Concussions in football: The gray area of gray matter

Updated: August 19, 2011 7:08PM

Routine drill, routine practice, routine August day in Northwest Indiana last summer. Another whistle, another snap of the ball, another testosterone-charged cacophony of plastic crackling, teenagers growling, coaches muttering.

A hole opened up, a running back barreled through, and Lowell linebacker Austin Magley did what he’s done countless times before — he lined the guy up and he tackled him.

Magley’s head was up, as it was supposed to be. The tailback’s head was up, as it was supposed to be. Everything went according to plan, according to coaching, according to the book.

Then Magley tried to stand up.

And he fell.

Got back up. Took a few steps.

Fell again.

“At least, that’s what other people told me,” Magley clarifies. “I don’t really remember any of it.”

This is a story about concussions. About children’s brains and their lives and their futures. About how one improper tackle — or even an unlucky proper tackle, or maybe a stray knee to the head, or maybe a head banging off a frozen field, or maybe the collective force of hundreds of daily collisions in the trenches — can cause lasting damage, seen and unseen.

This is a story about the biggest issue in high school football today.

And this is a story that Bob Parker’s not sure he wants you to read.

“I’m concerned about the future of football,” the longtime IHSAA referee says. “Because I think there are going to be a lot of parents out there who are reading these statistics and these published stories and these scientific reports. And they’re going to say, ‘You know what? My kid can play soccer, or volleyball, or golf.’”

Indeed, that’s what makes concussions so scary — to kids, to parents, to coaches, to athletic trainers, to physicians, to administrators, to legislators, to anyone who’s heard the alarming results of Purdue’s long-term concussion study at Lafayette Jefferson High School, to anyone who’s read about former Bears great Dave Duerson’s recent death, to anyone who’s heard the plight of the countless former NFL players with myriad physical and mental maladies.

The hard truth that has emerged is simple: The only true way to guarantee you don’t get a concussion playing high school football?

Don’t play high school football.

It’s an extreme, knee-jerk response to the huge surge in awareness about concussions (there always have been concussions, they’re just being properly diagnosed and treated these days) in recent years. And it goes to show just how dramatically the conversation has changed since coaches would reinsert a player two plays after he “got his bell rung” on a high-speed, head-to-head collision.

But as it so often does, the proper approach to the issue lies somewhere in the middle. And while it’s critical to teach proper tackling technique and to keep a watchful eye on a staggered player, the biggest weapons the football community has against the growing concussion concern are simply education, awareness and reason.

“It’s night and day,” says Dr. Elizabeth Pieroth, a neuropsychologist who works with the Bears, Blackhawks and Northwestern University through the Midwest Center for Concussion Care. “It makes me laugh — 14 years ago, when I started, I felt like I was yelling into the wind — ‘Concussions are bad! Really!’ And nobody was listening. Now, it’s like, ‘Oh my God, you have a concussion and you’re going to be drooling on your shirt at age 30!’ No, you’re not.

“We know very well, without question, that everyone gets better from these uncomplicated concussions. You just have to make sure it’s managed so it doesn’t become a complicated one, or a repeated one. We want to keep kids on the field, keep them playing sports. So now I feel like I’m the person running around putting fires out. I spend most of my day talking parents off the ledge.”

She’s right, of course. Handling concussions has become as complicated as the science behind the concussions themselves. For the record, a concussion isn’t simply a bruising or swelling of the brain, as many believe. What happens when the head is violently thrust forward and stopped suddenly — slamming the brain against the skull, or even spinning it rapidly — is the brain cells misfire, causing a chemical imbalance that can temporarily interfere with vision, memory, speech, coordination and even consciousness.

That part, the football and medical communities know. How to stop it and how to treat it? Well, they’re still trying to figure that out.

“It’s not a cookbook. We can’t just open it up and look for directions on how to make it all better,” says Hobart athletic trainer Mark Leto. “Every hit is different. And every kid responds to a concussion differently. That’s what makes it such a complicated issue.”

† † †

Routine post play over the middle. It was Week 7 of Manchester College’s 2010 season, and former Lowell quarterback Kurt Monix was starting to get the hang of this wide receiver thing.

Sharp cut, sharp pass — right on the hands. But at the same time the ball arrived, so did the backside safety. The two fast-moving targets met helmet-to-helmet, the safety’s head slamming into Monix’s temple, and Monix was out cold.

When he came to, the first thing he saw was the flagpoles on top of the stadium.

“The flags were waving in the wind,” Monix says. “But so were the flagpoles. They looked like noodles.”

The football community has come a long way in the last five or 10 years, from the era of having one’s “bell rung,” or from “seeing stars,” or from “quit-yer-whining-kid-and-get-back-on-the-field.”

The advancements are noticeable, measureable and undeniable.

Just about every varsity football game — big school, small school, rich school, poor school — has at least one certified athletic trainer on the sideline. A medical professional who can take the burden of decision-making off an unqualified and potentially conflicted coach, and give immediate care to an injured player.

Athletic trainers and referees each have the power to remove a kid from the playing field — even over a coach’s objection — if he displays concussion-like symptoms. That kid cannot return to the field without written permission from a qualified medical professional. The Indiana state legislature passed a bill last month that turned that IHSAA policy into the law of the land.

More schools every year are having all their players take the state-of-the-art ImPACT test — a computer program that measures cognitive reasoning, memory and reaction times — to get baseline readings on healthy kids, so they can compare the results when a kid with a suspected concussion re-takes the test. The IHSAA also has partnered with Clarian health to provide ImPACT testing for any interested student-athlete whose school does not.

Coaches can take online courses in concussion management from the National Federation of State High School Associations.

Experts such as Pieroth barnstorm the country to educate players, parents and coaches about trauamtic brain injuries.

It’s all added up to create an educated, prepared and vigilant football community.

“Thirty years ago, it wasn’t like this at all,” says longtime Munster coach Leroy Marsh. “It’s gotten much better.”

But all of those advancements are designed to diagnose concussions. Not to prevent them, not to treat them. Just to identify and remove injured players from the field, so as to avoid further injury.

So the big question remains: how to prevent players from getting hurt in the first place?

Proper tackling technique — don’t use the top of your head as a battering ram, see what you tackle — lessens the risk. But ask Austin Magley about that one.

You can limit the amount of full-contact workouts — the Ivy League this year decided to allow only two per week, a 60 percent reduction from the NCAA maximum, and NFL players successfully negotiated for fewer practices in their latest collective bargaining agreement — but it still only takes one hit.

Better, newer, more expensive helmets are great, too, but no helmet — short of one covering the brain itself inside the skull — can really make the difference. They’re designed to prevent skull fracture, not concussions.

“There’s no easy answer,” Leto says.

Then there’s the other big question: how to treat concussions once they happen? There’s no medicine, no pill or injection. There’s just waiting. Waiting for the headaches to go away, for the dizzy spells to disappear, for the memory lapses to fade. It can take a day. It can take a week. It can take months. No two concussions are the same.

Compounding the concern is the fact that once a player has had a concussion, he faces an increased risk of suffering another. And if he’s sent back out on the field before he’s entirely healed, he’s in even more danger.

“The last thing you want to do is send a kid back out there that hasn’t fully healed yet,” says Wheeler coach Dan Klimczak. “But you can’t always tell. Even the doctors don’t always know for sure. It can be scary.”

† † †

Routine quarterback sweep — a play Demetri Blanco had run hundreds of times before. The shifty Andrean quarterback darted to the right and was drilled under the chin by a 6-foot-2 South Bend St. Joseph’s safety. Nothing dirty, nothing malicious, nothing out of the ordinary. Just another big hit in a big game — this was the third quarter of the 2010 Class 3A regional, after all.

Blanco bounced back up and stayed in the game. Kept playing. Kept calling plays. Kept running the Andrean offense. Aside from a few botched cadences, he seemed fine.

Then he “woke up.”

“I remember going into halftime up 21-7,” he says. “Then I remember waking up in the fourth quarter and we were tied 21-21. It’s really hard to explain. I guess I just kind of blacked out, and my subsconscious sort of played out the game for me. I was like a zombie, I guess.

“It’s pretty scary, because there really wasn’t anything I could do about it or to prevent it. It was out of my hands. It’s football. It’s just part of the game.”

So how do you prevent the unpreventable? How do you treat the untreatable? How do you regulate the irregular? How do you soften a hard game?

Is there any point in even trying?

This is the grey area of grey matter. This is the issue everyone involved with football — from the last kid on the roster to the head of the IHSAA — is trying to tackle.

In a sport in which the routine can have such extraordinary consequences, how do you keep kids safe?

Nobody has the answer. And it’s quite possible nobody ever will.

But at least the discussion has started. And that’s a huge step forward from just a few short years ago.

“People are talking about it,” Pieroth says. “People are learning about it. We’re having an adult conversation. So we’re on the right track.”

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