BY CHRIS BARLOW
PROTECTING CHILDREN PARTICIPATING IN ATHLETICS FROM THE EFFECTS OF HEAD IMPACTS IS THE GOAL.
Studying the subject of concussions in youth sports with scientific methodology assists parents in sifting through what has been previously said, and it helps families make sound decisions about youth sports participation.
Using modern technology, Dr. Brian Stemper, Associate Professor of a joint department of biomedical engineering at Marquette University and the Medical College of Wisconsin, heads a local, active study looking at how to diagnose, prevent
and care for these athletes.
Dr. Stemper is conducting his research in an office at the Zablocki Regional Medical Veterans Administration and on the
fields of local schools, including Tosa East. “The more information we can feed (schools, parents, athletic officials) about
things like head impact exposure, the better they can start to see actionable things to do to reduce concussion risk,” Stemper
said. “One of the most important things parents can do, is to pay attention to what is happening on the field and with their
kid. Talk to the coaches and talk to the athletic training staff about any specific or general concerns.”
Holly Botsford, External Relations and Engagement Manager at the Medical College of Wisconsin, said that results from this study and others have concluded that a person needs fifteen days after a head impact to give the brain the rest and
recovery it needs to heal.
“A lot of this research being done is dispelling the myths,” Botsford said. “Active recovery can be more beneficial than isolating the affected person. Fifteen years ago, no one was studying this.”
For several years, Stemper has been working with Tosa East by placing sensors in the helmets of football players, called a head impact telemetry system, or HIT system. It is a series of accelerometers that are placed inside the helmet and every time a helmet sees acceleration above 10 Gs, it records a head impact.
“I think the level of head contact varies quite a bit from sport to sport,” Stemper said. “The sports that you see the most head impacts in are definitely football and rugby.” Stemper added that concussions rates for ice hockey, wrestling and soccer do occur, but not nearly at the frequency of football or rugby, where head impacts have been measured up to 20 times per game.
This year Stemper and his team are starting a new study at Tosa East where they are using a sensor placed in an athlete’s mouth guard that performs the same function as the previous study, but with more expansive options. “The mouth guard sensor allows us to measure head impacts in other sports, like ice hockey, soccer and lacrosse,” Stemper said. “So, we are expanding the study to other sports, based on what we found in the football analysis.”
Stemper said the HIT system for football is something that has been around for 10 or 15 years now and is very well developed. But prior to this new tech option, there had never been a good method to studying impacts in non-helmeted sports.
Michelle Guyant-Holloway, Athletic Director for East High School, said the mouth guard study is just beginning, but the school district is already seeing benefits from the relationship with Stemper and his team.
“We are happy to partner with another medical researcher as we work to better understand the effects of impact in contact sports,” Guyant-Holloway said. “Results of these studies will help school districts, coaches, and athletic associations determine if there are changes we can make – whether improvements in equipment, enhanced training, changes in how we coach or even in policy – to better protect student-athletes. While there’s no way to control all factors, these studies will help us -as an industry – identify where we can improve.”
The company who created the mouth guard tech is Prevent Biometrics, based out of Minneapolis. They say that prior to
developing these products, there was not an accurate and reliable solution for detecting concussion-causing impacts in real time. They state that this situation was leaving many concussions undetected, undiagnosed and untreated.
Stemper and his team are looking at all head impacts, not only those causing concussions. Despite the fact that concussions are not the only focus of Stemper’s study, they are always one of the main concerns for parents, athletes and coaches.
The center for Disease Control defines a concussion as “a type of traumatic brain injury—or TBI—caused by a bump,
blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”
“The mouth guard that we are using records the head impacts and stores them in the mouth guard,” Stemper said. “We
have an app on an iPad on the sidelines, and when the players come off the field, the mouth guard communicates with the app and transmits all of the head impact data.”
Stemper added that there is no real purpose in recording in real time what is happening with the head impacts, because
a coach or trainer will know if it is a big hit and if an athlete is concussed on the field. He also said that there is no truly defined threshold for concussions.
“What we use it for is to analyze retroactively and focus on the mechanisms of concussions and how they happen,” Stemper said. “We get all of this data from all of these kids and find out what’s different in the head impacts. We can compare data from the kids who were concussed with that from the kids who weren’t concussed.”
Stemper pointed out how difficult it has been for a concussion diagnosis, because a lot of the symptoms are very subtle in
terms of cognitive deficiencies. In days past, it was common for athletes to go right back on the field after suffering both major and minor head impacts and trauma. “The severity of a concussion varies dramatically,” Stemper said. “If an athlete
su ering from a head impact doesn’t feel right for a few days, it does not mean that they are going to eventually suffer from CTE.” CTE is an acronym for Chronic Traumatic Encephalopathy, which is a brain disease common with athletes and
others who have suffered brain trauma.
One recommendation Stemper had for parents of athletes, is to keep a line of communication open with children and
monitor how they are feeling. Most conclusions from the study are yet to come, but one thing Stemper did say is that there is some indication that protective equipment has some impact on the effects of concussions. If a school or a parent has the ability to purchase better equipment to protect the kids, they should do so.
In 2011, Virginia Tech instituted a five-star rating system to identify which helmets best reduce concussion risk. More stars equate to better protection, with five stars representing the best available helmets.
“We encourage athletes to get out of helmets with low ratings, and into 4- and 5-star helmets,” the school’s website says.
Other entities are taking action to prevent head impacts that lead to concussions, like The Ivy League Conference who in 2016, eliminated all full-contact hitting from practices after a unanimous vote by the eight coaches.
“The mechanism of diagnosing a concussion continues to be single, high magnitude impacts,” Stemper said. “That’s what makes the news or SportsCenter. What we are finding in our study, is that repetitive smaller impacts contribute to the onset of concussions as well. We are in the early stages of understanding that now.”
So there can be a gradual onset of symptoms from multiple impacts, and then there is the proverbial impact that is the “straw that breaks the camel’s back.” Stemper said that he believes limiting exposure to multiple impacts can be a good way that schools and parents can reduce concussions.
Guyant-Holloway said the most important thing for parents to know, is that the Wauwatosa School District takes the safety of student-athletes very seriously.
“Participating in medical research studies is just one way we’re working to help potentially improve safety in the long term,” Guyant-Holloway said. “In the present, we have a comprehensive system in place that includes educating our coaches, athletes, and parents about how to identify concussions, how they happen, and how they need to be treated. Every athlete completes a ‘baseline’ test every two years with an athletic trainer.”
The baseline test is used by most modern athletic departments and is designed to set and record baseline measures of an athlete’s typical mental state. If an injury does occur, the athletic trainer can go back to the test, perform another assessment, and see how the results compare. Baseline tests help determine next steps in emergencies and can be used for all student-athletes, not just those in high-impact sports.
The WIAA has a policy that was implemented before the 2017-18 school year. It is a plan to provide secondary insurance to families of a student-athlete who suffers a concussion while playing a WIAA sanctioned sport. Wisconsin is only the 4th state in the country to provide this additional insurance.