E.J. Jenkins leans against lockers in the dressing room at the New Hope High School field house. Jenkins has received at least three concussions in his life. The most recent was a season-ending injury. Photo by: Kelly Tippett
November 19, 2011 8:28:00 PM
It was the first quarter of the third game in the New Hope High School football season. E.J. Jenkins was running down the field with the football, trying to avoid Columbus High School defenders. The junior wide receiver then took an "awkward hit to the back of the head," and fell to the ground.
"It's hard to explain. I was just in a daze," Jenkins, 16, said. "I didn't know where I was at or what was going on. I couldn't remember anything."
As concussions become a more highlighted part of football, parents, coaches and doctors become more concerned about the injury's risks for high school athletes like Jenkins. This resulted in a number of states taking measures to protect the helmet-wearing teenagers.
As of the beginning of September, at least 30 states -- with more pending -- passed laws that keep players from returning to the field too soon after receiving the injury.
Mississippi stands in the small minority of states without any passed or pending concussion legislation.
Jenkins has received at least three concussions in his life. The most recent was the season-ending injury in the game against Columbus High School, but he didn't come off the field right after receiving the concussion.
"I played until the end of the first quarter," he said.
Why? Because he and others didn't immediately recognize that he received a concussion, a common occurrence for athletes.
A concussion is simply defined as trauma to the brain. It is usually caused by a hard hit to the head or hard fall to the ground that shakes or rattles the brain.
"The brain is protected by a hard shell, the skull, and is floating around in fluid," Dr. Jerry Turner, Lowndes Family Medical Clinic family practice physician, explained. "When you have a major impact, the brain sloshes around and collides with the skull and injures the brain."
A person does not have to lose consciousness to receive a concussion. While loss of consciousness is common for the injury, along with forgetting what happened right before the blow took place; others don't show visible symptoms. Some additional, less-obvious symptoms of the injury include confusion or dizziness, loss of energy, balance issues, sleep changes, nausea and loss of appetite.
This makes it tough to identify when a concussion occurs during practice and games, Victory Christian coach Chris Hamm said.
"If a guy complains at all, it's one thing, but it's a hard thing to diagnose," Hamm said.
For Jenkins, who "vaguely" remembers how the injury happened, he felt headaches and started losing his balance.
"As I kept playing, it kept getting worse and worse," he said. "When I got to the huddle, I asked the quarterback what to do in the play."
Finally, someone noticed his uncharacteristic demeanor and told a coach before Jenkins suffered another serious injury.
According to Turner, the danger of playing with a concussion is "second-impact syndrome," which is when a player is not fully healed from the previous concussion and returns to the game and receives another hard hit to the head.
"The dangerous things that happen after a concussion are swelling of the brain or bleeding of the brain. Those are the two types of concussions that have disastrous outcomes or long-term injuries," he said.
"I know that it's a lot more disastrous if you have a second (concussion) after already having one."
A number of media outlets reported toward the end of the decade that high school athletes were returning to the field too soon after receiving a concussion.
A USA Today article from May 2009 reported that around 40.5 percent of high school athletes return to the field or court prematurely after receiving a concussion. A quick return is unhealthy and sets the athlete up for more severe head injuries.
"Young athletes, whose brains and skulls are immature, risk death or additional concussions by going back too soon," the article reads.
A Time magazine article from January 2009 said it was "alarming" how many young athletes returned too soon.
"From 2005 to 2008, 41 percent of concussed athletes in 100 high schools across the U.S. returned to play too soon, under guidelines set out by the American Academy of Neurology," the article reads. "The 11-year-old guidelines say, for example, that if an athlete's concussion symptoms, such as dizziness or nausea, last longer than 15 minutes, he should be benched until he's been symptom-free for a week."
The New York Times researched and reported in 2007 that since 1997 at least 50 youth football players, which is defined as high school-level or younger, from 20 different states have died or sustained serious head injuries on the football field.
More cautious approach
Due to the injury being initially undetectable at times, anytime a player gets a hard hit to the head or looks like he might have a headache, Brandon Johnson -- a certified trainer with Encore Rehab in Columbus -- will keep the player off the field until he passes specific tests. Even then, it's no sure thing.
"He's got to remember what happened, his plays in football, his assignments, what number he wears, his coach, where he's playing. I'll give him a set of words and make him recite those words back to me in groups a couple times over the course of 15-20 minutes before I put him back in the game," he said.
"They have to have no symptoms. I'll hold them out a week after their last symptom. If they have headaches on a Tuesday following the concussion on a Friday night, I'll hold them out for the next game."
According to Turner, who is the Heritage Academy football team physician, he sees and hears of players trying to shrug off the injury and continue playing.
"One problem you have is the athletes are competitive and want to play, so they downplay their symptoms," he said. "If they have those major ones, it's obvious. But sometimes you hear the phrase, 'Oh, I just got my bell rung,' and they head back to the field. They appear normal on the surface."
Johnson believes local high school coaches are more aware of the dangers and praises them for staying on the side of cautiousness.
"The coaches in this area are good. I've worked with all of them," he said. "I had an incident last week where the kid had his bell rung. When we pulled him out, we didn't put him back in because he had a pretty big headache."
For New Hope players, there is a structure they must go through after being diagnosed with a concussion.
"At practice, if you show certain symptoms, the trainer will keep you out for the remainder of practice," Jenkins said. "If you have a concussion, you have to go through recovery steps before you get back to full speed."
Better late than never
The states of Alabama and Louisiana passed laws earlier this year requiring parents and coaches to learn about the dangers of concussions. The laws also requires coaches to keep a player, like Jenkins, who shows any symptoms of the injury off the field until a doctor clears the athlete to return.
According to the National Football League's Health and Safety website -- nflhealthandsafety.com -- Mississippi joins Arkansas, Kentucky, Georgia, West Virginia and Montana as states without passed or pending concussion legislation.
Turner agrees with the idea of concussion legislation, saying, "I would certainly be in favor of our state doing that, and I think that would increase awareness.
"I played football in high school and college and it was a sign of weakness when you wanted to sit out of a game," he said. "One of the major problems we had was there was never a general consensus on how to manage them.
"It might put financial hardship on some school districts or families, but we have to put the safety of our student athletes first."
Many local coaches also would be in favor, citing the need for some sort of protocol for coaches to follow in keeping athletes safe. New Hope High School coach Michael Bradley said legislation could "remove the ambiguity" of how to handle a player with the injury, and Hamm believes "a lot of times the fog of competition overrides better judgment" and legislation would prevent such from happening.
While coaches do their best to stay educated and cautious, legislation could make it illegal to send kids out to the field after receiving the injury.
Some coaches aren't so quick to agree that concussion legislation is needed.
Columbus High School coach Tony Stanford said coaches already go through these channels of ensuring player safety.
"If one of our players has a concussion, they aren't going onto the field right away until they are cleared by a doctor or trainer," he said. "I think (that) is already being carried out by the coaches and trainers."
Aberdeen High School coach Chris Duncan said the coaches are "trained professionals" and do not need any more "government interference."
"I think coaches have the best interest of the kids at heart and I don't think we need legislation to do our jobs," he said. "Ninety-nine percent of the coaches take it seriously and do their job well ... That same one percent will do it whether it's the law or not."
East Oktibbeha High School coach Randy Brooks said the number of concussions to occur in Mississippi is not high enough to start considering legislation.
"I don't think we've gotten to the point in Mississippi to where we've had a large enough number of concussions," he said. "We, as a coaching staff, are smart enough to spot when a kid has a concussion."
kj commented at 11/20/2011 1:00:00 AM:
So, no "if we even save one"-style advocates could be found for this article, eh? IMO, this is a perfect fit for Personhood USA. We've got actual persons at risk of being victimized when we could do something to prevent it. Granted, these kids aren't so cute and cuddly as a fetus, but even raising awareness could help save a real live kid from a life-threatening injury.
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