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Abilene Reporter-News (Texas)
For about a decade, the word has been looming over the football world like a vulture waiting for roadkill to expire.
National sports talk show hosts have debated whether concussions will kill the sport, parents have debated enrolling their children in youth football activities and medical professionals have taken a close look at the link between football plays - both the explosive kind and the mundane - and long-term brain damage.
It's only natural the sport, and its regulatory bodies that govern its rules, have evolved to limit potential problems for current athletes, whether it be implementing better Return-To-Play standards, providing better tackling instruction and offering better technology in equipment.
Football's Big C can't be eliminated from causing harm, but the efforts taken to mitigate the long-term effects are leaps and bounds better than what was done even at the turn of the decade.
Albany coach Denney Faith knows all too well the results of the increased attention to diagnosing and treating concussions.
"I know that our kids are well taken care of for sure now," Faith said. "With all of the concussion protocols the players go through, if one is diagnosed or if we even think one could be diagnosed, we take them out immediately and they can't play again until they're cleared.
"Before, we didn't have to get the doctor involved as much. I've always been very careful with my kids, but with the new protocols, it's a lot more strict, which is good."
A reaction to a problem
These changes, from limiting a player's ability to return to the field if a concussion is suspected to requiring baseline tests to determine a base cognitive ability a player must match in order to be cleared for contact, have been implemented throughout football squads as a means of combating the conversation about concussions and the debilitating effects they can have on individuals who suffer too many.
The degenerative brain disease chronic traumatic encephalopathy, referred to simply as CTE, has received national and international attention following high-profile deaths of athletes such as former NFL linebacker Junior Seau and movies such as "Concussion," starring Will Smith.
A study published in July in The Journal of the American Medical Association, the largest of its kind to date, showed 110 of 111 studied brains of former NFL players were afflicted by CTE. Looking beyond just professional players, 87 percent of 202 brains from football players across all levels of the game, including high school players, also showed the disease.
Those high school cases were determined to be mild, the study found, while more severe cases of CTE were found in college and professional players. But one of the authors of the study, Boston University neuropathologist Ann McKee, told the New York Times the debate about whether concussions and CTE are a problem for football is over.
"It is no longer debatable whether or not there is a problem in football - there is a problem," McKee told the Times.
Bill Abbe, co-athletic trainer for Abilene High School, hears words like this and has two thoughts. One is that the attention concussions are getting is important, as football's collisions can be hard to ignore. But as an athletic trainer for more than just football, he's also well aware of the dangers present in other sports.
Like soccer, he said. Or baseball and softball. He doesn't feel it's right to target football exclusively because concussions are prevalent throughout sports.
"I want them to test all athletes to see where (CTE) is," Abbe said. "I think it's been misdiagnosed in all sports. But the concussion rules we follow now (in football) are awesome. I'm glad we have a set protocol."
Mandated by the University Interscholastic League, the Return-To-Play protocol outlined by the state makes it almost impossible for a player to return to the field immediately after being checked out for a head injury, Abbe said.
Athletes now must pass several kinds of tests before being cleared to return to the playing field, starting with simply being symptom free for 24 hours. From there, players are allowed to begin light exercise, for 10 minutes, with the hope of remaining symptom free. Day-to-day, the amount of work they can do increases, with players allowed to return to the field for non-contact drills on the third day.
On the fifth day, they're cleared for full participation, as long as they've remained symptom-free throughout the process. If at any point they experience symptoms, the process begins anew.
This is just the bare minimum, though. Abilene High, as well as many larger schools and Cooper, have gone above and beyond with the help of team doctors. The Abilene Independent School District adapted its own concussion test, by ImPACT Applications Inc., a computerized evaluation that measures a player's cognitive functions such as memory, reaction time and sensitivity, Abbe said.
Athletes must pass 30 different aspects before being able to return to the field after a concussion.
When they're on the field, it can be difficult to diagnose a concussion. So Chelsea Martinez, who is new to the athletic trainer position at Abilene High and will serve as co-athletic trainer with Abbe this season, relies instead on technology.
It turns out there's an app for that. And it's also made by ImPACT.
Around the area
Large schools, generally 4A through 6A, staff team doctors (Abilene ISD and Wylie ISD have multiple, for instance) in addition to one or more trainers who roam the sideline in case of injury, concussion or otherwise.
But most schools, particularly the smallest of the small, only have the ability to staff a trainer, specifically to take some of the pressure off the head coaches.
Brent West, head coach at Cisco, said he's particularly happy to have someone else make the tough injury decisions for him.
"I've been real lucky on this," West said. "Ever since I started as a head coach, I've had a trainer who took care of all of that for me. In this day, we need (someone) who's a trained professional to tell the coach, 'This kid probably has a concussion.' I think that's vital for any program because I'm under other pressures, like trying to win the game.
"It's real tempting sometimes to put the player back in, so it's nice to have that professional next to you to make that call."
Like Faith in Albany, West, too, has a bit of a historical view on how the sport has changed under the concussion blanket. His father, Grady West, coached the De Leon squad as far back as the 1970s.
But the younger West said his father had a different approach to football at that time, which may have saved his athletes from hundreds of unwanted concussive and non-concussive blows.
"My dad did a pretty good job, looking back," West said. "There was very little contact in practice, which I feel helps a ton. I know everyone else at that time was out there butting heads five days a week."
Cisco's bitter rival, Eastland, coached by James Morton, also relies on a trainer to help make decisions.
Morton, who used to coach large school Midland Lee before taking the job at Eastland, said the UIL's decision to take a lot of the guesswork out of the coach's hands has helped protect the athletes.
"It's a clear-cut thing now," Morton said. "It's not up to the coaches.
"The safety of the players is our No. 1 concern as the coach. It's definitely important. Concussions have changed the game for us as coaches. There's more awareness."
Wouldn't change it
With more awareness, there's also the attention the problem is getting on the national and international level. Because it's making billions as a sport, there are a lot of eyes looking at the game, Cisco's West said.
But the truth, he said, is that concussions are a part of everything people do. Risks are taken.
Faith, in Albany, said he's seen the impact football has on students. He said the game isn't going anywhere as long as it gives players something to hang on to.
"I think the game does so much for young men," Faith said. "My hope is that we keep working on trying to be safe and doing things that can make our game safer, but I hope (football's) not downgraded so much that it takes the benefits a young man can learn because I think so many things the game teaches, like teamwork, dedication, desire and work ethic, are important. All those things are beneficial and can be taught through the game of football.
"I can see the other affects that it has on kids, too. Like having their self-esteem raised through success on the football field. I've seen cases where a kid wouldn't have gone to school or stayed in school without football to fall back on. We see those things all of the time, which to me personally outweigh the chance of debilitating injury."
"I've always been very careful with my kids, but with the new protocols, it's a lot more strict, which is good."
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