 high school athletes died during sports or physical activity and high school athletes lead t the nation in athletic-related deaths.

Westbrook said he was lucky to have an educated athletic trainer when he played for the Eagles, but not all athletes are that fortunate. Some players put themselves at risk of long-term injuries by returning to competition too early, or not informing their coach or athletic trainer about concussion symptoms.

If Westbrook had not waited to recover, he might join myriad other football players who display symptoms of Alzheimer’s disease and chronic traumatic encephalopathy.

“As athletes, we’re not thinking about injury,” Westbrook said. “We’re thinking about playing. I want [athletic trainers] to say, ‘We’re not trying to keep you off the field, but we want to make sure when you’re on the field, you’re the best player you can be.”

Source: USA Today Sports

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