The findings have forced the NFL to shelve its concussion skepticism. In February, the league urged all states to pass concussion legislation in youth athletics. But for the 75 former NFL pros who sued the league in July, alleging it concealed the dangers of the injuries for decades, it's too little, too late. Football retirees such as Mark Duper, Ottis Anderson and Raymond Clayborn are claiming that the league was careless in its false assumptions. (The NFL plans to contest the allegations.)
The proper treatment of concussions, especially in youth sports, is still a developing — and somewhat murky — science.
Daniel Kramer
Justin Landers, trainer for Katy High (Houston), says new helmets reduce the risk of concussions.
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Dr. Mark Ashley is co-founder, president and CEO of the Centre for Neuro Skills, whose clinics in Bakersfield and Irving, Texas, specialize in traumatic brain injury rehabilitation. He's currently helping Ali Champness recover from a number of serious health issues spawned by the not-too-dramatic hit from a soccer ball in January.
Champness, based on Ashley's advice, sat out the rest of the soccer season. Two months later, she joined the school's swim team. But three weeks in, Ali called her mom from a competitive meet in a panic. "Mom, you need to get me to a doctor," Kim Champness remembers her daughter saying.
At Ashley's center, an MRI and CAT scan revealed bleeding in Ali's brain. A cardiologist found that the initial concussion had deregulated Ali's autonomic nervous system. For months, whenever Ali jogged on the treadmill, her heartbeat soared high enough to trigger cardiac arrest or stroke. She still goes to rehab three hours a day.
One of Ashley's most severe cases, treated at the Centre's Texas facility in 2006, was a 13-year-old football player from the Seattle suburbs named Zackery Lystedt. In the second quarter of a game, Zack fell backwards after an unremarkable tackle and hit the back of his head, although the injury escaped the notice of his father in the stands. "I thought he had gotten the wind knocked out of him," recalls Victor Lystedt.
Zack played every down for the rest of the game, even forcing a fumble and sprinting to a 32-yard return. But when his dad met him after the game, Zack started stumbling and muttering, "My head hurts really bad." He collapsed onto the field. His left eye suddenly "blew out" and turned an inky black, the result of blood swelling in his skull. And then he convulsed into dozens of strokes. Says Victor, who witnessed the spectacle, helpless and confused, "My boy was dying on a football field." His son would survive, but his serious health problems continue to the present day.
Spurred by stories like Zack's, school districts en masse are adopting new procedures for dealing with blows to the head. The most popular is the ImPACT test. A simple computer program designed by a pair of Pittsburgh doctors in the early 1990s, the exam finds an athlete's "baseline" — his mental aptitude and quickness of reflexes when he's not suffering concussive symptoms — which can be used later in a comparative test to see if a collision has caused a lag.
But the test has hit real-world snags. The first is its price: At packages costing roughly $600 per school for the first year, ImPACT is deemed too expensive for some districts. And even when they spring for the program, few schools can afford to pay a specialist to administer it. That duty tends to fall on coaches or trainers, who are often unqualified to conduct the test.
In 2008, Ryne Dougherty, a 16-year-old high school linebacker in Essex County, New Jersey, sat out three weeks following a concussion. But after taking an ImPACT test, he was cleared to play. During his first game back, he suffered a brain hemorrhage and slipped into a coma. He died within a week.
But Ryne's ImPACT results were ominously low, the family has claimed in a lawsuit against the school district. Additionally, according to the test results, Ryne reported feeling "foggy," but he was still cleared to play.
"Fogginess is the lead predictor of lasting head trauma," says Beth Baldinger, the attorney representing Ryne's family in a suit against the district. "[The trainer] ignored the test results in front of her. This case screams ignorance."
Michele Chemidlin, the trainer who administered the test, ignored phone messages and an email requesting comment for this story. She told Sports Illustrated that Ryne's test was interrupted by a "disruptive" teammate, which made the results "invalid." But Baldinger claims that the trainer retracted that story in a recent deposition.
"It's better than nothing," says UCLA researcher David Hovda about ImPACT. "I don't mean any disrespect, but neuropsychological tests, which require responses and performance from individuals, are always going to have problems because there's always going to be variances."
Complicating head-trauma detection is a recently released Purdue University study that concludes that youth athletes who aren't clinically diagnosed with a concussion are still experiencing fundamental brain changes that may be detrimental. For two seasons, three Purdue professors tracked every practice and game hit sustained by 21 Lafayette Jefferson High School (Indiana) football players. "That's when we started to see that about half of the kids had some level of easily measurable neurophysiological change without any concussion whatsoever," says Purdue's Eric Nauman.
