Schools Tackle Sports Concussions Head On

Dover-Sherborn High School football players practice tackling technique in an early season work out. The athletic department launched a computerized concussion management program this fall. (Meghna Chakrabarti/WBUR)

BOSTON — Paige Brodie’s son, Kale, goes to a private school in Maine. Earlier this year, he hit his head. Hard. A few weeks later, he was home on break.

“He called down to me from the computer room upstairs and said, ‘Mom, I’ve either got a brain tumor or PCS,’ ” Paige recalled.  “And I said, ‘I don’t know about PCS, but I certainly hope it’s the latter.’ And he explained to me that PCS was post-concussion syndrome, and he had a lot of the same symptoms.”

Kale had almost all the symptoms: Dizziness, blurred vision, slurred speech, headaches and trouble thinking.

Paige turned to Neal McGrath, director of Sports Concussion New England and a clinical neuropsychologist. Five years ago, he got interested in mild head injuries when his own sons suffered concussions while playing sports at Brookline High School. Paige listened in as McGrath interviewed Kale. She was shocked by what her son had to say.

“So he had a concussion in hockey, didn’t complain,” Paige said. “Game two or three days later, he hits someone in a check. It rattles his cage enough that that causes a secondary concussion. Three or four days later, he falls down some stairs and hits his head on cement.”

Kale had self-diagnosed correctly. He did have post-concussion syndrome and it was treatable. McGrath put Kale through an unconventional program he also offers to Massachusetts schools.

Dr. Neal McGrath

The Symptoms: Dr. Neal McGrath says student athletes should watch out for the following symptoms of concussion:

• Headaches
• Dizziness
• Nausea
• Ringing in the ears
• Seeing lights or patterns
• Trouble concentrating, focusing, remembering or multitasking
• Irritability, anxiousness, sadness, nervousness
• Trouble falling asleep or staying asleep

How To Recover: McGrath says concussions don’t “go away” and that “playing through” could cause long-term health problems. To recover properly, McGrath recommends:

• Stop physical exercise and activity
• Get as much sleep as possible
• Cut back on school activity, if necessary
• Wait until symptoms are fully cleared before returning to play

McGrath calls it comprehensive concussion management. It’s a two-part program. The first part is a Web-based test called the imPACT test, or Immediate Post Concussion Assessment and Cognitive Testing. It is also used by professional athletes.

The test measures short-term memory, processing speed and reaction time — things that would be affected in a concussion.

Schools working with McGrath test athletes at the beginning of the season, before any injuries, to measure the student’s baseline or normal scores. After a bad hit, the student is tested repeatedly over time until their scores on the imPACT test return to normal.

The second part, McGrath said, is management. He educates the circle of school officials surrounding the student.

“What concussions look like, how they present and how athletes ought to be taken care of after they’ve been suspected of having an injury,” McGrath ticked off.

He also consults with teachers on how to adjust a student’s schoolwork to give the injured brain a break.

“We want people to understand that a concussion is something you can recover from fully, as long as you rest properly and undergo proper management,” McGrath said. “It’s when you go back to play too soon that you get into trouble.”

So, McGrath designed a kind of modified lifestyle for Kale. His mother, Paige Brodie, was so impressed with the program that she wondered why her two other children were not getting the same supervision.

“I then looked at DS High School, Dover-Sherborn High School, and said, ‘We should have this,’ ” Paige said. She worked closely with Athletic Director Heath Rollins to get the program up and running at Dover-Sherborn High School this year.

Rollins says he readily embraced the concussion management plan, because almost every Dover-Sherborn student plays at least one sport a year. But he had some initial concerns about the computerized test, namely, what he calls “sandbagging.”

“A student going lame on the first test to keep his score down, so even if he had an injury, he could score the same on his post test,” Rollins said.

Therefore, he can return to play that much faster. Students can often be their own worst enemies in managing mild head trauma. Rollins said they would do anything to play again, whether lying about how bad they felt or going doctor shopping until they find a physician who will clear them. Rollins should know. In college, he cut off one of his own casts to get back on the football field.

But that is exactly why Rollins says he likes the computerized testing. It makes it harder to hide head trauma and easier to accurately judge when sports are OK again.

“Now there’s some data, something to look at to say this student might not be ready yet to return. It just gives more information to doctors and our athletic trainer to make that decision,” Rollins said.

Still, schools like Dover-Sherborn are the exception to the rule. Just two dozen high schools currently run this kind of comprehensive concussion testing with Neal McGrath.

It can cost a lot. Dover-Sherborn High School pays $4,500 a year for the full program. Paige Brodie said she understands that some schools just are not able to pay. But, she believes computerized concussion management will catch on.

“You know, amazingly, most parents want their kids to be safe. And most of us know that our kids don’t have a career in sports,” Paige said. “But their brains will be with them the rest of their lives.”

As for her son, it took eight weeks of no sports and reduced schoolwork for Kale to recover. But he did. And while he will probably never skate for the NHL, Kale will be back on the ice, playing for his high school this winter.