Playing Through the Pain
By Charlotte Hoppen
“Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health care professional,” the Michigan High School Athletic Association (MHSAA) states.
This is part of the standard protocol that all Michigan high schools, including Seaholm, must follow when a player is injured during a contest or practice. Along with the concussion protocol, all high schools must follow related precautions for injuries involving the head, heart and heat related injuries.
An anonymous student, whom in this article will be referred to as Joe Smith*, has played football on the Seaholm team, and had two concussions. These concussions were medically documented.
According to Smith, he received his first concussion during a drill at a practice early on in the 2014 season.
He had been diagnosed with a minor concussion. He was out for two weeks of the season, as ordered by a doctor. He went back to playing after those two weeks off, but didn’t visit a doctor and then continued to play.
“I just thought I had a headache. My head was a little rocked.”
However, during the 2015 season, Smith received his second concussion during practice, almost exactly a year after his first one. He collided with another player while both players were wearing full equipment, and the other player’s shoulder came in contact with his head.
Smith proceeded to lose consciousness on the field, and he is unaware of how long he blacked out for. He doesn’t think anyone noticed him on the field.
“I woke up on my hands and knees,” Smith said. “Coach was yelling at me to get up, so I got up.”
His teammates and coach pushed him to play, and Smith played through the injury with proceeding tunnel vision and ringing in his ears. Smith claims that although his teammates encouraged him after some time to see the athletic trainer, he was resisting them.
“I knew I had the concussion not even after the first half of the practice,” Smith said. “I went almost until the end.”
Smith went to medical first responder and Seaholm athletic trainer Bill Watson, and Watson told him to go to the doctor after practice. Smith’s parents picked him up, and he left his car at Seaholm because he thought he was unable to drive. He then went to the hospital for a CAT scan.
He was unaware of the mandated protocol that was supposed to be followed immediately after the time of his injury, and believes that it shouldn’t be followed only after it is too late. He claims he wasn’t informed what the concussion protocol was before the season started, and he wasn’t told after either.
“They [the precautions] were followed once they started to know something was wrong with me when I already knew and I tried to tell somebody,” Smith said. “They essentially just said no you’re fine.”
Aaron Frank, Seaholm’s Athletic Director, was informed about the Smith’s story being published in advance in the case of Smith being an anonymous source. He urges Smith to step forward so he can address the lack of protocol followed at the time of the incident.
“I hope to learn about it somehow so we can address it,” Frank said. “Although at this particular point in time I can’t figure out how that is going to happen.”
Joanne Gerstner is a sports writer with the New York Times and the sports journalist in residence at Michigan State University’s School of Journalism. She recently wrote a book about concussions to be released in the spring of 2016, titled Concussion Clarity: real talk for students, parents and coaches.
According to Gerstner, when an athlete at any level passes out due to a head injury or impact, they are to be immediately taken out of the practice or game to be evaluated. If someone continues to play and has another head collision, Second Impact Syndrome can possibly occur.
Second Impact Syndrome, according to the Center For Disease Control and Prevention, can occur when there is another contact hit after someone receives a concussion. The second hit causes the brain to swell, which can possibly result in a coma or death. Second Impact Syndrome is extremely rare, but players need to take precautions immediately after the first time of impact.
“Nothing good can happen if you go back to playing or practicing if you’re concussed,” Gerstner said.
According to Watson, in the specific sports related case of concussions, a set of standard actions called a protocol must take place immediately after the time of impact.
“You have to get evaluated for concussions if you have the signs or symptoms,” Watson said. “If it’s a concussion you call mom or dad and you say this is what happened. You either have to go to Beaumont now or two hours from now, or you can see a regular doctor tomorrow.”
According to Aaron Frank, Seaholm has reported all serious injuries to the MHSAA in past years. This includes concussions and other sports related injuries that may affect the student athlete’s health.
“Fortunately we’ve never had a serious injury that went unaddressed,” Frank said.
However, Gerstner said that it is impossible to know the exact amount concussions that occur each year.
“Less than half of concussions get reported,” Gerstner said.
It is a requirement that all Seaholm coaches, assistants or heads, are trained for emergency or sports related injuries that may occur during a contest or practice.
Karl Hodgson has been the Seaholm women’s swim team coach since 1991, and each year he has to take a test through the MHSAA that certifies him to continue coaching.
“MHSAA now makes us take a test every year and that covers first aid, concussions, CPR, allergies, hazing, asthma,” Hodgson said, “almost like whatever the symptom of the year seems to be.”
According to Frank, coaches are trained in all areas of sports injuries, specifically concussions, so that they are able to immediately recognize when a player is injured.
“Our coaches all have to complete mandatory concussion training,” Frank said. “When a student exhibits signs of a potential concussion they’re taken out of a contest or practice. They have to be evaluated by a physician and then there is a return to play protocol which ends with a signed form by the physician that they can return.”
Another anonymous student, whom in this article will be referred to as Bill Jackson*, also received an alleged concussion during the 2015 football season. He was aware of a possible concussion, but chose to continue playing.
“I had a concussion at one point in the season but I played through it,” Jackson said.
Jackson said that he continued to play through because he didn’t want to let his coaches or teammates down.
Jackson’s head hurt, but he knew that if he went to the doctor’s office there would be a possibility he wouldn’t be able to continue playing.
When participating in a sport, players often realize the potential injuries and dangers that can happen when they sign up. However, like in the case of Jackson, athletes may continue to preform even though they are injured.
Senior Emma Williams swam competitively since she was four years old, and when she arrived at Seaholm, she signed up for the women’s swim team.
Williams had shoulder problems before she arrived at Seaholm due to her swimming career. After she had attended doctors visits and physical therapy, she was warned of the consequences that may come with her continuing the sport.
Williams informed Hodgson about her injury, and as a response he had her skip practices to attend physical therapy and doing other exercises that wouldn’t further her injury. Even though the necessary precautions were taken, Williams was still injured due to her continuation of the sport.
“Sophomore year at the beginning of the season I dove in during the medley relay and my shoulder literally popped out,” Williams said. “It was the most painful thing I’ve ever experienced.”
She didn’t finish the rest of her races during the meet, and instead went to the doctor to later discover that her shoulder was half way in the socket and half way out. Williams had surgery the next week, and the rest of her season was done.
Other cases involving sports-related injuries have been reported to the school. For example, Mitchell Wolfe, a senior football player, received a mild concussion during the Farmington Hills Harrison game. His head hurt, but he continued playing.
Wolfe was ordered by his doctor to sit out of practice and games for no less than three weeks, and after that he must get back into the flow of practices with ease.
Another football player, Nick Sierpien, received a concussion during practice that didn’t allow him to hear things well during class. After Sierpien went to the doctor one day after the collision, he was diagnosed with a concussion and had to take a baseline test, which can help indicate where the brain activity is, three times before returning.
Sierpian said that even though he passed the baseline test, he still didn’t feel completely in the right state of mind to play due to his bad headaches and fogginess. However, he returned to play before the season ended after his doctor cleared him.
These students were aware of the steps they must take due to their injuries, and they have followed them because they were educated on them before the season began. However, this doesn’t mean that all student athletes are fully aware of all the precautions that are mandated by the state in the case of a serious injury.
According to Frank, after the student goes to the hospital for a CAT scan and diagnosis, all participants must have a licensed medical provider clear their return after the school files paperwork with the MHSAA. The MHSAA also follows the state law, passed to help protect student athletes in the case of concussions.
“We document the concussion and it is recorded by the MHSAA,” Frank said. “We don’t use the student’s name, but we provide the details.”
Senior Sean Mackillop played water polo during his freshmen, sophomore, and junior years at Seaholm. During Mackillop’s junior year, he received his first concussion during a practice drill.
His coach allowed him to sit out when he received news of his condition, and he was allowed to sit out for a week after being ordered by his doctor to rest.
“They say you’re okay after a week,” Mackillop said, “but you definitely feel kind of off for a month.”
Mackillop is correct in his belief that a week may not allow a student to fully heal back to health. According to Gerstner, concussions take on average seven to fourteen days for a concussion to heal, and any lingering issues are categorized as Post-Concussive Syndromes, which usually heal within three months. Post-Concussive Syndromes can include migraines, sleep problems and sensitivity to light.
Almost exactly one year after Mackillop received his first concussion, during another practice he received a second one. There was only one week remaining in the season, so he was done playing for the rest of his season.
Even though Mackillop didn’t play for the rest of the season, he wasn’t sure what to do about his condition because he wasn’t informed by the school.
“I don’t know what the procedures were,” Mackillop said. “No one really told me. I didn’t know we had procedures.”
Watson believes that although there is a set standard of protocols when it comes to sports injuries, it doesn’t always mean that both the player and coach are following them.
“There’s some kids who will have a bone sticking out and will want to play,” Watson said. “There’s some coaches who say the same thing. I have to be the voice of reason sometimes.”
Hodgson also believes that even though all coaches are trained to report an injury when seen, it may not happen one hundred percent of the time.
“I have never heard of a Seaholm coach forcing someone to do something they couldn’t because of an injury,” Hodgson said. “That doesn’t mean it doesn’t happen, but I’ve never heard of it.”
To prevent the injury from furthering, Frank said that all players are taken out of a practice or contest if the injury involves the head or another fragile part of the body.
“If they’re exhibiting any symptoms after their event,” Frank said, “we don’t put them back in.”
Smith is still experiencing Post-Concussive Syndrome today, and this includes frequent migraines, memory and speech issues and difficulty balancing. He believes his symptoms wouldn’t be as bad had he stopped playing at the time of his injury. He is currently seeing a doctor for routine checkups to make sure the symptoms are not severe.
“It wouldn’t have been as bad had it been stopped earlier I can guarantee you that,” Smith said.
Smith doesn’t believe that the standard injury protocol has been followed in all of the sports related injuries, especially concussions.
“The responsibility falls on all of us,” Frank said. “The safety and well-being of our students is our number one responsibility.”
*These names have been randomly assigned to protect the identity of the sources. They are not the actual names of the sources.