High-impact sports like football, soccer and volleyball are back in full swing which means student athletes are at an increased risk for concussion and other injuries. On the sidelines of those games and practices is a collaborative effort making sure young athletes are ready for the season – in both body and mind.
Baseline Testing for Concussion
Inside the main gym at Washington High School, student athletes are gathered for quite possibly their most important practice of the year.
“So we're doing our concussion testing. We do what's called Sway and it actually takes the use of a cellular device and it uses the mechanics within the phone to be able to measure balance, acuity, memory, reaction time and inspection time as well,” said Caitlyn Martin, an Avera athletic trainer assigned to Washington High School.
“Then they use those scores if you do get a concussion, then you'll take that test again,” said Dana Harpe, a senior at Washington High School and one of the team’s outside hitters.
Athletic trainers and coaches can then use the data to compare how responsive an athlete is. If there's a significant difference in scores between the two tests, it's likely the athlete is injured or affected.
“It's really important to have that baseline because everyone's brain grows and changes at different rates and different times. So we do a baseline test every year,” said Martin.
“This would be my fourth time doing it. We do it every year before volleyball,” said Harpe.
“After you take it one time, you kind of know what you're getting into for next year. It's easier. It's like, if you know that you're going to have to memorize the letters, you're repeating them in your head as you're thinking about the tiles or whatever, focusing on your balance. It's kind of tricky when you have to close your eyes. It's easier with your eyes open, obviously, but getting that every year just really helps,” said Hannah Nesdahl, a senior at Washington High School and the team’s defensive specialist/libero.
The Sway test is not meant to be a challenge, it just tests the cognitive and control functions of the brain. Concussions are very tricky in that there may not be visible clues that an athlete is impaired without having the athlete focus and quiz the brain.
“it is definitely something that is very important for us to be able to identify quickly. Because if we can identify if there is a possible concussion, the sooner the better, there's less chance for them to have long-term issues,” said Martin.
Concussions Can Be Hard to Diagnose
Concussions can happen on any competitive playing field, but given the physical nature of tackle football and soccer, head injuries tend to be more common. But that doesn't mean volleyball is a concussion free sport.
“It happens more often than you think. Obviously, as a DS/libero, I've gotten hit in the face a couple of times and it's hard, but some of those hitters, they're coming at you really fast. So definitely really being able to know if you're going to be all right after taking a hit like that is very important,” said Nesdahl.
“Thankfully, I have not had one, but I have seen a lot of football players, when they're getting hit, they do these too. I've seen a lot of them go over to our trainer, Caitlin, and they just take the test. I think it's helpful for when everyone gets knocked sometimes or falls down,” said Harpe.
You might think that a big collision or a blow to the head is a tell-tale sign of a concussion, but when it comes to traumatic head injuries, sports medicine specialists say that's not always the case.
“Sometimes they actually don't even get hit on their head at all, but we end up with a whiplash type of mechanism. So inside the skull, the brain is wobbling back and forth or it's rotating, it's getting twisted and torqued. So the concussion baseline testing gives me some objective data to go off,” said Sam Schimelpfenig, MD, Avera pediatrician and sports medicine physician.
The sudden stop or whiplash impact causes the brain to impact or bounce off the hard surface of the skull and leave a bruise. This can happen from any quick stop or impact, whether it's on the playing field or simply tripping on some stairs. There's no level of force to say when a concussion will happen, some people may simply have a better natural insulation against concussions, but that's why having a quick test to rule them out is important.
“It is definitely something that I can do on the sideline. I can take you right off the court, I can take you right off the field, and we can have that reading. So we're not playing that guessing game and it's data right there. And again, I'm comparing yourself to yourself. So it's not like I'm going off of normative data and those types of things. So it's really accurate,” said Martin.
Making the Game Safer for Athletes
The Sway test is just one tool being used to help keep athletes safe. Even with the best technology, there is no surefire way to eliminate the possibility of getting a concussion. However, getting a baseline done, having certified athletic trainers on the sideline, and teaching safe mechanics during practice all go hand-in-hand to help make the games safer.
“Athletic trainers are well trained to identify that and also to help us out as physicians. We can make recommendations as an athlete is getting back into their sport, but the athletic trainers are the boots on the ground. They're the ones that actually walk with those athletes through those steps to make sure, hey, are you actually where we think you are? How are you doing with each one of these steps? And then reporting back to us when they're like, yeah, we put them through all their paces and they're 100%, we're all pretty comfortable now that that athlete is safe to go back out there,” said Dr. Schimelpfenig.
“You get one brain. So we need to make sure that we do what we can to make sure we have a good future and our brain health is fine,” said Martin.
Learn more about athletic training and sports performance training at Avera Health.
