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08/25/2016 12:00 AM

An Examination of Concussions


Old Saybrook-Westbrook football Head Coach Mike Marone discusses concussion safety with his team before a recent practice. Photo by Kelley Fryer/The Courier

Playing sports is supposed to be fun for athletes. It’s an activity that often builds character, teaches one how to work with others, and yields friendships that last a lifetime. Unfortunately, the downside of giving it your all on the field are the injuries that inevitably occur and one of the most-dangerous injuries any athlete can suffer is a concussion. In 2012, former National League Football (NFL) player Junior Seau and former Major League Baseball (MLB) player Ryan Freel committed suicide and tests later revealed that both athletes’ brains showed signs of chronic traumatic encephalopathy, a degenerative neurological condition associated with multiple concussions that can only be conclusively diagnosed postmortem. In soccer, two-time United States Olympic gold medalist Cindy Parlow Cone announced her retirement from international play in 2006, citing post-concussion syndrome. Concussions are a huge concern in sports these days and, in this story, we look at the negative affects they can have on athletes, along with what local coaches and doctors are doing to diagnose symptoms faster in order to protect athletes.

Suffering a Concussion

Ten years ago, Middletown’s Joey Witkowski was an All-State baseball player at Xavier High School. Witkowski then competed at St. John’s University, after which he played professionally in the minor leagues with the Houston Astros and Washington Nationals organizations. However, Witkowski saw his rise through the ranks derailed by multiple concussions that ended his career at age 25. It all started when Witkowski was hit in the back of the head with a pitch during his senior year at St. John’s.

“After I got hit, I was blinking and had a ringing in my ears, but I stayed in and caught the next inning before coming out. The next day, I got hit in the head again and played the whole game. It was the Big East-Big Ten Challenge and there were a lot of scouts there and I was doing really well, so I wanted to keep playing,” Witkowski said. “Catching is a tough position and you take a beating all year and, at the end of the season, I wasn’t feeling quite right.”

Witkowski signed with the Astros and played in the minors, where he suffered his second concussion when he was behind the plate and a bat struck him on the follow through. The next season, Witkowski took a foul ball off his catcher’s mask.

“My ears just exploded and I remember seeing my manager Stubby Clapp’s face and he looked concerned, but I shook it off,” said Witkowski. “There’s an old saying in pro sports that ‘You can’t make the club from the tub,’ so I just kept grinding.”

When Witkowski and his team returned home from that road trip, he went to a 7-11. When he got out of his car, Witkowski left it in drive and the car rolled into the store’s brick wall. Witkowski immediately drove to his team’s training facility and spent the next month “hanging out” as he wasn’t cleared for baseball activity. Witkowski felt his dream of becoming a Major League Baseball player slipping through his grasp. One of the hardest parts was dealing with the isolation of “the darkroom.”

“I would spend hours in a room, alone, with the lights off as treatment. It was very depressing. I was sitting in this room for hours and, when I wasn’t in the darkroom, I was away from the other players and thousands of miles away from my family and friends in Connecticut,” he said. “The other really hard part to comprehend as a player was that I felt fine physically.”

The Astros eventually released Witkowski. The Nationals signed him and, even though Witkowski was routinely hitting 95 miles per hour on the radar gun, they voided his contract after receiving the Astros’ medical report.

“I got the tap on the shoulder to go see the suits, which is never a good thing. Doug Phillips, the Nationals’ Farm System Director, [called me into his office] and about 10 other guys [were there]. He said because of my medical history they just couldn’t take the chance of me getting another concussion. I could take a comebacker on the mound or get hit covering first and that could cause serious damage to me. They were all really broken up about it, as I was, too, of course,” said Witkowski. “In the end, I feel grateful to the Nationals because they were more interested in preserving my quality of life than baseball. Who knows what another blow to the head could’ve done?”

Prevention, Testing, and Treatment

One of the problems with concussions is identifying the signs and how to treat the symptoms. That’s where sports clinics like HeadZone Concussion Care in Shelton come into play. Medical Director Dr. Karen Laugel spends countless hours caring for people who’ve suffered head trauma.

“There are three main steps to diagnosing a concussion and those are testing the athlete’s eyes, cognition, and balance. We work with schools and teams before the season to do baseline testing, which can help to gauge the severity of the case. For example, one screening test involves recording the player’s speed and accuracy, while reading a sequence of numbers after the athlete is injured. The coach or trainer or parent can use the initial test to see how the subject fares in the reexamination and determine whether they can continue to play or not,” Dr. Laugel said. “One of the main problems is that most concussions do not occur from a blow to the head because many are caused by whiplash. If the player doesn’t get hit in a head-on collision or take a direct blow to the head, they don’t think they’ve suffered a concussion and won’t report the symptoms to their coaches.”

Some sports have changed rules to try and decrease head injuries. In the NFL, players are no longer allowed to initiate forcible contact by delivering a blow with the top of the helmet against an opponent when both players are clearly outside the tackle box, plus penalties are also issued for hits made on defenseless players. MLB recently instituted rule changes to eliminate egregious home plate collisions. Other ways to help avoid head injuries are to strengthen certain areas of the body and make sure that you’re equipped with the proper gear when you take the field.

“One of the ways to prevent concussions is by building strength in the neck. A study by [Christy L. Collins from the Center for Injury Research and Policy at the Columbus Children’s Research Institute in Ohio] showed that for every pound of increase in neck strength, the chances for a concussion went down by five percent. Also, it is important to check your equipment to make sure it is not old, that helmets fit correctly, and that the bladder inside the helmet is pumped up. Helmets won’t necessarily prevent a concussion, but they will help limit the severity,” Laugel added. “In soccer, we encourage players to avoid heading the ball, to use their chest and knees rather than their head, especially the younger players whose brains aren’t fully developed yet. We would also like to see all girls’ lacrosse players and field hockey players wear helmets to help reduce injury. One of the sites we steer coaches and players to is www.cdc.gov, which is the Centers for Disease Control. They have a Head’s Up program that has videos and charts for free education for coaches, players, and parents to help identify and care for individuals who may be concussed.”

Mike Marone has been coaching football for more than 30 years and is currently the head coach at Old Saybrook-Westbrook High School. Prior to every season, Marone educates his players so they know what to do in every situation and he’s pleased with how the process of preventing and diagnosing concussions has progressed since his playing days.

“We have a meeting at the beginning of the year where everyone is informed about concussions and, once we get on the field, we are regulated by the [Connecticut Interscholastic Athletic Committee] rules of contact, so we only have 90 minutes of contact a week, unlike the old days. We are very careful with hitting drills, make sure we match up the same-size kids, and we have a freshman rule—two words: no contact,” Marone said. “We work on tackling every single day. We do 20 minutes of tackling circuits where we teach proper form and no longer use the head and do a shoulder tackle and everything we do is to avoid concussions. In my playing days, they gave me the smelling salts after you got knocked out and you got 15 minutes to get back in. Now, if a kid has a headache, [they go] right to the trainer and he’s on a five-day concussion protocol to return to practice and there is no fooling around. We don’t even bat an eye.”

North Haven boys’ soccer coach Federico Fiondella also has concerns about concussions and makes sure his players and fellow coaches know how to recognize the symptoms.

“All incoming freshmen automatically take a test that gets scored and the trainers and coaches can use the results to check on them in case of an injury to the head. Also, the [athletic director] has a meeting for parents and students, like an open house, where concussions are discussed,” Fiondella said. “As coaches, we are trained and we take a refresher course to make sure we are on top of things. In my case, if a player shows any signs, they are taken off the field—no ifs, ands, or buts. I won’t risk it at all because sometimes the symptoms—headache, dizziness, nausea, light sensitivity, loss of appetite—don’t show up until 24 to 48 hours later. Concussions are very peculiar situations, so we always err on the side of caution. You don’t risk hurting the kids to win. It doesn’t matter and it’s not even close.”

Valley Regional Athletic Director Jeff Swan agrees that knowledge is the key to ensuring player safety and feels that it’s crucial for everyone involved to learn as much as they can about how to deal with potential concussions.

“The major thing is education. All our coaches are certified in concussion protocol. They all know the signs and what to do in those circumstances. The CIAC is really doing a great job on the subject and pushing for people to be aware,” said Swan. “We spend lots of time training, taking tests, and every coach has to do 45 hours of classes and one of those is Module 15, which focuses on concussion management. In football, they have to take Module 51, as well, and, in swimming, they take Module 50, which has more details regarding those sports. We also have an ambulance at every football game and trainers and other people who can help. The state and Department of Education has been very proactive, and educating players, coaches, and parents is really the key to doing the right thing in those situations.”

Beginning in 2015, it became mandatory for all high school football coaches in the state to take the refresher course Module 51 after completing the concussion management course Module 15. The class must be repeated every five years, so that they understand the best practices for coaching the sport. There’s also Module 50, which is taken by swimming coaches because of the unique nature of the sport. Tim King, the head football coach at Valley Regional-Old Lyme, emphasizes the importance of such testing.

“Module 51 is a review of what concussions signs are and the effect they have on kids and what we should be looking for. We are not doctors, though, and I always fall back on our athletic trainers, who are worth their weight in gold,” King said. “It is vital for us all to know what to look for and how to handle situations with something as delicate and dangerous as concussions.”

In the end, sports remain an enjoyable pastime and that’s not going to change anytime soon. The thrill of winning a game under the lights on a Friday night or hoisting a state championship trophy is what every player dreams of, but whether they win or lose pales in comparison to whether or not they’re healthy. Protecting them from the effects of concussions by knowing the symptoms and how to treat them is critical for that to happen.

Old Saybrook athletic trainer Mark Dion (left) gets football player Anthony Jones set up to take the baseline impact test. Prior to each season, every Rams’ player must take the test before they can take the field. Photo by Kelley Fryer/The Courier