HEAD GAMES
This article was written for Carroll University's magazine, F1RST.
From the stands at Schneider Stadium, a spectator can easily hear the sounds of a Pioneer men’s football game: a quarterback calling out plays at the line of scrimmage, the defensive players yelling instructions to one another, and the hits. The hits. The shuffling low sounds of players tackling one another, the click-clacking of pads against pads, and, once in a great while, the sharp bang that cuts through the autumn air like a rifle’s report when two helmets collide. It’s a contact sport, football. The players – strong, fast and big – swarm to the ball and to each other like angry bulls. Soft cushioning and hard armor help to soften and absorb the hits, but bruises, sprains and breaks do occasionally occur. Those injuries are easy enough to deal with, at least from the perspective of a physician or team trainer. There is a protocol in place of wraps, or casts or ointments and a pretty good idea of how long the recovery will take. But when the injury is to the head, when that searing thunderclap of helmet on helmet echoes in the stadium and shakes the leaves on the trees, well, all bets are off. A concussion is a traumatic injury to the brain, that humming three-pound mass of close to one hundred billion neurons that allows us to think and to move and to be, really. When it gets violently jostled by a hard blow to the head, it slams up against the skull, and chaos ensues. The symptoms of a concussion are numerous. They vary from individual to individual and from concussion to concussion. They may include a short lack of consciousness, nausea, vomiting, dizziness, headaches, sensitivity to light, noise or other stimulation, confusion, vision problems, issues concentrating, loss of memory, depression, anxiety and balance issues, though this is not a complete list. The symptoms usually clear within several days, though they can linger for weeks, even months, and there are worries the effects may be deeper and more long-lasting than we’d imagined. Concussions aren’t confined to contact sports, or even to sports. A fall on a slippery sidewalk, a car accident, or even hitting your head on an overhead cabinet can give you a concussion. But contact sports up the risk. And in a contact sport like football, where collisions occur on every play, concussions happen. In the not-really-so-old days, they were called dingers, or getting your bell rung. Players would shake off the hit on the sideline, take a whiff of smelling salts, and run – or wobble – back on to the field of play. Which is about the very worst thing you could do. We know that now. We know that because of more sophisticated medical testing and imaging technology. We know the effects of a concussion can last days or even weeks. And we know that the risk of another concussion is far greater in the first week or two after the initial concussion. However, while it’s true that medical science has made great strides in increasing our understanding of brain injuries, much is still unknown. For example, some research seems to suggest that a major blow to the head isn’t all we have to worry about, that an accumulation of much smaller bumps and jiggles can cause damage as well. And then there is the potential of long-term impact. Chronic traumatic encephalopathy (CTE) is a progressive degenerative disease of the brain. Though it can only be detected postmortem, individuals suffering from CTE often show symptoms of dementia when alive – such as confusion, memory loss, depression and rage. Most of us have heard about the autopsies conducted on former pro football players by the Center for the Study of Traumatic Encephalopathy, which diagnosed CTE in 96 percent of the players analyzed. That’s alarming but incomplete. For instance, we don’t know how many of us who aren’t former professional football players may someday develop CTE. “One of the dilemmas in the field now is that there really aren’t any randomized studies of the general population (to determine the “normal” prevalence of CTE),” said Steve Staab, Carroll’s head athletic trainer. “In effect, that research is pre-selecting players with known conditions. It’s sort of like going to the cardiac ward to do a heart study.” While the news stories are frightening, we just don’t know how those numbers compare, nor can we draw direct links between concussions suffered decades ago and symptoms displayed in old age. Yet. Back on the field at Schneider Stadium, about 60 members of the Carroll men’s football team are wearing specialized helmets, equipped with sensors that record all the hits, rattles and rolls each player will experience during the game. They are part of an ongoing study being conducted by Dr. Michael McCrea, professor of neurosurgery and neurology and director of brain injury research at the Medical College of Wisconsin in Wauwatosa. The data collected will also be used in a far larger $30 million study into brain injuries being funded by the NCAA and the Department of Defense. It’s been a boon to Carroll medical and training staff to be located so close to McCrae. “It’s a wonderful resource to have nearby,” said Staab, who has called the researcher with his own questions. For his part, McCrea praised Carroll University, adding that the school has been a valuable partner in his research. The student athletes who volunteer for the study receive a small financial stipend when they undergo baseline testing and then again for any testing conducted post-concussion. The school receives the specially-equipped helmets. And everyone – medical and training staff, athletes, coaches and parents – gets a bit more information about a frightening and complex subject. Staab said the buy-in from Carroll’s coaching staff has been great. It can’t be easy to rest a star athlete before a big game but the student athlete’s health and welfare comes first. As for the athletes themselves? Well… “There are many who are very aware of the subject, but some are still in denial. Athletes are competitive, that never changes,” noted Staab. “They want to get back out there and compete.” Staab’s job then is to help educate them about the risk involved in returning too soon. And having objective data that illustrates just how much his or her performance has been affected helps convince even the most competitive athlete. Greater awareness of concussions and their impact is a happy byproduct of the huge (some 37,000 male and female student athletes are involved) NCAA study. The long-term goals are to develop better prevention, protection and treatment of head injuries. “We are already far ahead of where we were even ten years ago in how we treat concussions. And we know we need to get better.”
Life lessonS
This article was written for Carroll University's magazine, F1RST.
You can learn how the body is put together, memorize the muscles and tendons of the shoulder, practice feeling a pulse or stretching a calf, but how do you learn to talk to someone who is chronically sick, or to a frightened child? How do you develop a caring attitude? How do you educate empathy? What makes a good physical therapist? What does it take to become a good health care provider? Knowledge, sure. Critical thinking, too. And technical skills. But a kind heart, a good ear and a compassionate soul are all at least equally important, though they may be a touch more difficult to teach. At Carroll, there is a growing emphasis on the “care” in health care and numerous efforts underway to build compassionate, well-rounded students. Therapeutic Abilities Clinic (TAC) Craig Joerres has dark curly hair, a warm smile and a genuine affection for the students and faculty at Carroll’s Therapeutic Abilities Clinic. “I love it here,” he said. “I don’t like to miss this. I get so much value from it.” He’s been coming to TAC for six years now, maneuvering his wheelchair into the Sentry Building clinic every Tuesday and Thursday afternoon. When he arrives on this Thursday afternoon, he’s warmly greeted by faculty and students. Spend time here, and it’s hard to know who benefits most from his visits. Craig suffered a stroke at age 42. He’s accepted now, he says, that he is never going to get that life or that body, pre-stroke, back. “No,” he explained. “My only interest is in my quality of life.” Which is why he comes, twice a week, to work with students in Carroll’s Physical Therapy Program. Here, he’s paired with students who will spend a semester at the clinic. For nearly four months, they will work with him, gently guiding movements, recording his progress, listening to his feedback, joking back and forth. “We’ve made some great gains – small gains, yes – but positive ones, over the years,” said Craig. Those gains mean small but measureable improvements in his quality of life. That keeps him coming. That, and the laughter. “I am kind of known for joking around and giving the kids a hard time,” he admitted. More importantly, he is sharing his experience as a stroke victim with these students. Working with him and with the other three dozen clients who attend the clinic, they experience real bodies with disabilities and other health issues. This is far different from practicing on themselves or on each other in class. This is real life. “We definitely need each other,” said PT student Malerie Kurt. “I’m just so grateful to the members of the community who come to our clinic and facilitate this experience for us. By being able to apply what you have learned to someone who isn’t completely healthy, you learn so much more.” You also learn to give. “This program does that, it teaches us that giving back to the community is important,” said Kurt. “That’s such a big part of Carroll’s mission.” The training may be professionally oriented, but the lessons extend to all parts of life. Students start the semester getting to know their clients, by conducting interviews with them and consulting with notes left by previous classes and other students who may have worked with the person. In so doing, they practice the collaborative process that will mark their professional life. And, while they may begin by seeing a disability, they quickly come to see a whole person. Bonds are forged during the semester, the casual laughter and friendly joking building intimacy. Joerres allows that he has attended several commencement ceremonies over the years, to support his new friends on their big day. Gary Schoenicke has been coming to the clinic for three years. “It doesn’t seem that long,” he said. “Time flies when you’re having fun.” Schoenicke has had cerebral palsy all his life. When a job ended several years ago, he lost more than employment, he lost a large part of his social life. The clinic, which is free, gives him therapy he couldn’t otherwise afford, but the social interaction is priceless. “We’re here to provide wellness services to clients with neurological issues,” said adjunct lecturer Kris Erickson. “And part of one’s wellness is your social life. It’s not just the students and clients bonding, the clients bond with one another and with their families.” “You don’t realize what a benefit this is for us,” Schoenicke agreed. “When my work stopped, I missed that social life so much. So I try to give back and help (the students). I let them know how I’m feeling, what feels right and what doesn’t. It benefits us both.” Unsaid but just as important, it benefits the men, women and children these students will one day treat as professional physical therapists.