Student health and safety

Schools to tackle head injuries

Fall is around the corner and students and athletes are preparing to return to school and athletics. A simple fact of life is that many student-athletes will experience an injury while playing interscholastic sports.

A recently-enacted New York State Law, called the Concussion Management and Awareness Act, requires schools to adopt concussion management protocols.

The law also requires school staff members who with student athletes to complete a New York State Education Department approved course on concussions.

Most schools in Livingston County and Section Five are ahead of the new law in that they have already looked at and put in place prescribed concussion management protocols over the last few years. Even so, this is the first school making it mandatory according to education law.

For parents, athletes and coaches, it’s not a new law that has their attention turned to mild traumatic brain injury, otherwise known as concussion, it’s their understanding of the seriousness of the injury that once was dismissed as “no big deal, you just got your bell rung.”

Today, most parents and professionals understand that a concussion not only side lines the athlete, it also impacts the student in the classroom. Another commonly experienced injury is to the athlete’s knee. Torn ACL and MCL injuries land many student-athletes on crutches and facing surgery.

Cal-Mum Central School hosted a Concussion and ACL Prevention Seminar on Aug. 9, presented by University of Rochester Sports Medicine Physicians Dr. Gregg Nicandri and Dr. Mark Mirabelli, and Scott Roides, certified athletic trainer and orthopaedic care extender.

The free seminar was open to the public, and coaches and athletes were encouraged to attend and take advantage of the advice of these medical professionals.

Mirabelli is a specialist at the sports concussion center and the hip and knee arthritis clinic at the University of Rochester.

He is the team physician for St. John Fisher College, the Rochester Knighthawks, RIT and the Rochester Rattlers. He’s worked with hundreds of injured athletes.

He presented on the new concussion education law and what it means for school officials, coaches, parents and student athletes. He began by presenting the medical definition of concussion or MTBI (mild traumatic brain injury).

“Concussion is a brain injury with long and short term effects,” he said.

Surprising to many in the audience, there is no diagnostic test to positively determine if a person has a concussion.

Doctors rely on the person’s reported injury and the symptoms they present in making a diagnosis of concussion. A concussion can result from any hit to the head but it can also occur when a person sustains a hit to the body that causes the head and neck to snap sharply.

The doctor reviewed the long list of symptoms that typically present themselves in a person suspected of having a concussion. He then reviewed the typical protocol for removal from athletic activities and the protocol for reentry to physical and athletic activity.

These protocols involved extensive communication between the injured student, the student’s parents and physician, and the school district’s concussion management team.

The school’s responsibility is not limited to removal from athletics. Experts now understand that a concussed student may also experience cognitive deficits that affect their classroom performance.

Most schools have established specific protocols that deal with the student’s academic performance. These may include teacher observations during the recovery period and/or academic modifications for the student during the rehabilitation period.

Ask any school worker, and they’ll probably admit to seeing several students on crutches within the first few weeks of athletic play.

Knee injuries are very common in athletes who participate in soccer and basketball and females are at a much high risk for such injuries. ACL knee injuries are caused when the athlete plants their feet and pivots or twists their body.

The rehabilitation from knee surgery to correct the torn ACL is relatively long, about one full year. As many as 50 percent of the athletes who sustain a knee injury, later develop arthritis as an adult.

Nicandri said an uneven or rutty playing surface and some styles of cleats are knows causes of knee injuries as the foot plants as the body is pivoting.

The good news for athletes and parents is that knee injuries can be reduced and in some cases, prevented, by adhering to a program consisting of specific exercises to stretch and strengthen the stabilizing muscles around the knee joint.

Called the PEP program, Prevent Injury and Enhance Performance, it has shown a reduction in knee injuries in females that routinely completed the exercises. Coaches can contribute to a healthier season for the team by encouraging their athletes to make the PEP program a regular part of their routine.

The specialists conducted a jump test to evaluate the student athlete’s landing form, which is indicative of a potential injury. Specific exercises can target and improve the athlete’s landing techniques and in turn, reduce the risk of knee injury.

Cal-Mum’s Athletic Director Michael T. Monacelli encouraged attendance at the seminar. He’s been a leader in the establishment of concussion management protocols in schools as well as utilizing injury prevention strategies like PEP with high school athletes. He addressed the U.S. Congress a few years ago on Cal-Mum’s established concussion management practices at the time.

He plans to offer the seminar again in the near future and invites all area coaches, athletes, parents and teachers to attend to become educated on this important issue impacting athletes.