When Nigel Carter was tackled two weeks ago during practice and hit his head hard on the turf, he knew immediately what had happened.
It was a concussion, and he felt it.
After being knocked out for a few seconds, he came to with a throbbing in his head. He wanted to run the next play, but his coach and trainer wouldn't let him.
"I was trying to fight it, but it was hurting," he said.
The 17-year-old who plays for McLain High School missed the first game of the season and will miss the second game Friday.
After visiting with his doctor, he's staying out two weeks and a few days, just to be safe.
"It's real hard, especially with me being a senior," said Carter, who is verbally committed to the University of Tulsa.
An ongoing study at the Laureate Institute for Brain Research in Tulsa has shown concussions can cause temporary cognitive decline, as well as psychological effects that can be longer lasting, said Patrick Bellgowan, director of cognitive neuroscience.
Over the years football players show a decrease in verbal memory that gets worse the longer they play, he said.
From peewee leagues to the NFL, concussions have recently been a hot topic for players and fans alike.
The NFL recently agreed to a $765 million settlement with former players in concussion-related lawsuits.
Time to recover: The message players should get is that taking time off after a concussion is the best way to be safe. Athletes have a tendency to underreport their symptoms, Bellgowan said.
"Athletes will mislead you a little bit," he said, "because they want to play. So they know if they tell you they have symptoms they won't get to play."
Carter was experiencing light sensitivity and was vomiting for about a week after his concussion. He also felt some depression, zoning out and just not feeling right.
"I just felt down," he said. "It just came out of nowhere."
He feels fine now and is more than ready to get back in the game.
The study at LIBR involves giving athletes cognitive tests that look at memory and reaction time and psychological tests that examine depression and anxiety. They also do neuroimaging.
The athletes are tested again about 36 to 48 hours after concussions and again a week later, a month later and a year later, if possible.
They also examine concussed athletes who weren't previously tested.
A concussion isn't caused by direct impact to the head, but by the whipping action the head takes after a hit, Bellgowan said.
"The whipping action makes your brain accelerate and extend and warp inside your skull," he said. "That's the action that causes the damage."
Evaluating symptoms: There are typically four types of symptoms people experience after a concussion. One is somatic, such as headaches and light sensitivity. Another is cognitive, including memory loss. There are also sleep changes, usually insomnia, and psychiatric symptoms such as depression and anxiety.
Sometimes athletes may think their symptoms are gone but find they come back after they begin to exert themselves. Bellgowan compares the situation to a hamstring pull. The muscle may feel fine until the player begins practicing, he said.
In high school, an athlete suspected of a concussion is removed from competition or practice and must be evaluated by a trainer or qualified doctor before he or she is released to return to play, said Dan Newman, head athletic trainer at Union High School.
At Union, Newman's office must sign off before a player returns.
Coaches receive some concussion training every year, and players and parents receive information, as well.
"I feel we handle concussions very efficiently and with the utmost care," Newman said.
After a concussion, players must be symptom-free for five to seven days before they begin the process of returning to play, which starts with light exercise for a day or two and then some noncontact practicing.
If at any point the player experiences symptoms, he or she stops for at least a day and starts the process over.
Understanding the potential severity: Sometimes Newman has to try to scare players and parents a little to make sure they understand the potential severity of a concussion, he said.
Players don't want to appear weak, and parents can be just as insistent that their child needs to play, he said.
"We have to start protecting our brains," he said. "And it starts with our youth and educating our youth."
Athletes who come to the University of Tulsa, which is participating in the LIBR study, are showing up more aware of concussions and their consequences, said Dave Polanski, assistant director of athletics for student health and performance.
He always errs on the side of caution when evaluating whether someone should return to play.
"The easy thing to remember is, when in doubt, sit them out," he said.
Proper tackling technique can help prevent concussions, but there is no such thing as a concussion-proof helmet, and athletes and parents need to understand that, Polanski said.
"People are going to get hit in the head because that's part of the game, but you want to minimize that as much as you can," he said.
Hard hits start young: Some people think that young children can't get concussed because they're smaller and don't run as quickly, but studies have shown that their hardest hits during football can be as hard as average hits with older players, Bellgowan said.
Concussions can be particularly dangerous in children because they may have trouble describing their symptoms and understanding what is wrong, he said.
"The younger you are the longer your symptoms take to recover if you have a concussion and the later that they can be detected," Bellgowan said. "So sometimes they don't detect them until a day or two later. All of a sudden their headache hits the next day."
Coaches of younger children are usually volunteers who may not be properly trained in understanding concussions, he said.
"They have a full-time job, and they're trying to coach 40 to 50 little kids," Bellgowan said. "So the training and being able to detect what you need to be able to detect is pretty challenging."
Some high school teams have athletic trainers or team doctors, but not all. Teams may have a doctor or trainer on hand for games, but players get hurt as often if not more often in practice, he said.
In some leagues parents are educated about what to look for in players who may be concussed. That's not optimal, but it's better than nothing. Coaches usually can't be relied upon to stop and see how a player is responding, he said.
"Coaches are often focused not on the player's health during the game because they have to create the strategy, they have to call the plays, they have to move the players in and out," he said. "They have other things going on."
Signs of concussion
- Appears dazed or stunned
- Is confused about events
- Answers questions slowly
- Repeats questions
- Can't recall events prior to or after the hit, bump or fall
- Loses consciousness (even briefly)
- Shows behavior or personality changes
Source: Centers for Disease Control
Research opportunity
The Laureate Institute for Brain Research is seeking athletes as well as healthy control subjects of all ages to take part in research. Participants are compensated for their time.
For more information, call 918-502-5100.
Shannon Muchmore 918-581-8378
shannon.muchmore@tulsaworld.com
Original Print Headline: Hard-hitting injuries
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