EAST BRUNSWICK, NJ - It is not just the football players that need to be concerned. Soccer players of both sexes are next, then the cheerleaders. The brain damage caused by repeated concussions is an equal-opportunity offender. Wrestlers, basketball players, lacrosse players are vulnerable, too.
Just ask Phil Hossler, East Brunswick's athletic trainer since 1984. He wrote the book on concussions. Actually, he wrote two of them.
The importance of recognizing the role of concussions in sports has once again been put in the spotlight by the release of the new movie Concussion starring Will Smith as Dr. Bennet Omalu. Concussion focuses on the humanity and the science involved in uncovering CTE (Chronic Traumatic Encephalopathy), "a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head." Known to affect boxers since the 1920s (Remember the terms "punchy" and "punch-drunk"?) CTE develops over time and has impacted many former players in the National Football League, driving them to depression, violence and dementia.
Concussion tells the story of one such player, Iron Mike Webster of the Pittsburgh Steelers, a Hall of Fame center and four-time Super Bowl champion. As one Steelers fan in the film described Webster's poweful and violent peformance on the field: "We needed him. We used him. We leaned on him."
Webster's subsequent mental decline, then death and autopsy led doctors to perform detailed examinations of his brain and ultimately to the discovery of CTE.
The film also references ESPN's former feature the "Hit of the Week," a visual and aural review of crunching acts of game violence. Dr. Omalu calculated that Webster had taken at least 70,000 blows to the head in his years as a student player at Wisconsin and in his 18 seasons in the NFL.
"If only 10 per cent of mothers decides that football is too dangerous to play, that is the end of it," said NFL Commissioner Roger Goodell in Concussion. Is the answer to preventing the collapse of the memory, emotion, and judgment of veteran players caused by CTE to stop kids from playing sports, especiallly those which place them in the position to get hit in the head? According to Hossler, that is not the answer at all.
"If you want to change a philosophy, you need a large event with a consistent attack on the behavior. You can't give it a workshop or a weekend," says Hossler on the need to educate parents, teachers, coaches and students about what concussions are and how they affect the brain. Hossler's books on the subject, written in 2006 and 2010, build on each other and are backed by the newest science of sports medicine. "I am much better at this than I was 10 years ago," he said of his own focus on concussions and their lasting effects.
At Churchill Junior High School and East Brunswick High School, athletes are given a computer-based "neuro-cognitive assessment" to establish their baseline brain skills ("It's a fatiguing test that some kids say is harder than the SAT," Hossler said. Student athletes are tested for instant memory, speed of processing, and delayed recall, taking them through important brain functions. Hossler uses these tests to compare to a recovering player's brain function to his/her baseline score before approving a player's return to practices and games.
Hossler and the East Brunswick Athletics Department also inform all the people associated with the student athlete inlcuding parents, friends, teachers, school nurses, and teammates, about what to look for in a student who has returned to home and school following a concussion.
"Athletes are getting smarter and more informed," Hossler said. He recounted his own experience of being knocked unconscious during a football game in college and not having good advice beforehand or afterwards about the aftermath of a concussion. He is glad that the age of "suck it up" is over and that athletes know not to hide their injuries and boldly "play on" despite an injury. Coaches also know not to allow it. "When in doubt, sit 'em out," said Hossler.
Do parents complain that their children are sometimes not allowed to re-enter a game or are sidelined for several days? "It's not my job to win or lose," he said. "I am not scared of coaches, parents or kids. It is a state law that ahtletes suspected of or diagnosed with concussions must be removed from the game. East Brunswick is watching all the cracks kids used to slip through. It all comes down to education. Widespread education is key, in the same way education about seat belts or smoking was key and changed behaviors."
East Brunswick Athletics Director Chris Yannazzo agrees: "We inform all our athletes and parents about concussions - how they occur and what to do about them. Hoss gives kids and families the best information. It's not just football, and it's lots of different sports. It's not just boys; it's the girls, too."
Hossler reminds athletes not to count too much on helmets, either. "Football and goalie helmets were invented to prevent facial and skull fractures. You can't 'bubble wrap' a player's brain. Some concussions occur without a player getting hit on or dropped on the head. Concussons result from the impact of the brain against the skull; they don't always require an impact to the head."
The information and perspective contained in the movie Concussion dovetails with those beliefs held by the East Brunswick's "first responder" to student injuries and concussions: "It's not just my opinion." Hossler hopes that whatever motivates the governing bodies of sports organizations - whether it be player safety or fear of litigation - leads to more education about prevention and care.
Along with many former NFL heroes, it is too late for Webster, Terry Long, Justin Strzelczyk or the other 15 Pittsburgh Steelers who died as a result of CTE. It is the right time, though, for young players in East Brunswick, in New Jersey, and across the nation to learn how to play smart and to speak up on their own behalf.