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Schools watch for sports head injuries

By Lisa Kocian
Globe Staff / May 24, 2012
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Dozens of high school students in Greater Boston experienced head injuries while playing ice hockey and basketball this winter, according to a Boston Globe survey of more than 40 leading programs.

The numbers, while far lower than those collected by the Globe in the fall for football and girls’ soccer teams, show that injuries are not uncommon for area high school athletes who play in winter sports. This is the first year that Massachusetts is requiring school athletic directors to track “head injuries or suspected concussions” in all sports.

“Everyone is very cognizant,” said Peter Paladino, athletic director at Central Catholic High School in Lawrence. “You hear some of the terrible stories that have gone on around the country, where student athletes have gone back early and there is permanent damage or death.”

In all, the Globe found 72 concussions in boys’ and girls’ hockey and basketball across 44 high school sports programs that qualified for the state tournament this winter. By contrast, a Globe survey of high school football and boys’ and girls’ soccer programs found more than 300 head injuries reported by 78 sports programs. Of those three sports, boys’ soccer posted the lowest numbers.

In the latest survey, the single highest number, nine, was posted by the boys’ hockey program at Central Catholic High. (Technically it’s a coed program because two girls played on the junior varsity team, but neither of the girls sustained a head injury.)

Asked if his athletes are playing harder or are just better at reporting their symptoms, Paladino said it was likely a little of both. Central Catholic, which plays in the competitive Merrimack Valley Conference, made it into the elite Super 8 postseason tournament this year.

“Those kids play hard and hit hard, and we want to do the same to win,” said Paladino. “When they play hard, they hit hard, and the consequences are sometimes they get hit hard.”

Collectively, boys’ hockey programs posted a higher number of head injuries than the other sports programs covered by the survey, which included all levels of play: varsity, junior varsity, and freshman, where applicable. Two hockey programs reported four head injuries each: the Winthrop boys’ teams and the Westwood girls’ squads.

Central Catholic also reported the most head injuries in basketball among the schools surveyed by the Globe, with four injuries in the boys’ program. The next highest numbers came from the boys’ programs at Stoughton High, Lexington High, Newton North High and Hopkinton High, all with three head injuries. The girls’ basketball program at Shawsheen Valley Technical High reported three concussions.

In ice hockey, head injuries are often due to checking into the boards, said Brian Bradley, athletic trainer for Central Catholic. However, he noted, a goalie was hit in the head with a puck this season as well.

Some of the nine injuries or suspected injuries on the Central Catholic teams were resolved quickly. A couple required the players to miss one or two games and one or two days of school, he said.

Checking is not allowed in girls’ hockey, but Bradley said it is unlikely such a ban would be put in place for boys’ high school hockey programs.

“They would feel it would take too much out of the game,” he said. “There are proper ways to check.”

There have been high-profile incidents elsewhere. A Duxbury player, Tucker Hannon, suffered a concussion in January and missed five weeks of school after he was knocked to the ice by a Scituate High player at the Bog Ice Arena in Kingston.

This season, a new rule made any hit to the head an automatic penalty, according to Paul Wetzel, spokesman for the Massachusetts Interscholastic Athletic Association. Previously, referees used their discretion to determine whether a blow to the head merited a penalty, he said.

The change “may well have played a role” in keeping the numbers relatively low, said Wetzel.

But because this is the first year the state is requiring the data be tracked, there is no way to take a comprehensive, long-term look at such injuries. The survey did not examine the severity of the head injuries.

With the increased attention on head injuries, including continuing reports of NFL players suffering from dementia after retirement, coaches and medical specialists have begun to emphasize ways to prevent serious injury.

One way is to start teaching players proper conduct at the youth level, said Dr. Michael Stuart, professor and vice chairman for the Mayo Clinic’s department of orthopedics. All three of his sons have played in the National Hockey League, including former Bruin Mark Stuart.

In 2010, the elder Stuart was part of a group that recommended increasing the age level at which body checking is allowed. USA Hockey, which oversees youth hockey, subsequently adopted a change that eliminated checking at the Pee Wee level (ages 11 or 12) in an attempt to reduce concussions, he said.

At the high school level, Stuart said, it’s important to try to reduce injuries through rule enforcement, good coaching techniques, and player education.

“The hardest thing of all is trying to instill sportsmanship and mutual respect,” said Stuart.

In addition to the new reporting mandate, the state law, passed in 2010, requires schools to provide annual training to students, parents, and staff on how to recognize and respond to head injuries. Injured students must get medical clearance before returning to play and then must do so gradually. Parents are supposed to notify the school of any head injuries that students get outside of school, and those numbers are also reported to the state.

The new law applies to public middle and high schools, and any school subject to Massachusetts Interscholastic Athletic Association rules.

The new emphasis is raising awareness around the region and comes as professional leagues, especially football, are in the spotlight because of concussions and brain damage caused by years of hits.

In Arlington, Superintendent Kathleen Bodie told Town Meeting earlier this month that an additional $22,000 has been included in the school system’s budget for new football helmets in an effort to prevent concussions. Parents had complained that the team was using outdated equipment.

The American Journal of Sports Medicine published research in April suggesting that younger athletes and female athletes take longer to recover and exhibit more concussion symptoms than athletes who are male or older.

And as a lot of local parents have seen for themselves, girls can play hard.

“Technically, checking isn’t allowed in girls’ hockey, [but] there is contact,” said Paul Lilla, an athletic trainer in Westwood, which counted four potential head injuries in girls’ hockey. “That being said, hockey is still, even with the girls’ level, it’s a high-paced game. There are collisions and that’s a mechanism for concussions.”

Coaches and trainers have come a long way in recent years in terms of understanding and managing concussions, said Lilla. And one of the biggest differences, he said, is due to ImPACT, a computerized cognitive test used to help evaluate when an athlete is ready to return to play. It is not required under the new law but is being adopted by more and more high schools.

There does come a time when a player should be counseled to cease contact sports, said Eamonn Sheehan, head athletic trainer at Lexington High School, which recorded three head injuries in boys’ basketball.

He said he can only remember two such dire cases recently — one in football and one in girls’ basketball.

“I strongly advised them not to return to contact sports,” said Sheehan, who added that only one took his advice.

Both had a doctor’s clearance to continue playing, but he said he didn’t fault the physicians. There’s a certain “X factor,” he said, particularly because research into head injuries is ongoing and so much is unknown. But if a player has repeated concussions in a short period of time and a long recovery rate, that, to him, is a significant warning sign.

“It’s a judgment call,” said Sheehan.

“My thing is big picture. I want you to think beyond this current season.”

Lisa Kocian can be reached at lkocian@globe.com. Follow her on Twitter @GlobeLisaKocian.

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