Football

High school football: Concussion management has progressed, but far enough?

Editor's note: The IHSA, along with 13 area public high schools (Cary-Grove, Crystal Lake Central, Crystal Lake South, Dundee-Crown, Hampshire, Harvard, Huntley, Jacobs, Johnsburg, McHenry, Prairie Ridge, Woodstock and Woodstock North) provided their concussion management policies to the Northwest Herald. They are attached below. Alden-Hebron, Marengo and RIchmond-Burton said they did not have additional paperwork beyond the IHSA protocol

Sitting at a table in a downtown Crystal Lake coffee shop during a school lunch break, Brett Covalt tilts his brow forward, parts his wavy dark hair and rubs the top of his head to show a dent in his skull.

It’s been there since Nov. 9, 2013. The Prairie Ridge senior had never been hit harder.

The hit came against Lakes in the first round of a Class 6A playoff game. Midway through the game, Covalt took the snap from center, faked a dive to the fullback, held onto the ball and inched forward along the line.

Smack.

Covalt was hit from behind, lunging him forward. But rather than falling onto the grass, he was quickly pummeled — helmet to helmet — by an incoming defensive lineman. And then, as he was falling back, he was again hit, sandwiched between the two.

“All I kinda remember was seeing a flash,” he said.

Covalt stayed in for the next play. But in the subsequent huddle, he remembers feeling confused and asking what the play call was from fullback Zack Greenberg. At that point, he knew something was wrong. Greenberg’s voice sounded robotic. He alerted a team trainer and left the game. He did not return.

The next day, a Barrington doctor diagnosed him with a concussion. In accordance with District 155 protocol, he was kept out of practice the following Monday and Tuesday after failing a concussion test.

On Wednesday of that week, he was medically cleared after passing a second test, his highest score of any neurological test he had ever taken, and rejoined practice the next day. That meant he was back for the second round game against Marmion.

It was different in the playoffs.

When Covalt suffered a concussion earlier that year on Sept. 13 against Jacobs, he took a concussion test the following Monday and failed. That time, coaches said not to worry. His backup, Luke Annen, would start the next game at Crystal Lake South. Rest that week, he was told.

But as No. 5-seeded Marmion awaited, amid another playoff run, he felt there was greater urgency, and he took the second test.

Over the past year, Covalt has noticed mental changes in addition to the dent. His focus, especially in math class, has worsened. He has been prescribed Adderall to help. In general, he feels more “laid back.”

“Maybe it wouldn’t be like this if I had a little more time,” Covalt said during a school lunch break. “Like, if you saw me playing, it looked like I didn't even have a concussion. But I felt like I still was kind of questionable, on thin ice. I was still able to play and function, all that stuff, and think. But right now, I can just tell if I took another week off, this wouldn’t be happening, because obviously during that game, I took more hits to the head.”

By this point, he’s had at least three diagnosed concussions in four years, and he wonders if he should hang his helmet up. If he keeps playing, he worries he’ll put himself at a greater risk for the neurological problems he hears former football players talk about.

But he could play in college.

There may be scholarship offers to come this winter. Division II schools such as Bemidji State and Ferris State have expressed interest. He would become the second Covalt to play college football. His older brother, Stephen, is a quarterback at Ripon College in Wisconsin.

There’s still a little more than a month until National Signing Day.

Or he could try something else. Brett talks about attending film school, about applying to Arizona or Arizona State, about pledging a fraternity. Transition to a new phase of life, after graduation, when the tassel is turned.

“How do you make that call?” he asks. “I don’t know.”

Covalt has played the sport since he was 5, when his parents signed him up for the Crystal Lake Raiders youth tackle program. That’s 13 years of the 18-year-old’s life.

How high schools in McHenry County and across the state handle concussed football players has received heightened attention in recent years, as researchers continue to link blows to the head from playing football to cognitive problems later in life.

It’s an issue that, in the past month, has faced additional scrutiny in Illinois. In November, the Illinois High School Association became the nation's first high school sports governing body to face a class-action lawsuit concerning concussions, similar to the litigation the NFL and the NCAA have faced.

The lawsuit serves as a potential watershed moment for high school football, opening questions on the best policies to handle head injuries and reigniting an old debate on whether it's possible for football to be played without lingering scars.

***

A former Niles Notre Dame quarterback named Daniel Bukal was suffering from migraines and memory loss.

Bukal starred for the Dons from 1999 to 2003, but even a decade removed, he said problems lingered.

This marks the precipice of the IHSA’s new legal challenge.

On Thanksgiving weekend, Bukal’s attorney, Joseph Siprut, filed a class-action lawsuit in Cook County Circuit Court, alleging the IHSA did not do enough to shield players from the potential effects from concussions.

In 2011, Siprut filed a similar concussions lawsuit against the NCAA, seeking damages from college sports’ governing body. The case is currently being settled.

His suit against the IHSA, though, does not seek damages, instead, calling upon the association to implement stricter protocol concerning the treatment of head injuries, namely mandates to require medical personnel at all games and on-call for practices, in addition to preseason neurological baseline testing. Neither is currently required by the IHSA.

In a press conference earlier this month in New Lenox, IHSA Executive Director Marty Hickman said the lawsuit, if successful, would present challenges to the more than 800-member schools, and citing costs of the proposed measures, could prompt poorer and smaller communities to cut their football programs.

It’s just not appropriate, he contended.

“These safety measures continue to belong in the hands of those who work with student-athletes every day,” Hickman said. “They don’t belong in the hands of our court system.”

Siprut responded by email to the Northwest Herald, writing, “The IHSA’s claim that our firm’s concussion class action could result in the demise of high school football, or create a system of ‘haves, have nots’ (those that have football and those that don’t) is a cheap and cowardly tactic designed to engender opposition to the lawsuit.

“Put simply, the IHSA is trying to pass off this logic: ‘If you like football, then you should oppose this lawsuit!’ They might as well have said: ‘If you like cute puppies, then you should oppose this lawsuit!’”

Most of the IHSA mandates concerning the management of concussions were implemented in 2011. In April of that year, it passed its return to play policy, which requires any player who exhibits signs of a concussion to be removed from play and is prevented from returning until cleared by a certified athletic trainer or a physician.

Illinois lawmakers also passed legislation requiring junior high and high school athletes showing concussion symptoms to receive medical clearance before returning, becoming the 28th state to pass such a law. Gov. Pat Quinn signed the bill, known as the Protecting Our Student Athletes Act, into effect at a July 2011 ceremony at Soldier Field.

The second measure came last summer when Quinn signed a bill requiring Illinois athletic directors and coaches to take an online concussion awareness course.

All 50 states, plus Washington, D.C., have now passed similar concussion laws.

“They’ve been reactive like most people,” said Dustin Fink, a certified athletic trainer in Mt. Zion and author of the Concussion Blog, of the IHSA. “But they’re getting better, they’re definitely getting better.”

In Illinois, less than 50 percent of public high schools have access to an athletic trainer, according to Mike Sullivan, the president of the Illinois Athletic Trainers Association.

And nationally, it’s not much higher — 55 percent of public high schools, according to a National Athletic Trainers’ Association report.

“I mean, this is 2014 and we got high schools that have collision sports that don’t have health care for those kids,” NATA President Jim Thornton said. “It’s definitely a public health issue.”

The issue is almost a moot point in McHenry County.

Fifteen of the 16 area public high schools use certified athletic trainers for football, and require players to undergo preseason baseline testing.

The exception is Alden-Hebron, a Class 1A school. Though, the Giants’ athletic director and football coach John Lalor said he is considering hiring a trainer for next season.

Of course, Lalor might eventually have to should it become mandatory.

“It’s unfortunate it takes litigation,” said Paul Anderson, a Missouri attorney and an expert in concussion litigation, “but that is often the most powerful force, powerful vehicle in which you can change conduct.”

***

What was the score? Did we win? When did I come out?

As he sat in the back seat of his family car, driving from Winnebago to Mercy Harvard Hospital on the night of Sept. 5, Joe Quinn kept asking those questions to his parents, Mike and Cara. Over and over.

“10-15 times apiece,” he said.

Quinn left the game during the second half of the Big Northern Conference crossover game at Winnebago because of a concussion.

He was in as a defensive back, and when he went to make a tackle on the Indians’ tight end, he lowered his head and was run over.

“Got trucked pretty much,” he said.

He stayed in the game. Went out for the next drive at wide receiver for the Hornets. But he had trouble remembering the plays and kept asking quarterback Peyton Schneider what his routes were.

Suspecting something was wrong, Schneider alerted the team’s trainer, Vince DiRenzo, who gave a sideline evaluation before calling Quinn's parents from the stands and telling him to go to the hospital.

In 2012, the most recently available year, 237 Illinois high school football players were removed from games to be evaluated for concussions, according to IHSA spokesman Matt Troha — a figure that is likely lower than in recent seasons due to growing awareness.

Schools are required by the IHSA to report when a player in any sport is removed from a game due to a possible head injury.

Quinn’s experience suggests awareness may be on the rise, and working. Schneider noticed Quinn was experiencing concussion-like symptoms — short-term memory loss — and Quinn was removed from play to be evaluated.

Research backs up the theory.

A new study released this week by the University of Michigan found an uptick in the treatment of concussions among middle school and high school athletes, especially in states with concussion laws, where there has been an increase of 92 percent in teenagers seeking medical treatment for concussions.

***

There’s no debate for Richmond-Burton running back Luke Brinkmann. None whatsoever.

The senior wants to play college football, a dream since he was 8 years old.

Yes, he’s had, by his count, seven concussions while playing football. He’s played for 10 years now, beginning in the second grade in bantam weight with his friend and R-B backfield mate Brad Boelkow. And sure, the gutty 5-foot-9 senior is recovering from surgery to repair a torn labrum in his right shoulder, too.

But none of it is career-ending, he says. Brinkmann figures to play at a Division III school next fall, perhaps at North Central College, St. Ambrose University or the University of Dubuque.

The potential effects from concussions isn’t something that keeps him up at night. He's played through them in the past. He didn't want to tell anyone.

"Just for the love of the game," he said. "You don’t want to go out."

Brinkmann had an especially concerning one as a junior when he was knocked out of a week seven games against Burlington Central. He was removed by the Rockets’ trainer, Julianne Stewart. After passing out on the sideline, he was taken to Nimsy Hospital in McHenry, where a CT scan revealed brain swelling. He was kept overnight.

As for post-concussive syndrome? No lingering headaches, he said. Felt fine.

“Concussions do happen and they’re a bad thing,” Brinkmann said. “It’s dangerous. But not everybody gets Alzheimer’s, or something from it. It happens. It’s a physical sport.”

When a reporter brings up the case of Covalt, the Prairie Ridge quarterback, he nods, and mentions how players react differently to head injuries.

He has his own example.

This season, he watched his own teammate, Boelkow, take a hit hard enough to the head during a game at Marengo that it left him crawling. The play was a 26 counter. Boelkow took the handoff on the right side and looked to cut. He tried to lower his shoulder to run over the defender, but he was knocked on his back.

He had to watch film to see what happened.

“You ever had, like, a dream where you can only remember parts of it?” asks Boelkow.

He was removed from the game, and re-entered after passing a three-question test — what’s the score? What’s the date? What’d you eat for lunch?

But the next Monday, he failed a longer assessment, and missed the next game at Johnsburg, and then the following game against Rockford Christian as a precaution.

“I would be sensitive to light,” Boelkow said. “I would just get random headaches sometimes. It was just a sharp pain. I don’t know if it’s from that, but I never had it before.”

School was tough, too. He asked teachers to turn the lights off during class. It took forever to finish an English paper. And he took a lot of naps.

It was similar for Quinn. He sat out the following game on Sept. 13 against R-B. School presented challenges. He at least got an extension for a physics test.

“It was just kind of hard retaining information and focusing in class,” Quinn said. “I was dazing off a lot.”

In football, everyone is hit. It's a collision sport.

The question is, how long do, and should, the dazes last?

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