Monday, January 24, 2011

Dr. Larkin helps Fort Zumwalt tackle concussion issue

Originally appeared in the St. Charles County Suburban Journal
 
Getting back on the football field after suffering concussions is getting tougher in the Fort Zumwalt School District.

That's something district officials don't mind, because they don't want athletes to have more of them.
Based on the results of a study last year, freshman and junior football players are required to undergo baseline testing as part of a new concussion management program. The testing has not been extended to other sports.

Letters about the testing will be sent to parents this spring.

The baseline tests are good for two years. To play again, students who suffer concussions will have to satisfactorily answer questions they were asked this summer when the baseline testing was conducted.
A concussion is a brain injury caused by a collision of the brain against the inside of the skull. It can result in temporary headaches, memory loss and confusion. But health care professionals now worry about serious long-term health issues that weren't as readily recognized earlier.

The rising concern about the impact of concussions on athletes, particularly in the National Football League, has trickled down to the high school level. A big impetus is not sending athletes back out on the field too early and risk the possibility of more concussions.

"One of the great things it's done is focus attention on concussions," said Dr. Brandon Larkin, a sports medicine physician at St. Peters Bone and Joint Surgery.

Larkin discussed the treatment and management that the district's medical and training staff are employing with the Board of Education during its Jan. 18 meeting.

"Fort Zumwalt is on the forefront of a gold standard in concussion management," Larkin told the board.
The district may be one of the few school districts in the area with a baseline testing program. The tests are identical to those used in the NFL and the National Hockey League, he said.

Last summer, Larkin and the sports training firm that the district employs, Excel Sports and Physical Therapy, began to look at new ways of treating concussions and when to allow recovering athletes back on the field.
Symptoms vary. They can include headaches, blurred vision, nausea, dizziness, concentration problems and even changes in behavior. There is no single test that can confirm or rule out a concussion.

Often in the past, treatment simply looked at whether symptoms such as headaches had subsided and graded concussions based on those symptoms.

Larkin said 436 district athletes — mostly football players — completed baseline testing before the regular football season began last fall. These "neurocognitive testing" tests included puzzles and memory concentration exercises.

Once injured, athletes were required to take the baseline test again to see if they would do as well as when the test was first administered. The test results also are compared with data collected from other athletes of the same age and physical characteristics to help determine how an athlete is recovering.

"You would expect, for example, that an 'A' student would not come in at the 75th percentile," Larkin said. "That shows that something may be wrong."

The usual recovery time for symptoms such as headaches is seven to 10 days, but passing baseline testing satisfactorily took about 21 days for players last fall, he said.

Larkin said health care professionals are particularly concerned about repeat concussions. Having a concussion puts athletes more at risk for repeated concussions, which can happen easier, he said.
Larkin said there have been 65 recorded concussions from district fall and winter sports so far this school year. Of those, 37 were in football, seven in soccer, five in cheerleading, three in volleyball, two in swimming, four in baseball and six in wrestling.

A player at Fort Zumwalt East High School had to quit football in the preseason due to repeated concussions.

Larkin said the feedback from coaches and parents about post-concussion tests has been positive. Some parents occasionally have a hard time accepting recommendations because they remember how they were treated when they played high school sports.

"There is less and less of that with the NFL putting the emphasis that it does on the issue, and they're showing commercials that show that head injuries are a serious matter," Larkin said.

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