Sunday, November 2

High School Football and Head Injuries: An Emerging Epidemic?

Football in North Carolina faces some serious issues. No, it’s not Butch Davis possible relocation or Wake’s offensive ineptitude, but the health and well-being of high school players. Three of these young men have lost their life playing this season, two to brain injuries. While the NCHSAA has been quick to respond, the state needs to face the reality that the safety of the players must be protected or the Friday Night Lights need to be turned off until they can be protected.

This is not an attempt at sensationalism, but an opinion shared by Dr. Kevin Guskiewicz, one of the nation's most prominent concussion researchers and chairman of the Department of Exercise and Sports Science at the University of North Carolina. In his meeting with a panel of North Carolina High School Athletic Association (NCHSAA) representatives, Guskiewicz, "said the issue was so important that the alternative would be for high schools to eliminate football, boys and girls lacrosse, boys and girls soccer and wrestling until a system has enough money to hire a full-time trainer." (Greensboro News and Observer)

The first death this season was of Greenville Rose running back, JaQuan Waller. Waller suffered a concussion during a practice, and played in a game two days later where he collapsed. He was pronounced dead the next day. Waller’s death was determined to be from Second Impact Syndrome, which occurs following two (sometimes minor) brain injuries in a short time. His story was profiled on ESPN’s Outside the Lines:

The second death was of Matt Gfeller, a sophomore linebacker at RJ Reynolds High in Winston-Salem. “State athletics officials said they couldn't recall any football injury in the state as severe as Gfeller's, reports said. The doctor operating on him said the force of a blow to his chest likely whipped the athlete's head backward, causing a key blood vessel to tear and his brain to swell, an accident that he said is a million to one chance of happening.” (source)

The unfortunate passing of both young men only tell a portion of the story. New Jersey has also had three football related deaths, two of which were the result of brain injuries(1,2). Reports from California, Massachusetts, and Ohio all involve high school football players taking multiple hits and resulting in at least trips to the hospital and in two of the cases brain surgery. Two other local North Carolina kids have been seriously injured in recent weeks. Anthony Gomenis, a senior linebacker and fullback at Marvin Ridge High School collapsed after a hit to the head. This was his second game back after suffering a previous concussion. Chris Williams, an East Gaston senior, also collapsed and required surgery after sustaining multiple hits to the head. While football-related deaths are easy to track, concussions are as hard to track as they are to accurately diagnose.

The shear numbers of high school football players certainly contributes to some of these incidents, but the fact that both the college and pro ranks are virtually devoid of this types of deaths and surgeries points to a problem in either diagnosis, equipment failure or both. The human body is still developing in the high school years, but this alone cannot be attributed to this increase in severe traumas. The NCHSAA appears to be recognizing this and has promptly begun taking action.

The NCHSAA's quick response has involved enacting three new measures to help protect the safety of the athletes. Now, schools are required to have an emergency plan for all injured athletes. Any player exhibiting concussion symptoms will be required to present written permission from a doctor to return to the field of play, and lastly schools will be required to verify that their trainers/first responders are qualified for the position. As quick as the board was to act, some schools have been slow to respond. A page on the NCHSAA website reveals that 186 High Schools have failed to comply with the trainer verification to this point. The complete list can be found HERE. One of the schools that has failed to comply: RJ Reynolds, where Matt Gfeller played.

NCHSAA's information on concussions falls far below what should be acceptable. This painfully generic document serves as the lone information source on concussions on the site, and offers no explanation of possible effects. The board has been swift in response to this, and it should continue to include increased education for all coaches and players.

Much of the discussion, like this Greensboro News & Observer article, focus on requiring certified athletic trainers at schools and the projected cost of $18 million, but in the cases of head and brain injuries, the value of trainers is preventing second incidents. Is there something that can be done to prevent the initial brain injuries?

A complete review of helmets being worn needs to be conducted. Advances in helmet technology have been occurring in recent years, but with budget restrictions is the technology reaching the prep levels? As it stands now, individual schools are responsible for selecting and purchasing helmets. Several questions should be looked at: the age, fit, and effectiveness of particular models should all be considered. The best way to prevent these types of injuries would be to prevent the first concussion. While they are a part of any sport, every possible precaution needs to be taken. Experimental devices such as accelerometers have been placed in helmets and while not cost effective for the masses, these technologies must be monitored and pro-actively sought if it can mean the prevention of one surgery or death.

Comprehensive training should also be instituted. Coaches and players need to be educated on the potentially devastating effects of these hits. While the tough guy mentality can never be removed from football, making teammates aware of the warning signs should aid in getting effected players out of the game, or keeping them out if symptoms linger. Parents should also be made aware of the warning signs and the importance of honesty in this regard.

Nothing will bring the young men who died playing this fall back, but their deaths and the injuries of countless other should serve as a nation-wide warning. Already in Ohio, one player heard of JaQuan Waller's death and removed himself from the game after suffering a concussion. It's impossible to know if it saved his life, but thankfully for that young man's family, friends, and school they'll never have to find out. It's a tough time economically right now, but this is one area we should not cheap out on. Due diligence must be done to ensure the safety of the players and if people are not willing to invest in that, then the only responsible thing to do is shut it down.

This article is by no means comprehensive, but there are several sources from which to learn about concussions in sports (CSM Foundation), the Annual Survey of Football Injury, and the equipment requirements for high school sports (NOCSAE) which includes possible revisions to helmet requirements.

1 comment:

Taylor said...

Nice read. This has become a pretty big issue though out the UNC exercise and sport science program; obviously with Dr. Guskiewicz leading the charge. I have heard a couple lectures talking about the lack of well educated athletic trainers at some high schools and improper equipment usage.

The deaths from second impact syndrome could have been prevented but as was written sometimes these "tough" kids will lie to get back on the field and will give the trainers an incorrect self examination.

I would expect the NCHSAA to make some major changes considering how big this issue is getting. A real potential possibility is mandating every high school have an athletic trainer if they want to play football.