Concussions: Centre’s Conservative Approach
The following conversation with head athletic trainer Jamey Gay and college physician Brian Ellis ‘86 is the second installment in a three-part Centrepiece series exploring “the concussion issue,” including ongoing research at Centre College and the conservative and proactive approaches taken by Centre Athletics.
Concussions have become a considerable concern at every level of college sports, both because of their immediate impact as well as the possibility for continuing adverse effects over the long term. Centre’s approach to treatment is conservative and holistic.
Head athletic trainer Jamey Gay, College physician Brian Ellis ’86 and Amanda Goodwin, physician assistant in Parsons Student Health Center, work together with the injured athlete—and the student’s professors—to ensure the health of Centre’s athletes in the event of a concussive brain injury. Recently Gay and Ellis sat down for a conversation about how Centre addresses concussions.
Jamey Gay: We have managed concussions very conservatively and proactively for at least the last decade. The biggest change now is that we do preseason baseline testing—memory testing, balance testing, recall testing—all things that would be affected if you had a concussion.
Brian Ellis: So much of diagnosing a concussion is subjective. Having the baseline is really important.
Gay: One of Dr. Ellis’ rules has long been that students have to be symptom-free for one week before they can begin to return to play. The day after you are symptom-free—with no headaches, no nausea, no dizziness, no fogginess—you begin the concussion protocol by riding a bike for 30 minutes. The next day you increase the intensity of the ride. The third day you run on the field with some bounding and making your head change directions and levels to see if the brain tolerates that. If at any of those steps you have any symptoms, then we start over from the beginning.
Ellis: If you’re having symptoms with exertion, you’re not symptom-free. Same thing in the classroom; it’s not unusual for students to say, “I feel good today,” but 15 minutes into reading, their head is pounding and they feel nauseated. We know it’s best for students to rest the brain for two or three days. Screen time: shut it down. Computers, music, video games: shut them down. We want your brain to rest. As you start to feel better, study for 20 minutes, then take a break.
Gay: A concussion is a bruising of the brain. A lot of people, and I’m one of them, believe every time you have a blow to the head that results in you having a headache, you should classify that as a concussion. That’s one of the things Marcia Mount Shoop ’91 points out in her story: all the subconcussive events. The brain is floating inside that fluid in your skull. When that brain comes forward and compresses and rebounds against the skull, there’s force there.
Ellis: We really need to be as conservative as we can managing concussions. The NFL was not doing that, which is one reason why they’re in a big mess now. We feel like we’ve been ahead of the curve in that regard for a long time in the way we manage our athletes.
Gay: We are much more intentional. We’ve always done education, especially with our football team, about the possibility of head trauma and concussions and how to manage that, but now we’ve expanded education to all of our athletes.
Ellis: We’re seeing more concussions. I think there’s no question it’s a component of the fact that our athletes are bigger, stronger, faster than they used to be, certainly more so than when I played football here 30 years ago.
Gay: We have 10 to 15 concussions a year just on the football team.
Ellis: I would say we see concussions from the other sports almost every season; almost always soccer and lacrosse. Concussions have the potential to touch a lot of different parts of Centre’s community. Some kids come to Centre having had two or three concussions in high school. That’s part of the survey we do early on: how many have you had and when was your last one. Statistically, you are more likely to suffer another concussion if you’ve already had one. But there is no good information on how many are too many.
Gay: An important part of Centre’s concussion management is the way we involve student health and our faculty as part of the team. We also talk about concussions during preseason training. I do think that because of the education and our process of handling them, students know the importance of reporting any concussions.
Ellis: Being able to play their game to a very high competitive level is important to many Centre students, so it’s important that we’re doing all we can for their safety. The potential for danger is there. The potential for benefit from playing the sport is also there. All of life is a balancing act. Historically, presently, and I think in the future, sports are going to be a big part of the Centre experience. I think it should be, and I want to make sure we’re doing it well.
Edited from a conversation with Diane Johnson for Centrepiece
August 11, 2016