Letter: The School District Dropped the Ball on High School Concussion Protocol

Dear Editor,

Due to staffing changes at the Manatee County School District this year, the ball was dropped and a new concussion protocol with baseline testing did not become a district policy as many who had worked tirelessly to define it had hoped for. A small group of parents are going to address the School Board Members about this issue at the next meeting on Monday, Oct. 28 at 5:45 p.m.

While advances in helmets and protective equipment are important, there is a limit in their capacity to prevent concussion. So far this school year, Manatee High School has treated 12 concussions, Palmetto High School 13 concussions, Southeast High School: 4 concussions; Lakewood Ranch High School: 6 concussions; Bayshore High School: 5 concussions (this was as of 2 weeks ago and I was unable to get information regarding Braden River).

A concussion is an injury that affects brain chemistry and function, typically caused by any hit or action that causes the head to quickly rotate or change directions (you do not have to get hit in the head to have a concussion). Symptoms typically include headache, nausea, confusion, dizziness and more. Because a concussion impacts the brain's cognitive function engaging in cognitive activities may make an athlete's concussion symptoms worse, and even delay recovery.

If you break your arm you can put it in a cast; if you break your brain you cannot. With new researched information that has only become available in the last few years, experts now recommend that concussed student-athletes go on cognitive rest allowing the brain time to heal. Cognitive rest means; time off from school or work; no homework, no reading, no visually stimulating activities (such as computers, video games, texting or use of cell phones), no exercise, no athletics, no chores that result in perspiration/exertion, no trips, no social visits in or out of the home, increased rest and sleep and limited television.

A team of folks including our local concussion specialist (Dr. NG with Coastal Orthopedics), a pediatrician and athletic trainers worked with the Manatee County School District staff to develop a concussion protocol for all high schools which included baseline testing. The protocol allowed for an athlete with a concussion to be excused from school work or gave them extra time to make up the work. Sending an athlete post-concussion back to school and requiring that they do double the workload to catch up is like running on sprained ankle. Just like you would feel pain in your ankle you can experience headaches, nausea and dizziness from the increased cognitive processes.

By establishing an athlete's baseline or "normal" score on tests of cognitive functions that are often affected by concussion, such as memory, processing speed, reaction time, and attention, and on measures of physical/emotional/cognitive symptoms, re-testing after a suspected concussion can help determine if and when an athlete's brain has recovered. If the youth feels symptom free, and post-concussion testing is the same or better than baseline (pre-concussion) testing, recovery is imminent. Without baseline testing the doctor has no idea where the post-concussion athlete should test and has to guess by asking questions like, what kind of grades do you get, what level classes do you take, are you the first to turn in a test. Without baseline testing completion of the test is required multiple times to see if scores improve or remain the same.

The school district had worked out a fee schedule with Coastal Orthopedics to conduct baseline testing to include all high school athletes participating in football, soccer and basketball. The cost per student was 87 cents. Parents are not asking the school district to be responsible for this fee, it could be added on to the insurance fees already paid by student-athletes to participate in sports.

The protocols and baseline testing would not have prevented any of these concussions. They would have allowed for a recovery time consistent with the most current researched information and given our local sports concussion specialist information to help him determine when recovery has occurred. A district wide protocol would also allow our Athletic Trainers to ensure that all concussions are treated appropriately without any pushback from teachers and/or coaches. This is an issue that some schools are already experiencing. One athletic trainer explained to me, “We have student-athletes that are evaluated and show signs of a concussion so we recommend that they go on cognitive rest. They can then go to a physician and get a note that overrides our decision. This has happened this year. The protocol would not allow this to happen.”

If you would like to show your support for the Manatee School District’s adoption of concussion protocols with baseline testing please come to the Manatee County School District’s Board meeting on Oct. 28, and wear a local high school shirt to show that we stand united on this issue.

Michelle Atkinson

Manatee County