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News 8 Investigates: Concussions in the Classroom

Local high school concussion protocol

News 8 Investigates: Concussions in the Classroom

WEST SALEM, Wis. (WKBT) - The seriousness of concussions continues to grab headlines, and the discussion surrounding these head injuries is now making way into high schools.

Local school districts are becoming more pro-active when it comes to protecting children.
In 2008, Gundersen Health System partnered with school districts, including schools in the Mississippi Valley Conference, to begin implementing ImPACT tests. The computerized tests are given at schools and measure students' memory, speed, and reaction time. Over the past five years, high school athletic trainers employed by Gundersen Health System in La Crosse have administered more than 2,600 tests to student athletes.
If one of these athletes is diagnosed with a concussion, he or she will take a second test at a hospital to compare scores to measure their recovery.

While effective, ImPACT testing is a small component to a student athlete's recovery. As research on head injuries continues, there are still many questions about how to keep athletes, and students safe long-term.

Concussion protocol is different at every school district, with high schools developing and adding to their concussion procedures as more research becomes available.
High schools in the Mississippi Valley Conference recently started keeping computerized records on the number of athlete concussions. Here's a breakdown of the numbers from the 2014-15 school year:

La Crosse Logan - 14
La Crosse Central - 16
Aquinas - 10
Onalaska - 18
Sparta - 30
Tomah - 33
West Salem - 20
Holmen - Unavailable at this time

No one knows the affect a concussion can have a student athlete, more than the athlete.

Former University of Wisconsin-La Crosse football player Trent Cummings says his struggles with concussions changed the way he played sports, and the way he lived.

Cummings started playing as a fourth grader in Waunakee, Wisconsin and always enjoyed the physical aspect of the game of football.

"I was always a little bit more physical. Always wanting to wrestle around a little bit more and I liked the hitting," said Cummings.

The hits he enjoyed, led to a successful high school career. Cummings, a Waunakee high school student, won the state championship in 2009.

After a brief stint at Minnesota State University, Cummings transferred to UW-L in 2013.

"Just seeing the field, seeing the bluffs, I knew this is a spot where I wanted to be and I didn't make a bad decision," said Cummings.

Over the next few years, Cummings would settle in as the team's starting quarterback. Until the hits that got him into the sport, starting keeping him from playing it. Cummings would suffer multiple concussions during his time at UW-L, and while symptoms kept him off the field, they'd also impact his performance in school.
"I was constantly having brain farts where I would look at something I know I know the answer to but I just couldn't spit it out," said Cummings.

That's one of the concussion related classroom struggles area high schools are looking to avoid. Connie Troyanek, West Salem High School's nurse, says a concussed student's education can be noticeably impacted, with grades sometimes falling one or two full letters.

"They can't recall what it is they learned. We had one girl who had a significant head injury, she had three in a row and she couldn't remember anything," said Troyanek.

It wasn't always that obvious. Troyanek says high schools didn't understand concussions, much less have a protocol to follow after a student suffered one, when she first started 15 years ago.

"They wouldn't even necessarily be pulled from the sport, never given any type of classroom modifications, nobody really payed attention to what it was doing to them academically," said Troyanek.

That's not the case anymore at West Salem High School. Along with advances in ‘back to play' protocol, a larger focus is being placed on a student's recovery in the classroom. It's a process that Troyanek began in 2011, and continues to refine as more research on concussions becomes available.

Protocol now starts after the school's athletic trainer notifies Troyanek that a student athlete has suffered a head injury while playing sports.

"At that time we'll call the student in and we'll ask them how are you doing? If they have any type of a headache, that's when we institute our concussion protocol. At that time, we email the teachers and say this student has had an injury and has a possible concussion," said Troyanek.

Teachers will then enforce classroom restrictions including:
-Limited computer work (screen time)
-No academic testing (final exams, ACTs, standardized tests)
-Modified homework assignments
-Rest periods throughout the school day depending on a student's schedule
-Excused from classes that will intensify symptoms (P.E., band, shop)

It's also important to note that while there is no concussion severity grading system, all student concussions are taken on a case-by-case basis depending on reporter symptoms.

Troyanek says it's a slow process, but is important in working students back towards their regular classroom attentiveness.

"You have one brain, you have one chance to recover from a concussion correctly, because there's no going back and redoing," said Troyanek.

There's ‘no going back and redoing' for Trent Cummings. After suffering numerous concussions, he eventually made the decision to quit the sport he loved in 2015. An ultimatum West Salem High School hopes no athlete ever encounters, but knows, when it comes to their students: there's only one right decision.

"They're in school first of all to learn. This is the reason they are here but they need to be able to be back in the classroom. If they can't sustain a full day in the classroom and can't do all the academic rigors of work, then they shouldn't be out on the field or on the court," said Troyanek.

"Make sure you're playing for the right reasons, and make sure you're taking care of yourself. Don't be selfish out there. It's tough to walk away from but there are bigger things in life than the game of football," said Cummings.

Kirsten La Mere, West Salem High School's athletic trainer, works very closely with Troyanek. She's also in charge of the school's ‘back to play' protocol. Both agree that student communication is an important tool during recovery, which can actually sometimes turn out to be a difficulty in its own.

"More often times than not, I have students that will willingly tell another to lie to the trainer because that they have symptoms. The nicest thing that I have seen recently is I had a student that came to me and said yeah all my teammates were telling me to lie about it," said La Mere.

Both La Mere and Troyanek say education on concussions and possible long-term effects is another great tool in hopefully stopping students from lying about symptoms.

High schools from the Mississippi Valley Conference keep in contact with one another for the latest and most successful concussion protocol.

We also asked those schools how they plan to continue keeping athletes safe. Here's what the responding schools had to say:

Sparta High School
Bob Sanders, the Activities Director at Sparta High School says the ImPACT test will continue to be a staple in their protocol. He says while the test is not required, it's still highly encouraged. Sanders also credits the school's athletic trainer for staying on top of new tests and strategies to make sure student athletes stay safe. He says the school has adopted a new step in their ‘return to play' protocol for Day 3, with additional evaluations to look for vestibular and ocular problems through various tests.

Tomah High School
Alec Hinrichs, the Tomah High School Athletic Trainer, says the school adjusted their ‘back to play' protocol this year. He says if someone has sustained a concussion, they must take the head trauma follow-up assessment form. Within the form is a series of balance exercises, vestibular screening, vision screening, and a symptom score.
Hinrichs says they then try to find out what area of the brain the concussion may be affecting the most. He says there are many categories but they most focus on the vestibular system (dizziness, balance, lightheadedness) and the ocular-motor system (pressure from behind the eyes when using screens, reading). Hinrichs says this gives them a general idea of how to treat the athletes. Students are also often referred to their clinic of choice to take an ImPACT test. According Hinrichs, it is also preferred that athletes are cleared by a doctor. Hinrichs says the school's back to play protocol which can be extensive. He says students can be in that protocol sometimes from four days, to four months, to possibly never playing again depending on symptoms. Hinrichs, also a Gundersen Health System employee, says Gundersen stays up to date on concussions, and all staff (meaning athletic trainers from around the area) seek out new information at local stat meetings as well as national meetings.

West Salem High School
West Salem's Athletic Trainer, Kirsten La Mere says there are a few important factors to continue looking into. She says continued education on all aspects of concussions with athletes, parents, teachers, coaches, and administrators are necessary. La mere also encourages open communication and honesty from the athletes regarding symptoms and recovery. She also says up-to-date equipment is important, as well as the instruction on proper techniques by coaches, and knowledge of the rules. La Mere also says weight training and conditioning programs are important to the sport.

Onalaska High School
Charlie Ihle, the school's Activities Director says Onalaska will continue concussion education during preseason meetings, and require athletes to take the ImPACT test. They will also continue implementing both the return to play and return to classroom protocols.


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