When Joseph Atkins coached high school football in New York state in the 1980s, he regularly had players come to the bench after taking a hard hit to the helmet. “What did I do?” said Atkins, now a psychology professor and assistant dean of students at Colby. “I asked them how many fingers I was holding up, and then I said, ‘Get your butt back in the game.’ Who knew better?”
Most people know better now. But, according to the principals in the Colby-supported Maine Concussion Management Initiative, there’s still a way to go.
“We have all of the resources in the world,” said College Medical Director Paul Berkner, D.O. “But what about the students in the high schools, who are at higher risk for more concussions?”
The brainchild of Berkner, Atkins, and Portland physician William Heinz, M.D., the project in three years has provided more than half of the high schools in Maine with state-of-the-art training, testing tools, and education to better diagnose and treat concussed athletes. More high schools are being added each year.
The group, which includes Colby professors Jan Holly (mathematics and statistics), Bruce Maxwell (computer science), Liam O’Brien (statistics), Edward Yeterian (psychology), and James Scott (statistics), wants to reduce concussions by spreading the word about existing guidelines and to provide resources for neurocognitive testing that can show when a brain injury has occurred, and when and if it’s safe for an athlete to return to play.
MCMI has done this by educating high school athletic trainers on the latest protocols and by offering funding for concussion-testing software provided by a company called ImPACT. Seventy-five athletic trainers from Maine high schools attended a 2009 kickoff conference on the subject at Colby, made possible through a grant from Colby’s Goldfarb Center for Public Affairs and Civic Engagement.
Said Arlene Dudley, athletic trainer for Kennebunk schools. “I got involved from day one.”
That number of schools has grown to 68 of the 152 high schools in the state, with many of the nonparticipating schools using what is fast becoming accepted practice in Maine and elsewhere. A grant from the Bill Alfond Foundation is being used to add more schools to the MCMI rolls.
Berkner and his allies also helped craft legislation being considered by the Maine Legislature that would require schools to follow the concussion protocols. The law, Berkner said, would back up trainers and coaches who want to protect injured athletes but get resistance from players, parents, and others. “They can say, ‘It’s not my decision. It’s the state’s decision,’” he said.
Allowing concussed athletes to return to play too soon—and in some cases ever—can result in prolonged symptoms or possible catastrophic brain injury if the head is subjected to continued blows. Despite that risk, trainers still sometimes are pressured to allow an athlete to to play, Dudley said. If the athlete had a badly sprained ankle, there would be no argument. “But the brain,” she said, “It’s, ‘When can I go back?’”
The MCMI initiatives, along with national attention to professional sports, are increasing awareness of the problem, Dudley said. When a school system adopts formal guidelines, administrators and teachers must be educated.
At South Portland High School, head athletic trainer John Ryan, a member of the MCMI board, said students are more willing to come to trainers to report an injury and coaches and parents are more attuned to the seriousness of brain injuries. “The kids are starting to sit up and take notice that athletics is just a small piece of their lives,” Ryan said.
The goal is for fewer of those injuries to take place. Berkner said more and more high schools are following the same or similar procedures used at Colby. All Colby varsity athletes and members of the men’s and women’s rugby clubs take a computerized baseline neurocognitive test that can be used for comparison if an athlete suffers a concussion. The health center, he said, now sees three or four concussed athletes each week, and some 75 every year. “If your cognitive function is affected, this can document it,” he said.
Bruce Maxwell, associate professor of computer science, is developing a device that measures athletes’ balance, a test that had been done manually. The goal: more-objective results.
In addition, Berkner, Maxwell, and intern Callie Wade ’13, a biology major planning to enter medical school, prepared a grant request for the National Institutes of Health that, if funded, will allow for further study of data from some 17,000 high school baseline tests and testing of more than 800 concussed athletes.
“We’re the only statewide injury-management program for concussions,” Berkner said.
The Colby-based initiative has an advantage over hospitals and other medical entities because MCMI isn’t seen as competition. “This is not a business,” he said. “This is a truly philanthropic endeavor.”