THINKING CLEAR

Bryce Alderton

A computerized test developed by a Newport Beach neuropsychologist

that football players at Newport Harbor first took to help prevent

them from returning to the field prematurely after a concussion has

found its way to Costa Mesa High with the urging of its coach and,

depending on reviews, could sprout to other high schools in

Newport-Mesa, Sage Hill and throughout Orange County.

Newport Beach neuropsychologist Douglas Harrington administered

the Immediate Post-Concussion Assessment and Cognitive Testing

(ImPact), a Microsoft Windows-based program that measures cognitive

activity such as word discrimination, design memory and visual

attention span, to the Newport and Costa Mesa players. After a player

has sustained either a concussion or blow to the head in practice or

a game, he or she retakes the test and is advised to return to play

only when the athlete reaches his or her “baseline” level.

Six or seven Newport players and about same number of Costa Mesa

players have taken the tests with both Newport and Costa Mesa coaches

Jeff Brinkley and Dave Perkins praising the program.

“Everyone feels comfortable, the athletes, coaches and family,”

Brinkley said. “It puts everyone’s mind at ease. I’d rather have a

player out two weeks that to rush back.”

All of Costa Mesa High’s 98 football players on all levels took

the baseline test and five or six have retested since Coach Dave

Perkins and staff began using the program after the team’s second

game this season.

One player missed a game and another missed some practices,

Perkins said. He added that all players that retook the test have

been back playing in two weeks, but only after they show no symptoms

such as headaches or dizziness.

The school financed $2,000 for the program and Perkins said it’s

been well worth it.

“It’s been terrific for us,” Perkins said. “It gives us immediate

feedback and the physician has even more information to make a

determination on what a player needs.”

Harrington spoke with Corona del Mar High Coach Dick Freeman at

halftime of this season’s Battle of the Bay game pitting the Sailors

and Sea Kings about instituting the program at the high school next

season. Harrington hopes more schools will learn about the procedure

and consider using it.

It’s a program that’s just getting off the ground locally,”

Harrington said. “But I’m looking at expanding the program broad

stream. I spoke with the CIF office last spring to promote it more

statewide. I think (the Impact test) has been going very well. It

helps the physicians feel more comfortable with returning the

athletes to play.”

Newport Harbor and Costa Mesa are the only Orange County high

schools currently using the program, Harrington said. More than 200

high schools in the United States use the program as well as the

Pittsburgh Steelers, Philadelphia Eagles and seven other National

Football League teams, all National Hockey League teams, 85 colleges

and universities, the Swedish World Cup Soccer team and Championship

Auto Racing Teams (CART).

Mark Lovell, Ph.D., Director of the University of Pittsburgh

Medical Center’s Center for Sports Medicine Concussion Program

partnered with UPMC and Steelers’ team neurosurgeon Joseph Maroon to

develop the ImPact test.

Newport senior tight end Paul Toman missed one game and practice

time until he retested back to his baseline level. He suffered what

Harrington termed a “mild concussion” and took the memory test three

or four days following the concussion, but only after symptoms

dissipated, said Newport’s athletic trainer Brian Melstrom.

“The player has to have no nauseousness, is thinking clearly, is

not confused or dazed to retake the test,” said Melstrom, who assists

Harrington with administering the exam and is in contact with a

player’s family physician.

In Toman’s case, he also saw a family physician, who advises if

and when a player is fit to return to play. Toman didn’t meet

baseline levels the first time he retested so he was held out for 10

days, missing one game and practices.

Melstrom hails the test as more objective than subjective.

“If a player doesn’t test back to baseline levels we hold him out

until he retests back to those levels and he’s running around the

field with full exertion and blood is circulating through the brain,”

Melstrom said. “I think the system works really well. It’s more of an

objective test than a subjective test where a player might say, ‘I

feel fine and I’m not dizzy,’ but he doesn’t pass the test. This test

doesn’t lie. Every doctor and every trainer has a subjective opinion

about how bad something is and this is a more objective measure of

what’s going on inside the brain.”

One can never be too cautious when it comes to head injuries,

Melstrom said.

“I think every football program should have it,” Melstrom said.

“It’s very painless, taking only about 30 minutes per person. I would

rather take one or two hours of time to be careful than push people

into football and have something catastrophic happen.”

Kelli Colby, mother of the late Costa Mesa High football player

Matthew Colby, who died in September 2001 after taking himself out of

a game against Westminster High, collapsing shortly thereafter and

eventually dying from brain injuries that caused bleeding and

swelling, is in the early stages of championing the Matt Colby Head

Injury Foundation with the goals of raising money to research brain

injury and insert the Impact program in many places as will accept

it.

Colby, who recently moved to Santa Rosa, believes schools can do

more to address the problem of concussions and or brain injuries.

“Some are better than others and cover the spectrum of efficient

and good to just horrible,” Colby said, referencing the way schools

and organizations handle taking care of players who suffer head

injuries. “We’re smarter now, we have more money and we’re aware of

the long-term effects. I’m committed to do whatever we can at the

foundation to find out about head injuries and to advocate safe

conditions for student-athletes. I want to help raise money to help

the less-privileged schools with preseason physicals and injuries to

get the information out and prevent catastrophic injuries from

happening like they did to (La Verne quarterback Rollie Dykstra) and

my son.”

Dykstra, 24, a La Verne College quarterback, is in comatose and

serious condition at Pomona Valley Hospital Medical Center after

sustaining a head injury on a second-quarter option run in La Verne’s

game against Redlands Oct. 19.

Dykstra’s girlfriend and father contend that the quarterback

suffered a concussion after being sacked eight times in a game

against Claremont-Mudd-Scripps. Ross has told the Times that Dykstra

told her he informed La Verne trainer Jim May of headaches but

received no medical treatment prior to the Redlands game.

La Verne spokeswoman Deborah Mandabach and May have refused to

comment.

Estancia Coach Jay Noonan had not heard about the program, but

showed interest when asked if he would like to see the program in

place at the school. He said in his 15 years of coaching football, a

player’s safety has always been the No. 1 concern.

“In 15 years of coaching I can’t remember a time when we weren’t

completely cognizant of looking for the best interest of our

student-athletes,” Noonan said. “We put safety above anything else.

Our district does a great job in replacing equipment that doesn’t

meet safety standards and the district has never asked us to pinch

pennies when it comes to equipment for our kids.”

Estancia quarterback Brad Young suffered a concussion earlier this

season and was held out of practice for a week with no physical

contact and the coaching staff still held him out of a game against

Katella even though a physician had cleared him to play, Noonan said.

“Anything that scares us we are on the side of caution,” Noonan

said. “I’m comfortable with the procedures the district has set forth

in accordance with what we’re prescribed to do from the medical and

training staff. I for the most part stay clear of those decisions and

will ask to see what the diagnosis is from the trainers and doctors.

And that’s with anything, ankles and knees. I go along with the

professional’s decision -- I don’t make the decisions to clear a

player or not.”

Corona del Mar’s team physician, Andrew Gerkin, and trainer Paul

Lachiniloa, use a criteria that Dave Chapin introduced in 1996-97

when he was the Sea Kings’ athletic trainer. Chapin is now the head

athletic trainer at Fullerton College.

Under the system, a player who displays symptoms, such as

headaches or dizziness, although Freeman said the symptoms vary

depending on the player, cannot practice for a week until a doctor

has determined the symptoms have subsided.

As soon as the symptoms stop, an athlete performs a stress test

and exercise test to assess if the symptoms reoccur. If the symptoms

reoccur within a week’s time, the player cannot exercise at all,

Freeman said.

Junior wide receiver Andrew Fowler suffered his third concussion

earlier this season and will sit out the rest of the season, while

junior tight end Casey Hales suffered his second concussion and has

been sidelined for four weeks with persistent symptoms such as

headaches and dizziness this season.

“We tell our kids there’s no way to hide from (concussions),”

Freeman said. “We need to find out what’s wrong -- that’s more

important than high school football.”

Former CdM defensive end Justin Wald suffered his third

concussion, which turned out to be a brain contusion, after a blow he

suffered to the head in a game against Estancia in 2000

Wald spent a day in the hospital in intensive care following the

contusion and had an MRI done by CdM team physician Steven Jennings,

Wald’s family physician at the time. He hasn’t played football since

the injury even though doctors told him he could go back if he wanted

to.

“(Playing football) wasn’t recommended, but I haven’t wanted to

play football again,” Wald said.

The 2002 Sea King graduate said he doesn’t suffer any loss of

memory and said his grades improved following the contusion.

He suffered his first and second concussions during his freshman

and sophomore seasons with the Sea Kings and sat out one game during

those seasons before returning.

“For players, (the ImPact test) is a way of knowing they are

better and can go and play because it’s a risk to go back quick,”

Wald said. “I didn’t feel like I rushed myself in coming back. But I

wanted to go play and not sit on the sidelines.”

Wald said his parents speculated at the time of his concussion

that he didn’t have enough air in his helmet.

“At the time I never really thought about checking the air in my

helmet,” he said.

With the rash of head injuries plaguing football players, the test

is a step in the right direction toward Kelli Colby’s goal of

educating more people about the seriousness of concussions.

“Just asking, ‘Are you OK?’ is not the answer,” Colby said. “Just

by doing the test itself kids become aware of the things that are

involved in a head collision and if they are hit, they can recognize

symptoms and ask to be tested again.

“The idea that the brain is not injured unless one loses

consciousness is an antiquated idea.”