What Happened Within This Player’s Skull

An article in the New York Times by Sam Borden, Mika Grondahl and Joe Ward describes in video what happened to the brain of a football player during and after a stunning hit.

When player No. 81 took this blow to his head several years ago, it was just one of many concussions that have occurred throughout college football and the N.F.L. But what made this one different was that this player was wearing a mouth guard with motion sensors.

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An Examination of Concussions | Zip06.com

An Examination of Concussions
By Brett Selmont, Assistant Sports Editor • Contact Reporter
Published August 25, 2016. Last updated 05:44 p.m., August 25, 2016

Playing sports is supposed to be fun for athletes. It’s an activity that often builds character, teaches one how to work with others, and yields friendships. Unfortunately, the downside of giving it your all on the field are the injuries that inevitably occur and one of the most-dangerous injuries any athlete can suffer is a concussion. In 2012, former National League Football (NFL) player Junior Seau and former Major League Baseball (MLB) player Ryan Freel committed suicide and tests later revealed that both athletes’ brains showed signs of chronic traumatic encephalopathy, a degenerative neurological condition associated with multiple concussions that can only be conclusively diagnosed postmortem. In soccer, two-time United States Olympic gold medalist Cindy Parlow Cone announced her retirement from international play in 2006, citing post-concussion syndrome. Concussions are a huge concern in sports these days and, in this story, we look at the negative affects they can have on athletes, along with what local coaches and doctors are doing to diagnose symptoms faster in order to protect athletes.
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Suffering a Concussion

Ten years ago, Middletown’s Joey Witkowski was an All-State baseball player at Xavier High School. Witkowski then competed at St. John’s University, after which he played professionally in the minor leagues with the Houston Astros and Washington Nationals organizations. However, Witkowski saw his rise through the ranks derailed by multiple concussions that ended his career at age 25. It all started when Witkowski was hit in the back of the head with a pitch during his senior year at St. John’s.

“After I got hit, I was blinking and had a ringing in my ears, but I stayed in and caught the next inning before coming out. The next day, I got hit in the head again and played the whole game. It was the Big East-Big Ten Challenge and there were a lot of scouts there and I was doing really well, so I wanted to keep playing,” Witkowski said. “Catching is a tough position and you take a beating all year and, at the end of the season, I wasn’t feeling quite right.”

Witkowski signed with the Astros and played in the minors, where he suffered his second concussion when he was behind the plate and a bat struck him on the follow through. The next season, Witkowski took a foul ball off his catcher’s mask.

“My ears just exploded and I remember seeing my manager Stubby Clapp’s face and he looked concerned, but I shook it off,” said Witkowski. “There’s an old saying in pro sports that ‘You can’t make the club from the tub,’ so I just kept grinding.”

When Witkowski and his team returned home from that road trip, he went to a 7-11. When he got out of his car, Witkowski left it in drive and the car rolled into the store’s brick wall. Witkowski immediately drove to his team’s training facility and spent the next month “hanging out” as he wasn’t cleared for baseball activity. Witkowski felt his dream of becoming a Major League Baseball player slipping through his grasp. One of the hardest parts was dealing with the isolation of “the darkroom.”

“I would spend hours in a room, alone, with the lights off as treatment. It was very depressing. I was sitting in this room for hours and, when I wasn’t in the darkroom, I was away from the other players and thousands of miles away from my family and friends in Connecticut,” he said. “The other really hard part to comprehend as a player was that I felt fine physically.”

The Astros eventually released Witkowski. The Nationals signed him and, even though Witkowski was routinely hitting 95 miles per hour on the radar gun, they voided his contract after receiving the Astros’ medical report.

“I got the tap on the shoulder to go see the suits, which is never a good thing. Doug Phillips, the Nationals’ Farm System Director, [called me into his office] and about 10 other guys [were there]. He said because of my medical history they just couldn’t take the chance of me getting another concussion. I could take a comebacker on the mound or get hit covering first and that could cause serious damage to me. They were all really broken up about it, as I was, too, of course,” said Witkowski. “In the end, I feel grateful to the Nationals because they were more interested in preserving my quality of life than baseball. Who knows what another blow to the head could’ve done?”

Prevention, Testing, and Treatment

One of the problems with concussions is identifying the signs and how to treat the symptoms. That’s where sports clinics like HeadZone Concussion Care in Shelton come into play. Medical Director Dr. Karen Laugel spends countless hours caring for people who’ve suffered head trauma.

“There are three main steps to diagnosing a concussion and those are testing the athlete’s eyes, cognition, and balance. We work with schools and teams before the season to do baseline testing, which can help to gauge the severity of the case. For example, one screening test involves recording the player’s speed and accuracy, while reading a sequence of numbers after the athlete is injured. The coach or trainer or parent can use the initial test to see how the subject fares in the reexamination and determine whether they can continue to play or not,” Dr. Laugel said. “One of the main problems is that most concussions do not occur from a blow to the head because many are caused by whiplash. If the player doesn’t get hit in a head-on collision or take a direct blow to the head, they don’t think they’ve suffered a concussion and won’t report the symptoms to their coaches.”

Some sports have changed rules to try and decrease head injuries. In the NFL, players are no longer allowed to initiate forcible contact by delivering a blow with the top of the helmet against an opponent when both players are clearly outside the tackle box, plus penalties are also issued for hits made on defenseless players. MLB recently instituted rule changes to eliminate egregious home plate collisions. Other ways to help avoid head injuries are to strengthen certain areas of the body and make sure that you’re equipped with the proper gear when you take the field.

“One of the ways to prevent concussions is by building strength in the neck. A study by [Christy L. Collins from the Center for Injury Research and Policy at the Columbus Children’s Research Institute in Ohio] showed that for every pound of increase in neck strength, the chances for a concussion went down by five percent. Also, it is important to check your equipment to make sure it is not old, that helmets fit correctly, and that the bladder inside the helmet is pumped up. Helmets won’t necessarily prevent a concussion, but they will help limit the severity,” Laugel added. “In soccer, we encourage players to avoid heading the ball, to use their chest and knees rather than their head, especially the younger players whose brains aren’t fully developed yet. We would also like to see all girls’ lacrosse players and field hockey players wear helmets to help reduce injury. One of the sites we steer coaches and players to is www.cdc.gov, which is the Centers for Disease Control. They have a Head’s Up program that has videos and charts for free education for coaches, players, and parents to help identify and care for individuals who may be concussed.”

Mike Marone has been coaching football for more than 30 years and is currently the head coach at Old Saybrook-Westbrook High School. Prior to every season, Marone educates his players so they know what to do in every situation and he’s pleased with how the process of preventing and diagnosing concussions has progressed since his playing days.

“We have a meeting at the beginning of the year where everyone is informed about concussions and, once we get on the field, we are regulated by the [Connecticut Interscholastic Athletic Committee] rules of contact, so we only have 90 minutes of contact a week, unlike the old days. We are very careful with hitting drills, make sure we match up the same-size kids, and we have a freshman rule—two words: no contact,” Marone said. “We work on tackling every single day. We do 20 minutes of tackling circuits where we teach proper form and no longer use the head and do a shoulder tackle and everything we do is to avoid concussions. In my playing days, they gave me the smelling salts after you got knocked out and you got 15 minutes to get back in. Now, if a kid has a headache, [they go] right to the trainer and he’s on a five-day concussion protocol to return to practice and there is no fooling around. We don’t even bat an eye.”

North Haven boys’ soccer coach Federico Fiondella also has concerns about concussions and makes sure his players and fellow coaches know how to recognize the symptoms.

“All incoming freshmen automatically take a test that gets scored and the trainers and coaches can use the results to check on them in case of an injury to the head. Also, the [athletic director] has a meeting for parents and students, like an open house, where concussions are discussed,” Fiondella said. “As coaches, we are trained and we take a refresher course to make sure we are on top of things. In my case, if a player shows any signs, they are taken off the field—no ifs, ands, or buts. I won’t risk it at all because sometimes the symptoms—headache, dizziness, nausea, light sensitivity, loss of appetite—don’t show up until 24 to 48 hours later. Concussions are very peculiar situations, so we always err on the side of caution. You don’t risk hurting the kids to win. It doesn’t matter and it’s not even close.”

Valley Regional Athletic Director Jeff Swan agrees that knowledge is the key to ensuring player safety and feels that it’s crucial for everyone involved to learn as much as they can about how to deal with potential concussions.

“The major thing is education. All our coaches are certified in concussion protocol. They all know the signs and what to do in those circumstances. The CIAC is really doing a great job on the subject and pushing for people to be aware,” said Swan. “We spend lots of time training, taking tests, and every coach has to do 45 hours of classes and one of those is Module 15, which focuses on concussion management. In football, they have to take Module 51, as well, and, in swimming, they take Module 50, which has more details regarding those sports. We also have an ambulance at every football game and trainers and other people who can help. The state and Department of Education has been very proactive, and educating players, coaches, and parents is really the key to doing the right thing in those situations.”

Beginning in 2015, it became mandatory for all high school football coaches in the state to take the refresher course Module 51 after completing the concussion management course Module 15. The class must be repeated every five years, so that they understand the best practices for coaching the sport. There’s also Module 50, which is taken by swimming coaches because of the unique nature of the sport. Tim King, the head football coach at Valley Regional-Old Lyme, emphasizes the importance of such testing.

“Module 51 is a review of what concussions signs are and the effect they have on kids and what we should be looking for. We are not doctors, though, and I always fall back on our athletic trainers, who are worth their weight in gold,” King said. “It is vital for us all to know what to look for and how to handle situations with something as delicate and dangerous as concussions.”

In the end, sports remain an enjoyable pastime and that’s not going to change anytime soon. The thrill of winning a game under the lights on a Friday night or hoisting a state championship trophy is what every player dreams of, but whether they win or lose pales in comparison to whether or not they’re healthy. Protecting them from the effects of concussions by knowing the symptoms and how to treat them is critical for that to happen.

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Sign up for FREE Concussion Training for Teams, Coaches, and Parents

We provide FREE concussion education for coaches, parents, and teams, including free baseline King-Devick Tests for ages 5 and up.
We offer FREE Safety Parent & Safety Coach training that includes information about:
  • Sports  Safety Basics
  • Concussion
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 Contact Vicky Graham for more information: graham@head-zone.com or call 203-538-5400.
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U.S. Soccer: Ban headers for players 10 and under

The U.S. Soccer Federation is recommending a ban on headers for players 10 and under, limits for players between 11 and 13 and having medical professionals rather than coaches make decisions on whether players suspected of concussions can remain in games.

As part of an announcement that a lawsuit over concussions filed last year had been settled, the USSF said Monday it is implementing the changes for U.S. youth national teams and its development academy, which are controlled by the governing body. The USSF is strongly urging they be adopted by all of its members, which includes youth local level entities and American professional leagues not under direct authority of the defendants in the lawsuit.

Under the new rules, a Health Care Professional (HCP) must be present at all development academy matches and will make all decisions regarding head injuries, taking decisions away from coaches. The replacement for a player who leaves a game for a suspected concussion or head injury will not count against a team’s total for allowed substitutions. If the injured player is cleared to return by the HCP, he or she must replace the original substitute.

A group of youth players and parents sued in August 2014 in U.S. District Court in San Francisco, naming FIFA and the USSF as defendants along with the U.S. Youth Soccer Association, American Youth Soccer Organization, US Club Soccer and the California Youth Soccer Association.

U.S. District Judge Phyllis J. Hamilton dismissed the case against FIFA in July, and the USSF and lawyers for the plaintiffs announced a settlement Monday, when the rest of the suit was dismissed.

The USSF said within 30 days it will announce an initiative to improve concussion awareness, return-to-play protocols and substitution rules. The USSF said it had been developing a player safety campaign before the lawsuit.

“With the development of the youth concussion initiative by U.S. Soccer and its youth members, we feel we have accomplished our primary goal and, therefore, do not see any need to continue the pursuit of the litigation,” Steve Berman, a lawyer for the plaintiffs, said in a statement.

The USSF said it reached out to the medical community to develop the protocols.

“In constructing the concussion component, U.S. Soccer sought input from its medical science committee, which includes experts in the field of concussion diagnosis and management, as well as from its technical advisers, and worked with its youth members to develop a true consensus-based program,” Secretary General Dan Flynn said.

“While there is always more that can be done to keep our youths safe, I am confident that this agreement will help reduce the risk of concussion on the soccer field and provide the necessary tools to properly address a situation in which a head injury occurs,” Kira Aka Seidel, a parent who was one of the plaintiffs, said in a statement.

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An Athlete Felled by Concussions, Despite Playing a ‘Safer’ Sport

CLARKSVILLE, Tenn. — Months later, the father mustered the strength to sort through what was left in his dead son’s bedroom. A Little League photo collage. Mardi Gras beads from that soccer tournament in New Orleans. And a typewritten personal essay tucked into a yellow folder, with a single word pen-carved into its plastic cover:

“Concussions.”

His son Curtis had written the paper for a college composition class in 2009, five years before his death. In it, Curtis recalled having been knocked unconscious three times in 14 years while playing soccer, twice after leaping to head the ball, only to — “WHAM” — collide with another player. The continuing side effects, he wrote, included “horrendous migraine headaches.”

“If I feel this way now,” he wondered, “what will it be like when I’m older?” He was 19.

Former Soccer Player Sues Illinois, Saying Concussion Was MishandledJUNE 8, 2015
The German player Christoph Kramer was helped off the field after suffering a blow to the head during the World Cup 2014 final against Argentina in Rio de Janeiro in July.Global Soccer: Concussions Can’t Be Ignored by Soccer Any MoreSEPT. 9, 2014
Looking at Soccer’s Concussion Risk, and Asking It to ChangeOCT. 23, 2014
Reading those words, his father, Bill Baushke, felt the floor drop beneath him. This meant that Curtis knew. He knew well before most of us that repeated concussions could also lead soccer players — and not just those who box or play football — down the dark spiral of cognitive damage and decline.

Curtis Baushke, pictured in his Clarksville High School soccer uniform in 2009, was knocked unconscious three times in 14 years while playing soccer.
Well before the death in 2012 of the semiprofessional soccer player Patrick Grange, 29, who was posthumously found to have chronic traumatic encephalopathy, the degenerative brain disease linked to concussions. Before the 2014 death of Hilderaldo Bellini, 83, the retired Brazilian soccer star, also found to have C.T.E. Before the specter of C.T.E. began to loom over every contact sport.

Curtis Baushke, racked by migraines and struggling with focus, was still focused enough to know. “Allowing kids to play too soon after a concussion could be very dangerous,” he wrote. “We need to find out the actual damage concussions cause people.”

When Curtis was not quite 5, a neighborhood boy bragged that his father was signing him up for soccer. Curtis then wanted to play soccer, too, but his parents were football and baseball people. “You go ahead and play soccer,” Bill Baushke recalled saying. “But next year you’re going to play baseball.”

Although Curtis excelled at both games, he eventually chose to concentrate on soccer, partly because he had been hit by pitches several times, once to the head. “He wanted to play a safe sport like soccer,” his father said.

With Curtis’s older brother, Ryan, playing as well, the Baushkes became a soccer family, their free time revolving around practices and games, field conditions and out-of-town tournaments. Life was lived on the mosquito-rich lawns down by the Cumberland River, under the lights at the sprawling Heritage Park and in the stands at the athletic field behind Clarksville High School.

Curtis played as a freshman on the varsity team, as well as for a premier club that served as a feeder system to colleges. “You’d start him maybe on defense,” Dave Donahue, one of his high school coaches, said. “But if you needed some punch, you’d put him in midfield, and then if you were a goal behind, you’d put him up front.”

“He was full speed, and just a terrific athlete,” said Donahue, who coached hundreds of players in his 26 years at Clarksville High. “He stands out, even to this day.”

Bill Baushke, 57, recalled how gifted his son had been at winning balls in the air with headers, at setting up teammates with pinpoint-perfect passes, at sending corner kicks curving toward the goal. But he also remembered the many times when Curtis “had his bell rung, sat out a couple of plays, and was told to go back in” — as well as that upsetting day when a disturbed classmate hit him in the head with a bowling ball, knocking him out.

Curtis began exhibiting behavior now recognized as suggestive of postconcussive trauma. Dramatic mood swings. Depression. Headaches so debilitating he would need to lie down in a dark room.

After high school, Curtis took a few classes at Hopkinsville Community College, where he wrote his personal essay about concussions. He moved to Chattanooga, Tenn., to live with his brother and took more college courses in hopes of becoming a sportswriter.

But Curtis, who was also found to have bipolar disorder, continued to struggle. He lost his job writing a blog about college draft picks. He injured himself while competing in a new passion — disc golf — and became addicted to prescription medicine. He moved back to the family house in the country, with that large front lawn where he and his buddies used to kick around a soccer ball. He stole, and used drugs, and lied. Maybe not lied; maybe he forgot.

Looking back, Bill and Patti Baushke might have dismissed their son’s self-diagnosis of C.T.E. as a convenient excuse for his problems. Credit Joe Buglewicz for The New York Times
“He wouldn’t remember doing things,” his father said. “He would sit there and deny it, but in his mind, he was telling the truth.”

Because of those severe migraines, his parents took him to a series of specialists, to no avail. They even had his brain scanned for tumors. Nothing. But it had to be something, Curtis insisted. He began to maintain that he had C.T.E.

Looking back, the Baushkes might have dismissed his belief as a convenient self-diagnosis by Internet. All they knew was that their sweet younger boy — who loved his grandmother, loved practical jokes, loved duck hunting — was failing to find his footing. More than once he made arrangements to move out, only to pull back at the last moment.

“I just don’t think that he felt he could do it,” his mother, Patti Baushke, 55, said as she sat before family photographs splayed across the dining room table.

A year ago last week, Bill and Curtis Baushke made plans to watch the United States play Germany in the World Cup. The elder Baushke left his job in Nashville early, only to come upon his son snoring loudly on his bed. He went to his own bedroom, changed his clothes and turned on the television in the living room, where wooden duck decoys adorned the shelves.

The game began, and the father called for his son. Called again, then went to rouse him. But Curtis had stopped breathing, and neither his father nor emergency medical technicians could revive him. Accidental overdose of prescription drugs.

His parents did what they knew Curtis would have wanted.

A few months later, the Baushkes participated in a conference call with researchers who had examined Curtis’s brain at Boston University’s CTE Center, which works with the Sports Legacy Institute, a nonprofit organization dedicated to brain trauma research and prevention.

Their determination: Curtis had Stage 2 C.T.E., meaning there was clear evidence of deterioration in the brain — surprising, given his young age.

“I cried and cried,” his mother recalled. “He was so right. Curtis wasn’t just making it up and talking crazy. He thought he had it, and he did.”

With that, the silence of unspoken what-ifs filled a house in the country, where the photographs on the dining room table depicted a gifted and airborne young athlete, meeting yet another soccer ball head-on.

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Pediatrician calls for more attention to childhood concussions

By Judy Benson

New London — While much of the focus on sports-related concussions has been on professional athletes, Dr. Karen Laugel, a Shelton pediatrician who helped found The Concussion Corps to educate parents, schools and medical providers, believes more attention needs to be paid to the issue of head injuries in youth.
“A half a million kids under the age of 14 are getting TBIs (traumatic brain injuries) and going to the emergency departments (annually),” she said. Of those, she said, 75 percent had concussions.
Laugel spoke to about 40 school nurses, registered nurses, doctors and others during a program at Lawrence + Memorial Hospital Thursday co-sponsored by L+M and The Child & Family Agency of Southeastern Connecticut.
Dr. Fred Santoro, chairman of the L+M Pediatrics Department, said the program also was offered to emergency room staff and others at the hospital, “so that we’re all on the same footing with how we evaluate kids and when they’re ready to return to school.”
In her talk, Laugel noted that, contrary to common perceptions, about 30 percent of childhood head injuries occur during sports activities, while the rest happen due to accidents or other incidents.
“These are kids who are just playing the dangerous game of childhood,” she said. In describing a concussion to a young patient, she said, she often compares it to the brain being shaken “like a snow globe,” so that the neurons “leak.”
After taking the audience through a step-by-step process of how to evaluate a child’s physical, visual and cognitive functions to determine whether they’ve had a concussion and how far they’ve recovered, she advised doctors, school nurses, teachers and parents to create “concussion management teams” to monitor the child. She also listed accommodations a student may need in school and at home after a concussion, including using audio books, extended test-taking time and limits on computer screen time. Returning to sports teams too soon, she added, is an all-too-common problem.
“We want them to play, but it’s our responsibility to make sure they play safely,” she said. Youth recovering from concussions, she said, need to be taught to self-monitor and self-limit their activities.
“Tell them to remember the snow globe, that if they’re getting a headache after watching TV for three hours, they’re shaking the globe,” she said.
She advocates students returning to school with accommodations after three or four days, and adding aerobic non-contact exercise soon after. But rejoining an athletic team, she said, should wait until the child has “returned to full academics” including a complete restoration of cognitive abilities. Returning too soon, she warned, risks long-term damage, especially if the youth is reinjured. Concussions, she added, are not just a problem for high school-aged students who play football, soccer, ice hockey, lacrosse and other contact sports, but for a broad cross-section of ages involved in a variety of activities.
“Don’t forget your elementary and middle school kids,” she added.
Her talk came as the General Assembly is considering a bill that would require coaches and other leaders of youth sports activities to provide parents with information about concussions.
State Rep. Diana Urban, D-North Stonington, co-sponsor of the bill, said Thursday that the bill has advanced out of the Committee on Children and the Appropriations Committee, and she is now hoping to get it scheduled for a vote on the House floor. Urban is co-chairwoman of the Committee on Children.
On Wednesday she spoke at a news conference on the bill with former University of Connecticut quarterback Casey Cochran, who urged passage of the bill. Cochran, a UConn senior who also played for New London High School, quit football in August after suffering his 12th concussion. Parents, he said, need to be informed about the risks of concussions and “how dangerous they really are.”
Urban said the required information sheets are readily available online. Coaches will be able obtain and distribute documents that would fulfill the requirements from the Centers for Disease Control and the Connecticut Interscholastic Athletic Conference’s websites at no cost to the towns or school sponsoring the teams, she said.
“There’s no question there is more awareness, but many parents still are not aware,” she said. “The little ones, when they take a hit, their brain really flaps around.”
The bill requires that the information sheet describe the signs and symptoms of concussions, how to obtain proper medical treatment, the nature of concussions and their risks, and proper procedures for allowing an athlete who has had a concussion to return to sports. It would take effect on July 1.
Laugel urged audience members to get their school districts to develop concussion management policies and post them on their websites, to name staff to a concussion management team, and take advantage of online resources such as training programs on the Centers for Disease Control’s website.
Parents and medical providers also need to realize, she said, that youth may suffer setbacks as they heal from a concussion.
“Remember,” she said, “recovery is not always linear.”
j.benson@theday.com
Twitter: @BensonJudy

Kathy Sinnett APRN,
Nurse Practitioner & SBHC NP Coordinator

Child & Family Agency of SE CT’s
School Based Health Center at
Regional Multicultural Magnet School
1 Buckeley Place
New London, CT 06320

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Smart QB: UConn’s Casey Cochran Goes Out A Winner

STORRS — By Casey Cochran’s best estimate, he has played the game for 20 years. Casey Cochran is 20 years old..

“I grew up around football,” he said Monday in his first public comments since retiring from the game a week ago. “I had a football in my crib, I’m sure, when I was born.”

There are few young guys in Connecticut who ever loved football more, who ever pursued it more resolutely. Certainly no quarterback threw for more yards, more completions or more touchdowns at any Connecticut high school. The son of the most famous high school coach in state history, he began playing with the New Britain PAL at 7, played in West Hartford, went on to high school at New London and Masuk-Monroe, won a state title, set all the passing records and then went on to be the starting quarterback at State U.READ MORE

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