HEAD GAMES: SRU profs use Super Bowl as education platform

According to the Sports Concussion Institute, football is the most common sport with concussion risk (75 percent chance) for men.

SLIPPERY ROCK, Pa. - As anyone who's ever watched the Super Bowl can attest it's one of the most exciting spectacles in sports. The game, half-time entertainment and even the commercials have become part of a "must see" experience.

While the more than 100 million Americans expected to watch the Feb. 7 battle between the Denver Broncos and the Carolina Panthers in Super Bowl 50 will tune in to cheer on the teams or to be entertained, two will be eyeing the game from the head-knocking perspective of concussion awareness and education.

Bonnie Siple and Stacy Arend, Slippery Rock University exercise and rehabilitative sciences faculty who teach athletic training, said the game and movies such as the recent release of Will Smith's film "Concussion," provide important opportunities to discuss sports-related traumatic brain injuries.

Because the brain is very complex, every brain injury is different. Some symptoms may appear immediately, others may not show up for days or weeks. Any blow or jolt to the head can disrupt the normal function of the brain.

That's why SRU takes these injuries very seriously, Siple said.

"SRU's athletic training department has been on the frontlines of concussion intervention for five years or longer," Siple said. "We have been following standard protocols with our physicians. Now we also include the NCAA and PSAC mandates for concussion management."

A concussion is type of brain injury that changes the way the brain normally works. They usually result from a blow to the head, such as helmet-to-helmet in football, but can also result from slipping on the ice, a car accident or a rapid, back-and-forth motion that jostles the brain, she said.

Cognitive symptoms can include difficulty thinking, concentrating, feeling fatigued or in a state of fog. Physical symptoms may include headache, nausea, dizziness, double vision and sensitivity to light.

Emotional symptoms, Siple said, include anxiety, depression and irritability.

Concussions are far from rare. According to the Sports Concussion Institute, between 1.6 and 3.8 million concussions occur each year. Football, the SCI reports, is the most common sport with concussion risk for men (75 percent chance of experiencing one); soccer is the most common sport with concussion risk for women (50 percent chance).

Much of the University's concussion protocol focuses on education. It starts at the beginning of the academic year. Athletic training professors are assigned teams that they must cover during games and matches to provide the first line of injury intervention.

"Athletic trainers meet with each of their teams at the beginning of the school year to go over concussions and our protocol that includes return-to-play and return-to-classroom guidelines," Arend said. "Once a student athlete is diagnosed with a concussion, he or she must be symptom free of a concussion before being allowed to progress back to the classroom and practice.

"There are steps that are evidence based that the student-athlete must complete each day before allowing to be cleared to participate 100 percent," she said. "Usually, this will take up to two weeks depending on the student athlete."

She said all student athletes are required to view an NCAA concussion education video and are tested on its content. All student athletes also must obtain a baseline on SCAT3 and or ImPACT testing prior to participating in their sport.

"ImPACT is a computerized test that is 30-45 minutes that gathers their baseline on how they concentrate, recall and memory," Arend said. "The issue with impact is that you really need to know the student athlete because if he or she has a learning disorder, then you need to determine if after the hit, are their symptoms normal because of a learning disorder or is it a concussion.

"By comparing the baseline of the student-athlete and first ImPACT or SCAT3 after an athlete reports symptoms from a hit, you can determine if the athlete is concussed or not," Arend said.

She said if people have or been diagnosed with anxiety, depression, a learning disorder or migraines, then it is important for athletic trainers to know this because symptoms can be the same for concussion and emotional disorders.

One of the problems with concussion diagnosis and treatment, Arend said, is it includes a wide range of pathology. Many clinicians will assume anyone who gets hit in the head or has a migraine with nausea has a concussion.

Arend said she is not convinced that there should ever be just one device or test to definitely determine whether someone has experienced a concussion.

Siple said athletic trainers work diligently with student-athletes to encourage them to be truthful about symptoms. Some athletes, because of their gusto for competition, hide or deny symptoms in order to keep playing.

Unlike a clinician responding to an obvious injury such as a broken bone, athletic trainers can't accurately diagnose a head injury without a description of symptoms from the patient.

"If a person sprains his or her ankle, we can see how it happened. The person can describe how it happened. We can see the swelling and redness. We can feel the heat and measure the loss of motion," Siple said. "We can even get an x-ray to rule out fracture.

"When someone has a concussion, we do not always see it happen. They may not remember what happened, and we cannot see their symptoms - headache, nausea, dizziness and light sensitivity. We are dependent on the patient to tell us a lot of what they are experiencing to make a diagnosis. That means they have to communicate with us and be truthful about those symptoms."

When left undetected concussions can result in long-term damage and may even prove fatal.

"For that very reason, we have a rigorous concussion protocol at SRU," Siple said.

MEDIA CONTACT: Gordon Ovenshine | 724.738.4854 | gordon.ovenshine@sru.edu