Ringing the bell | SteamboatToday.com

Ringing the bell

Steamboat Springs embraces national concussion awareness trend

— A few years ago, Steamboat Springs High School football coach Lonn Clementson was faced with a choice.

He could continue to follow the norms established by coaches who came before him or embrace the changes that were coming to the game he had played in middle school, high school and at Colorado College in Colorado Springs.

By looking to the future, Clementson is hoping to help his players escape injuries that can last well beyond their high school careers — especially head injuries, which, if overlooked, can have dire consequence.

"The brain is a delicate and important thing," Clementson said. "We want our kids to attend their high school graduation, we want them to go on to college and live a healthy and happy life long after they stop playing football."

That's why the Steamboat Springs High School football program, with fundraising support from the Steamboat Springs Booster Club, invested nearly $30,000 into new equipment prior to the 2011-12 season, including three different types of helmets, new and improved chin straps and state-of-the-art mouth guards.

Sailors football also adopted a new, more proactive approach to concussions. The program elected to limit contact outside of games, and instead of hitting, players worked on skills that helped them get into better position to make the tackle and use better technique in an effort to avoid injury.

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The team also has been aggressive at recognizing when an athlete has taken a big blow on the field. Coaches and medical personnel are quick to pull those players from a game or practice and evaluate them to avoid a condition called second-impact syndrome, or SIS, in which the brain swells rapidly after a person suffers a second concussion before symptoms from an earlier one have subsided.

That's one of the reasons it is so important for athletes to fully recover from a brain injury before returning to the field or court. The second concussion may occur minutes, days or weeks after an initial blow, and even the mildest grade of concussion can lead to SIS.

The condition can be fatal, or it can leave an athlete severely disabled.

The Steamboat Springs football program has become a leader in addressing concussions, and its program was featured on the NFL network after team concussions were reduced from 13 during the 2011-12 season to five in 2012-13. The numbers increased to 10 in the 2013-14 season and nine the following year, but Clementson and the school think the program has been effective.

"If we can avoid just one concussion, it's worth it," Steamboat Springs High School athletic director Luke DeWolfe said. "Our program is very progressive, and it's at the forefront of what's going on across the country now. Our goal is to limit the number of concussions, but we also want a constant approach to how to handle them when they happen and to make sure that our student-

athletes' health and safety is always the most important thing."

DeWolfe said eliminating concussions in an active community such as Steamboat would be nearly impossible, and he added that most concussions reported at the high school level are suffered off the field or court.

During the 2014-15 school year, the high school reported 32 concussions that took place outside of school, and that number is consistently higher than what he sees in high school sports.

He said students can suffer a concussion riding their bikes, goofing around on a skateboard or jumping on a trampoline. Every year, more than a few student athletes stop by the office to let the school nurse know they hit their head skiing and are recovering from the symptoms of a concussion.

The school district requires athletes playing football, lacrosse, soccer, hockey, cheerleading, wrestling and basketball to have an impact test on file before they play in a game or practice. The test also is recommended for baseball and volleyball. The only athletes not required to take an impact test are those involved with tennis, golf, track and field and cross country.

The impact test establishes an athlete's cognitive baseline, which is used to help medical professionals diagnose and treat concussions and recommend when a player is able to come back after suffering a concussion.

Dr. Brian Harrington, who has helped raise concussion awareness in Steamboat, said doctors can diagnose and treat concussions without an impact test, but it provides a starting point.

"The pendulum has definitely swung back the other way." Harrington said. "A few years ago, when young athletes took a hard hit or just hit their head, we said they got their 'bell rung.' At the time, we would say to shake it off. But these days, we have a better understanding of what is going on and how serious concussions are. Of course, we err on the side of caution sometimes, but it's better to be safe than sorry."

The topic of concussions also is a common theme of discussion among parents on the sidelines of nearly any youth football, soccer, hockey, baseball or lacrosse game. According to Harrington, this elevated level of awareness is good for local youth sports programs, and he advises parents to educate themselves, take steps to protect their children and understand the impacts of concussions before they have to deal with one. Harrington said there is always a risk of injury in any sport, and the benefits of playing the game far outweigh the risks.

"I think we have to change the culture," Harrington said. "I think it has changed, and I think it has changed for the better."

Re-evaluating youth programs

This year, the city of Steamboat Springs Parks and Community Services Department will decide whether to continue to offer tackle football for fifth- and sixth-grade students or transition to a format with less physical contact.

The city currently offers flag football to third- and fourth-grade students and a tackle program for older fifth- and sixth-grade students.

Sports coordinator David Stevenson said a number of issues, including concussions, have led to a discussion that might bring changes to the program, which involves between 100 to 120 youth players each year.

"We will probably make an official decision sometime in May," Stevenson said last week.

And though concussions are not that common — there were two reported last season — Stevenson said it's something the league is always examining and working to eliminate.

He thinks going to a flag football format or a kind of hybrid would help, but he also understands the physical nature of the game. He added the leagues would be looking at making changes, even if there had not been any reported concussions last year.

"We are facing a number of issues because of the size of the program in Steamboat Springs," Stevenson said.

He explained that youth football leagues are normally based on weight as opposed to age in larger towns. This allows kids of similar size to compete against one another and reduces the risk of injury.

But the size of the program in Steamboat makes organizing it by weight nearly impossible. Instead, leagues here are based on age.

"Sometimes, you have a kid who might weigh 70 pounds trying to tackle a kid who weighs 140 pounds," Stevenson said.

To reduce the risk of injury, heavier players are only allowed to play line positions, which limits those players' enjoyment of the program. Stevenson said if the city switched to a flag football program or some other format, the heavier kids would be able to play any position, and the game, in his opinion, would be more fun for all players involved.

Stevenson said parents have been passionate on both sides of the issue.

A personal perspective

As president of the Yampa Valley Baseball Association, Jim Hansen is well versed on the topic of concussions, but the issue became personal a few years ago when his son suffered a concussion sliding into second base.

"We don't have that many concussions in baseball, but the coaches are trained and very aware of the symptoms," Hansen said. "I'm not sure that there are more concussions in the game today, but at times, it really seems like there are."

His son took an impact test, but Hansen didn't need the test to know his son was hurt. He was sensitive to light and noise, he had a twitch in one of his eyes and he wasn't nearly as quick on his feet, Hansen said.

"He didn't play baseball and had limited physical activity, but it still took several weeks before he got back to normal," Hansen said.

As the person in charge of ensuring association standards are followed, Hansen has taken training sessions online and has addressed the topic of concussions in meetings, with parents, coaches and umpires.

He applauds the efforts of state, regional and national organizations that have adapted rules and guidelines to make the game safer, however, he hopes those guidelines don't become too prohibitive in the future.

"We want to be aware and protective," Hansen said. "But we can't wrap our kids up in bubble wrap."

Enacting strict concussion protocol

The Steamboat Springs Winter Sports Club began following strict concussion protocol long before the state of Colorado mandated it several years ago.

"I think the most important thing is awareness," said David Zink, Winter Sports Club director of strength and conditioning. "We want our athletes and their parents to be OK with coming forward and letting us know that they may be having an issue with a concussion."

Zink said it is common to have at least two athletes going through the return-to-sport protocol at any one time.

Zink said the club is proactive at identifying concussion symptoms, both in competition and in training. He recommends his coaches use a mobile app called PAR for concussion recognition and response.

PAR runs coaches through a checklist when evaluating an athlete and actually records that athlete's responses, and circumstances, at the time of the incident. Zink said it's a great reminder for coaches, and the information can be used by medical personnel when diagnosing an athlete's conditions.

Zink said protecting the athlete is paramount, and one of the biggest challenges is making parents and athletes aware of concussions that happen away from Winter Sports Club programs.

No soft spots for hockey

Concussions and concussion protocol are constantly discussed when it comes to the physical, hard-

hitting sport of hockey.

"You have the ice, the boards and the equipment," said Cory Allen, director of hockey for the Steamboat Springs Youth Hockey Association. "There is nothing soft in the game of hockey."

With that in mind, the association follows similar protocols to other youth sports in Steamboat Springs, including coach and referee training, player evaluation and return-to-play policies. Last year, Allen said the SSYHA saw two major concussions, and one of those involved a girl in a game where checking is not permitted.

"No checking doesn't mean that there is no body contact," Allen said. "A check is a tool used by hockey players to separate the puck from another player."

Allen said checking is not allowed for players younger than 13.

"It's not always a hit that results in a concussion," Allen said. "A coach could be on the ice and have a player slide into the back of his legs. The coach falls and hits his head on the ice and gets a concussion."

Allen said the association requires coaches and players to wear protective equipment, sets a minimum age to allow hitting and works with players to teach them the proper ways to hit, be hit safely or avoid the hit all together. If a player is hit, coaches have been trained to look for, and recognize, the symptoms of a concussion.

"Hockey is a contact sport, not a collision sport," Allen said. "Football is a collision sport."

Allen said many concussions can be avoided by teaching players how to skate and to keep their heads up and be aware of their surroundings.

"Hockey players need to know where they are on the ice at all times," Allen said. "They need to know where they are in relation to the puck, they need to know where they are in relation to the boards and where they are in relation to the next player."

Because hitting is part of the game, and chances are high a player will end up hitting the ice at some point, the association has established guidelines for what to do if a player suffers a concussion.

"All of our players are required to take a baseline test before they train, practice or play in a game," Allen said. "Our coaches also go through an online training program before the season starts that teaches them what to look for and when it's time to pull a player off the ice.

"If a kid says he got his bell rung, we will pull him off the ice," Allen added.

New rules for youth soccer

Parents watching their children play soccer this fall may not notice the new rules handed down from the United States Youth Soccer Association, but local organizers said the changes should help limit young players' exposure to concussions.

"Concussions have been a hot topic for quite some time in youth soccer," Nate Shotts, CEO of Colorado Soccer said. "Every coaching conference at the state, regional and national level have been addressing concussions for a long time, and it's not just soccer. Concussions are every sport's number-one focus."

The Colorado Youth Soccer Association adopted new rules for heading the ball this year. Heading will not be allowed for players younger than 10. Players age 10 to 12 will be allowed to head in games but not in practice. Players 13 and older will be allowed to head the ball in practices and in games.

Steamboat Springs Youth Soccer Association director Rob Bohlmann said the new rules have the potential to reduce the number of reported concussions, but he points out the local soccer organization already follows stringent guidelines when it comes to identifying and dealing with concussions.

Youth soccer coaches in Steamboat and across the state must complete online training regarding concussions at the start of each season. Players who show signs that they may have suffered a concussion are pulled from games and not allowed to return before being cleared by a medical professional.

Bohlmann said coaches work with players on the proper way to head balls to limit injuries and are always observing players in game and practice situations to take appropriate action if they think there is a possible concussion.

"We take concussions very seriously," Bohlmann said. "We follow the protocols that have been handed down by the national and state associations, and player safety is always more important than winning."