Tackling the concussion issue in youth sports

Despite new medical information surfacing about the dangers of football - especially negative effects on the brain - Palouse coaches say participation in perhaps America's most popular sport is still steady.

Doug Ryan, Pullman Youth Football Association coach and president, said player participation numbers in the PYFA have remained steady during his seven years, and he does not expect numbers to drop because of increased awareness of brain injuries resulting from the sport. He said parents know coaches are doing their best to correctly teach the fundamentals of football.

"We don't ask kids to go do something that's not safe," Ryan said. "We try to keep it as safe as possible and I think the community has seen that."

On the other hand, Andy Kiblen, who coaches a Moscow Thrashers fifth/sixth-grade team, said Thrasher numbers have been a bit of a rollercoaster. Overall numbers are down from past years, but coaches are trying to attract more players to the program.

He said he believes the risk of head injuries is a major part of the decline.

Coaches with both organizations undergo concussion training to learn the symptoms and the steps to take if a player appears to have one. If a coach suspects a player sustained a concussion, the player is immediately removed from the practice or game and does not return until he is cleared by a doctor.

Jordan Hess, whose sixth-grade son, Kaden, plays for the Thrashers, said he did not allow his son to play football until he learned the players were using top-of-the-line helmets and guardian caps, or extra padding on the exterior of the helmets.

"They're ahead of the curve when it comes to implementing this technology," Hess said of the caps.

Hess said he is still worried about the safety of his son, who sat on the sidelines during Thursday's practice because of a sprained ankle. He still believes the benefits of the game, such as camaraderie and teamwork, outweigh the physical risks.

He said the Thrasher coaches are proactive when it comes to safety and care for their players, which is also why he is comfortable with his son playing.

Sonny Naranjo, whose fourth-grade son, Antonio, plays on a third/fourth-grade Thrashers team, also expressed full confidence in his son's coaches. He said the coaches focus on teaching correct tackling techniques, and if a player does not tackle the right way, coaches will work to correct the player's mistake.

Naranjo said he is not too concerned about his son sustaining a head injury because of the great coaches and the quality equipment. He said football is a risk just like any other activity or sport.

Michael Kiblen, Andy Kiblen's son and an eighth-grade quarterback and safety, said he suffered his second-ever concussion this week. The latest was considered mild but last year's concussion, which also came on the gridiron, kept him out five or six weeks.

He said the head injuries have not made him re-think playing the game he loves, since the injuries do not arise often.

At the high school level, Moscow High School Head Coach Phil Helbling, who is in his seventh season leading the Bears, said one of the biggest focuses in the last couple years is taking the head out of tackling and using shoulders instead.

Helbling said he teaches his players to tackle from the shoulder pads down.

He used to teach his players to put their head across the ball carrier's chest but now he instructs them to put their head behind the ball carrier, essentially taking the defender's head out of danger.

"We're trying to make the game as safe as possible," Helbling said.

He said he has also limited contact in practices to reduce head injuries and to keep players fresher for game days.

Helbling said MHS has always struggled to a degree with player participation and he is worried about declining numbers in the future.

He said some students have told him they will not play because of parents' concerns or because the student had sustained multiple concussions.

Helbling said concussions are handled with extreme care. If a symptom is present, an athletic trainer will remove the player from the game.

"If a kid gets a concussion Friday night, the chances of him playing next Friday night are slim to none," Helbling said.

David Cofer, who is in his 12th season on the Pullman High School football staff and second as a head coach, said his staff has also changed the way they teach tackling and has adjusted their practice structure. Cofer said his team has no more than two full-contact practices a week, and the contact periods are limited.

Cofer said many concussions are a result of repeated collisions, not necessarily one huge hit.

"We really try to initiate contact with our shoulder primarily, and by doing this, we've actually seen a huge reduction in the amount of concussions we've had over the last five years," Cofer said.

Cofer said his players do not have full-contact practices until about two and a half weeks into practice, which is a stark contrast to when he first started coaching.

Cofer said the number of players in his program has stayed pretty consistent over the last five to eight years, but they are down from 20 years ago.

Declining numbers is something that crosses his mind, but he said the positive steps taken to make the game safer is also something he considers.

"I think right now, the game is safer than it's ever been," Cofer said.

Kelly Isakson, a physical therapist and one of the owners of Moscow Mountain Sport and Physical Therapy, said she offers area athletes free ImPACT and VOMS, or vestibular/ocular-motor screening tests. Isakson said a baseline ImPACT test involves a series of questions that require memory and reasoning from the athlete and determines how an athlete's brain is functioning. If the player sustains a concussion, he or she can take the test again and then compare the data to when the athlete was not concussed. The test is one tool physicians can use to determine when an athlete can return to the field or court.

While Isakson said she has offered the ImPACT test the last half a dozen years, she started offering the VOMS test a couple years ago. She said the standardized test determines how an athlete's eyes and balance are functioning and it is helpful in determining what part of the brain is injured, how the athlete is recovering and what rehabilitation methods should be taken.

Benjamin Stellmon, a registered nurse in Gritman Medical Center's Emergency Department and clinical coordinator for the department, said concussion treatment has not changed much in the past decade. He said typically a computed tomography scan is performed to determine if there is brain bleeding. If the concussion is mild, the patient will stay in the hospital for a couple hours to be monitored before being sent home with possible medications for pain and vomiting. If visible damage is done to the brain, sometimes patients will stay overnight or be sent to see neurologist.

He estimated 30 to 40 percent of concussion patients seen at Gritman are injured playing football.

Depending on the severity of the concussion, Stellmon said football players typically need to wait at least a week before returning to contact activities, and they need to be cleared by a medical professional before resuming contact.

Sometimes football players are encouraged to sit out the remainder of the season, or if more than three concussions are sustained, Stellmon said doctors often suggest quitting football altogether. Stellmon said every concussion sustained increases the risk for long-term neurological problems.

Garrett Cabeza can be reached at (208) 883-4631, or by email to gcabeza@dnews.com.