Tag Archives: soccer

Return to Play is Important But Return to Learn is Vital

With a rise in awareness in the world of sports regarding the strikingly prevalent danger of brain injury and its deleterious effects, there has been a corresponding increase in the development of various concussion protocols for returning to active participation in sports following an injury.  These protocols are now the norm in the major sports leagues such as the NFL, NHL, MLB and NBA.  These “Return to Play” protocols are important for ensuring that athletes do not suffer a second concussion that can compound the damage of a not yet fully healed first one, causing an even more serious injury.  Schools around the country are following suit, pushing for more training on concussions.  In many school districts, concussion training for school athletic trainers and/or coaches is mandatory.  There is also a considerable amount of discussion in the media about return to play policies at the school-age level.  Just as professional athletes do, student athletes need to avoid the effects of compounding brain injuries.  However, there is a subject that seems to be garnering less public conversation but is even more important than when a student may be “ready to play”.  There is far too little discussion about an immensely more important topic, namely when a student is “ready to learn”.

School-age youth universally have one primary “job” in their lives, and that is to perform at their best in school classes.  Though sports are enjoyable and often quite meaningful to students, only a tiny few will go on to earn a sports scholarship to college and just a small fraction of those will ever play professional sports.  And even of this small fraction, only a handful will play more than a few years in professional sports.  Sports are not likely to be any particular student’s full time future job.  However, almost every single student’s future is tied in some way to his or her ability to learn information in a school setting. Most every job, and adult life in general, will require extensive dependence upon skills learned in the classroom such as writing and math.

School is similar to an adult’s full-time job as it encompasses the majority of daytime activities and requires a significant expenditure of cognitive energies on a daily basis to ensure performance at optimal levels.  Pushing a child back to school too quickly post-injury can engender an inability to learn effectively which can lead to a downward spiral of emotional distress and academic failure.  Schools need to work with parents and health professionals in order to create a plan for return to school after a brain injury, whether that injury be suffered on the playing field, in a car accident or by any other means.  Not every child will be able to return quickly or to a full load of classes.  Adjustments may be necessary to the schedule, format or setting of classes and school material.  The child may require special assistance from aids, tutors and note-takers.  The child may also benefit from breaks in the day to when he or she has crossed a threshold of cognitive overload.  If injuries are particularly serious and long-lasting, a Section 504 plan may be necessary.  The Brain Injury Association of Vermont has a sample return to learn protocol that can help guide parents, educators and health professionals as to when a child would likely be ready to healthily engage in different school tasks.

 

http://biavt.org/concussion-kit-documents/Section%207%20-%20RTL%20Protocol-pub%20final_5-9-13.pdf

http://biavt.org/concussion-kit-documents/Section%207%20-%20RTL%20Protocol-pub%20final_5-9-13.pdf

A healthy return to play protocol following a brain injury is important, but we need to remember that a child ultimately does not need to play a sport.  However, every child most assuredly does need to learn in school. So let’s increase the discussion on “ready to learn” plans and needs!

Learn about brain injury treatment services at the Transitional Learning Center: http://tlcrehab.org/

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English Premier League Concussion Protocol

The English Premier League, one of the top leagues in professional soccer, recently enacted new protocols designed to help manage the effects of concussions suffered by its players.  Under the new rules, all players will be given baseline neuropsychological testing for later comparison prior to each season, in much the same way that the NFL, the NHL and NASCAR already do.  Any player who has received a concussion  (or is even sufficiently suspected of having received a concussion) will be automatically removed from the remainder of a given game.  The decision whether or not the player has received a concussion will be solely up to the team doctor, rather than allowing coaches or players themselves to make that all too crucial call.
These new rules follow on the heels of the World Cup, at which Alvaro Pereira of Uruguay and Christoph Kramer of Germany both continued to play after receiving concussions.  Former United States National Team member and current television analyst Taylor Twellman brings up the concern that a neutral doctor would be a better choice to make these evaluations than a team doctor, as the team doctor may feel pressure from the organization under which he’s employed to allow a star player to return.  Though his point is valid, this nonetheless still doubtlessly represents a much-needed step in the right direction as concerns the health and well-being of professional soccer players.  Moreover, as the English Premier League tends to be a trendsetter for other leagues, this likely bodes well for the further implementation of concussion protocols in leagues around the world.  After all, a concussion is just another word for brain injury and the better that these injured players are cared for, the less likely it is that their injuries will lead to permanent brain damage.

http://www.nytimes.com/2014/08/07/sports/soccer/premier-league-concussion-protocol-could-force-injured-players-from-games.html?_r=0

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

World Cup Error

As the top athletes in soccer gather to play in the World Cup, we’ve seen both good decisions and poor decisions made in relation to brain injury and its effects.  Let’s start with a remarkably poor decision.  During the Uruguay-England match, Uruguayan midfielder Alvaro Pereira was knocked unconscious after accidentally being hit in the head by the knee of an English player.  Once Pereira regained consciousness, he argued with the doctor against being substituted out and was allowed to finish the game.  This is problematic on a number of levels.  First, a player should never be allowed to overrule a doctor regarding medical issues.  Players are not medical  experts, they are experts at playing the game.  Moreover, with adrenaline flowing the athlete is unlikely to give sufficient consideration to potential health risks.  Second, a player with a concussion should always undergo testing in order to properly evaluate the seriousness of the injury.  Since the brain is inside the skull, it is difficult to assess the level of severity of such an injury or determine if swelling of the brain is beginning to occur.  Third, this is a terrible example to provide for young players as to the care one should afford oneself after receiving an injury.
In contrast, Netherlands player Bruno Martins Indi’s Word Cup concussion was handled very differently.  Martins Indi suffered a concussion while playing Australia.  He was immediately taken off the field and sent to the hospital for testing.  He was allowed the entirety of the next week to slowly recover and his coach even insisted that he miss his team’s next game against Chile.  Both Martins Indi and Pereira are world-class players who play in top European leagues yet the quality of treatment each received was light years apart.
In reaction to Pereira’s injury, the international soccer player’s union FIFPro wants to have all players suspected of having a concussion be temporarily substituted out in order to have an evaluation.  Perhaps a better idea would be to follow a protocol similar to that which is followed by Major League Soccer (MLS) here in the United States.  League protocols include:
“Any player suspected of having sustained a concussion shall be removed from play immediately and evaluated by team medical staff. If the initial evaluation results in a concussion diagnosis, he will not be returned to play in the same game or practice…Every MLS club has a designated Team Consulting Neuropsychologist, one of whom will conduct the post-concussion neuropsychological evaluation when an injured player is symptom-free at rest, prior to his return to play. Any player diagnosed with a concussion will be free of somatic and cognitive symptoms for at least 24 hours before starting an individualized, graded return-to-play progression under the supervision of the team physician.”
Moreover, MLS mandates that players have baseline neuropsycological testing performed so as to have those results on hand for later comparison with post-injury results.  The MLS protocol is very similar to protocols used by the NBA to evaluate basketball players suspected of having suffered a concussion.
Competing in the World Cup is an exciting opportunity, but nothing justifies any level of disregard for player safety.  Any game is, after all, ultimately just a temporary set of circumstances.   A poorly managed injury however, can leave its mark for a lifetime.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org