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Part 1 of a series of stories that will provide a first-ever analysis of high school concussions in Oregon

GRAPHIC FILE PHOTO - Although football is the sport most often associated with concussions, other sports like soccer, lacrosse and volleyball also account for a fair amount of the injuries every year.

The statistics are staggering. According to one study, on an average school day, more than 750 U.S. high school students will suffer concussions. A report published last fall by the Journal of American Medicine found that one in five American teens reported having suffered at least one concussion and more than 5 percent reported multiple concussions.

Behind each of those injuries is a story. For most students, it's a relatively tame tale: a headache, some rest, and then back to a normal routine.

But for others, it's a life-changing event — not only for them, but their families. Traumatic brain injury, as the name implies, is a serious matter.

A concussed brain — particularly one repeatedly rattled — can lead to short-term and permanent learning disabilities, chronic headaches, memory loss, insomnia, depression and uncharacteristic behavior.

While much of the concussion discussion centers on football, brain injuries can happen in any sport.

Just ask Sami Howard, who 15 months ago was finishing her senior year of high school at Columbia Christian and looking to play college basketball at George Fox University in Newberg.

Then, a contested rebound during her final home game sent her to the floor. The stomach-churning thud of her head on the hardwood signaled her fourth concussion, the end of her hoops career, a change in her college trajectory and lingering health issues she still deals with today.

Howard shared her story this week as part of Rattled: Oregon's Concussion Discussion.

The investigation, which will continue through the end of the year, will include regular print and digital content, shared by Pamplin Media Group and InvestigateWest, a nonprofit journalism studio conducting investigative and explanatory journalism in the Northwest.

Journalists at the two news organizations began reporting last fall, conducting preliminary interviews, reviewing academic studies and filing the initial round of public records requests. Their collection of stories, photos, videos and podcasts will be collected both at www.portlandtribune.com and rattledinoregon.org.

Although the reporting is not finished, some things already are clear, including the key role that athletics plays in the development of many young Oregonians.

"There are many studies out there that show that students who participate in activities do better in school," said Peter Weber, executive director of the Oregon School Activities Association. "It provides them that opportunity to work with team members, with coaches, with people from other teams, the officials. How to face adversity. It teaches them resilience, grit, and those aren't always things that can be taught in a classroom."

As Weber readily admits, athletic activities come with some risks.GRAPHIC FILE PHOTO - Oregon is regarded as a leader when it comes to protecting young athletes from injury.

The good news is that Oregon is viewed as a leader when it comes to protecting young athletes. Nearly a decade ago, the Oregon Legislature passed a law requiring high school coaches to be trained annually in spotting concussion injuries. It was the first law of its kind when enacted, followed shortly by a similar law in Washington.

School coaches in Oregon also are required to follow strict rules preventing students from playing sports when they show signs of concussion. The rules require medical releases for athletes with head injuries, to ensure they don't return to sports too soon, a move that can hinder a full recovery. Subsequent legislation extended similar safeguards to youth sports that take place outside high schools.

So, how many kids benefit from Oregon's pioneering laws?

No one knows.

That's because even though the 238 Oregon public high schools that participate in the OSAA have screened student athletes for concussions and documented their medical care for nearly a decade, no one in the state has ever analyzed, or even collected, the concussion data schools must keep. Until now.

Over the past six months, InvestigateWest has contacted every public high school in Oregon, requesting concussion records for the 2015-2016 and 2016-2017 academic years.

In announcing the initiative last fall, InvestigateWest managing director Lee van der Voo acknowledged that the public records push might set off alarm bells.

"We understand that the statistics, which have never been made public, may cause concerns," she wrote. "But they also may help us uncover best practices to prevent and heal concussions sustained in youth sports. The data may also help us determine whether some schools' unique responses to youth concussions are working and, if so, whether they can be duplicated in other districts."

The data also may highlight problems. Our reporting already has uncovered some flaws in the laws and poignant examples of what can go wrong, even when best practices are followed.

Those issues, and others, will be covered during the course of the series. But reporters, supported by national and regional partners, also will focus on what's working and what might be done to keep kids even safer and, we hope, foster a statewide discussion about the topic.

As van der Voo wrote last fall, "We think that the safety of kids who play sports is important enough to collect this data and find out what it can tell us."

The payoffs and perils and sports

The OSAA helps students, parents and coaches navigate the rewarding and risky world of high schools sports

When it comes to keeping high school athletes safe in Oregon, many parents and students may think of the folks on the front line: athletics directors, coaches and trainers. What they may not realize is that behind the scenes a nonprofit group plays a big role.

The Oregon School Activities Association (OSAA) has a broad mandate, overseeing everything from the upcoming statewide track meets in Eugene to the state choir championships in Newberg. And, for the past decade, they have been a driving force behind Oregon's efforts to reduce the risk of head injuries among high school athletes.

Earlier this year, OSAA Executive Director Peter Weber and Assistant Director Brad Garrett sat down with Lee van der Voo of InvestigateWest and John Schrag of Pamplin Media Group to talk about Rattled, the two news groups' collaborative investigation into Oregon high school concussions. (The following has been edited for clarity and brevity).

Rattled: Talk a little bit, since you both have a history in high school sports, about at what point head injuries started to rise to the top of concerns.

Garrett: I think 2008 was really a watershed moment for a lot of coaches and athletic directors, not only in Oregon but around the country. We started to learn more, specifically about concussions in general. That is when education efforts really started to come to the forefront about recognizing signs, symptoms and behaviors related to a concussed athlete and what are the appropriate steps to take from that point.

Rattled: What's the simple rule about concussions and participation in Oregon?

Weber: If a student is recognized to have the signs and symptoms of a concussion, they're removed from a contest so they can be evaluated by an appropriate health care professional. If it's determined that they do have a concussion, they don't go back in that day. That's kind of a baseline.

Rattled: Your organization has created some protocols and some best practices when it comes to preventing, identifying and responding to high school concussions. What are some examples?

Garrett: Obviously the sport of football gets highlighted in these conversations. It is a contact sport. We know that concussion does occur there. We were the first state in the country to require that every single coach, paid or volunteer football coach, is Heads Up Football-certified. Heads Up certification (developed by the federal Centers for Disease Control) means that you've taken a series of courses, essentially proper tackling, blocking, equipment fitting, heat and hydration, and concussion. You gotta take those five courses.

Rattled: You've moved now from "should" to "must." So what is your leverage to say you can't go out and have full-contact football practices five days a week?

Garrett: Well, the OSAA has the ability to fine our member schools, levy sanctions and forfeitures. They don't like that, but we will.

Rattled: Something that we're noticing in talking to parents and school officials throughout the series is maybe a tipping point, from taking these incidents seriously to having a real fear about participation. Are you seeing that also?

Garrett: We are seeing declining participation numbers in some contact sports, for sure. That's not just in Oregon; that's around the country. Parents are taking the notion that their son or daughter could be involved in an incident where they could have a brain injury. As parents, your natural instinct is to say, 'That sounds like something I don't want my kid involved in.' So that's where you, as a parent, have to weigh the benefits versus the risk.

Rattled: We know why parents would want to avoid risk for their kids. Tell us what the pros are. What are the benefits of playing sports?

Weber: I think there's a tremendous number of benefits. Just from a personal standpoint, a lot of who I am today as a person and the role that I play in the organization is because of the experiences in my life growing up and participating in activities and athletics. There are many studies out there that show that students who participate in activities, no matter what the activity is, do better in school, have better attendance rates, are more likely to graduate. It provides them that opportunity to work with team members, with coaches, with people from other teams, the officials. How to face adversity. It teaches them resilience, grit and those aren't always things that can be taught in a classroom

Garrett: Pete and I happen to have two sons that are right in the same grade level. My son, Mac, is an 11-year-old. Right now Mac is wrestling, and I picked him up from practice the other night and he asked me if it was really worth it. Mac has not won a wrestling match this year, he's 0 and 14. But you know, I'm watching my son not give up. Watching him grow as a person. It's really a great time in my life watching my young son understand that life isn't always fair. It's a hard lesson. He's questioned it several times, but I'm proud of the fact that he's working through that right now. And as I see that later in his life, that is going to benefit him greatly, and I don't know too many venues where you can get that situation, outside of athletics.

Rattled: And, as you've noted, there also are risks

Garrett: Our experience as the Garrett family is that 'Hey, as long as these organizations that are governing these activities and the coaches that are coaching it are as well-trained as possible to know and understand what actions to take, I'm more than comfortable in allowing my son to participate.'

Rattled: What's changed since 2008?

Garrett: One of the dynamics that's shifted over the last 10 years is parents who have become a lot more involved in programs. You know, it wasn't, 'Well the coach said this, and we shut the door on the parents.' Parents can educate themselves, they can question, they understand the protocols that should be in place. And that's been a welcomed thing. Parents need to be involved in those programs.

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