Congratulations to Alex Schley, who received a Silver Key award for this editorial in the 2014 Boston Globe Scholastic Art and Writing awards. We originally published this piece in the December 2013 print edition of The Big Red.
by Alex Schley
“When in doubt, sit them out.” The Massachusetts Interscholastic Athletic Association (MIAA) adopted this slogan after the Massachusetts state legislature passed a Return to Play Law on June 24, 2010. The law requires students, parents, and coaches to receive annual training to recognize the symptoms of concussions, and for athletes to be removed from play if they possibly have a concussion.
However, along with these new precautions has come a growing resistance among high school athletes to report concussions. When I surveyed 84 Hudson High School varsity athletes, I asked them to explain why they continued to play despite believing they may have a concussion. One anonymous student wrote, “Concussion= 2 weeks out.” Like many others I surveyed, it was the Return to Play Law that led them to continue playing, exposing themselves to possible brain damage.
According to statistics gathered by Moms Team, the trusted source for sports parents, in high school sports the average rate of reported concussions has increased annually 16% since 1997. Moms Team claims this is largely due to the increased awareness of concussions and their symptoms. However they are also quick to point out that this may be due to the total number of concussed athletes also increasing. But along with the increase in reported concussions, has come an increase in athletes who are not reporting concussions.
All student athletes at Hudson know the concussion symptoms, which are drilled into our brains at the beginning of every school year when we are forced to take the National Federation of State High School Associations (NFHS) concussion course. This educates and then quizzes us on the recognition and management of concussions.
However, 87% of Hudson High School athletes we surveyed who have been diagnosed with one or more concussions admitted that they had continued to play despite believing they may have another concussion.
Seven out of every 25 varsity athletes we surveyed reported that they have been diagnosed with at least one concussion in their athletic career. Therefore, all athletes know what happens. We are out indefinitely for at least 2 weeks. We are athletes; we play sports because we love it, enduring the pain and losses through pure passion. For most competitive athletes being taken off the field for a water break is torture in itself. The whole time we want nothing more than to go back out there and do what we love. Taking an athlete off the field for 2 weeks is devastating.
Junior Andrew Nugent is a two-way starter for the football team. After he suffered his eighth concussion this past season, he decided the lifelong mental effects he has noticed outweighed the benefits of his high school football career. But it was a tough decision. “You see things that when you’re out, you see things that someone does and there’s always that question of I could have done that better, right? Or if I was playing ,would we have won, sort of thing, so every time something goes wrong and you’re not in there, then you take responsibility, or at least for me I do. It makes you feel kinda helpless and useless, I guess.”
However, it’s not only guys trying to be tough. Many girls have the same dedication to their sport. One member of the girls soccer team explained to me why she denied having concussion symptoms after experiencing second hit syndrome this past season. “I just wanted to play more. Because I don’t like sitting out. I hate sitting out. And like I’d rather be on the field and like kind of in pain than just sitting on the bench watching the game happen and not being able to go out and play or do anything.”
Not only do we athletes want to keep playing, but no one wants to be “that kid,” the one who makes the coach take them out after the slightest hit or fall. We’ve all had “that kid” on our team at one point in our athletic career and know the utter annoyance of when “that kid” gets hurt, again. Therefore, no one wants to be known as “that kid.”
And it only gets worse the more crucial you are to the team. Nugent explained his experience. “I feel horrible. Just being out I feel embarrassed, like I’m not tough enough to play with these kids. I feel like I’m letting people down. I’m a big part of the team and a solid presence on the field, and when I’m not on the field, I feel like people are mad at me, sorta.”
Two weeks is a long time in terms of high school sports. Within that time a team can have as many as 6 or 7 games, which is one fourth of the regular season. Even if the key athlete is out, the team still has to play, which requires someone to step up and fill the position. The concussed athlete then wonders what his playing time will look like when he returns. As all athletes know, no one’s playing time is secured. It is earned not given. So athletes worry about being replaced.
I have personally witnessed this happen on my own teams numerous times, especially in hockey where playing time is so competitive. Last year my teammate Nicole Coulombe, who got more ice time than I did, was out with the flu. I substituted for her. Seeing this as an opportunity to prove my worth, I skated my heart out and produced an assist, helping us claim our first win of the season. The next game when Coulombe came back the coach kept me in her spot.
Our love for our sport outweighs the consequences an undiagnosed concussion brings. Prior to writing this piece, I had only heard the long-term effects concussions have on athletes in the news. At no point in my athletic career has anyone personally educated me on the issue. This I believe is the key element missing from any organization’s concussion education program.
As teenagers we fail to evaluate how something will affect us in the long run, and we won’t care unless we are convinced that we need to care. Therefore, I believe in order for concussion prevention to be successful adults need to scare kids. They should use the same techniques used in drug and alcohol prevention, educating students about what will happen to them if they don’t follow the laws that have been put into place to protect their health.
They should educate athletes on things such as secondary hit syndrome, which can happen to people if they are not removed from play and given the necessary time for their brain to heal. However the devastating effect of this is that the symptoms caused by the second hit are permanent. There is no shaking that one off. “Taking one for the team” will result in permanent changes to your brain, making tasks you once found easy more difficult or if serious enough, impossible.
Educating athletes on being able to recognize a concussion is only half the battle. We now must make them want to sit out.
Angela Banks • Feb 13, 2014 at 7:34 pm
Great article! As a parent of a HHS student athlete who suffered a mild concussion this school year, I had to live with my daughter expressing similar emotions as the athletes in this article. I concur with you Alex, students need to be shown the damage that can occur to their brains if they continue to play with a concussion. The consequences can be deadly! Thank you for bringing more awareness to this issue Alex. Open and honest dialogue is educational and refreshing.
Sue Bowen • Feb 6, 2014 at 12:52 pm
Congratulations, Alex, you nailed it!. I’ve always been concerned athletes would fail to report symptoms when injured or deny symptoms through the recuperation process. I am hoping hearing it from a peer both on and off the field will reinforce the message.
Pat Emmons, RN • Feb 5, 2014 at 5:42 pm
This is an excellent article Alex – the first I’ve seen written from an athlete’s point of view. As someone who is usually the first to tell an athlete that he or she cannot participate, I understand how devastating this news can be. As a healthcare provider I also know how important it is to tell it. We are very aware that educating athletes regarding concussion is a double edged sword – they need the information in order to report possible symptoms but it also enables them to be savvy enough to hide them. While we applaud the dedication it takes to be an athlete, science can now tell us the long term effects of “pushing through”, and, as you mentioned, Second Impact Syndrome, which is life threatening. I especially liked the end of your article where you acknowledge that teenagers do not appreciate the long-term consequences of their actions – it is a developmental phenomenon. How do we make them “WANT to sit out” indeed? I also want to applaud Andrew Nugent for his candid responses and for speaking for so many of his peers. As one of your school nurses, I care deeply about this issue and struggle with the decisions it requires on a daily basis. Thank you again for writing this wonderful piece!