Concussions in sports aren't new, but the long-term effects of a concussion has become a hot-button topic. Athletic trainers, doctors and coaches for South Carolina are doing all they can to assist in prevention, preparation and proper treatment of student-athletes who suffer from concussions.
"The number one priority of the coaches on our staff is the safety and the health of their student-athletes," said John Kasik, Associate Athletics Director for Sports Medicine. "Our coaches are not going to argue with any of our doctors or athletic trainers. We're going to do what's right."
One of the keys for the athletic training staff at South Carolina is to educate student-athletes about dangers of not reporting symptoms and have multiple measures put in place as part of the protocol to make sure nobody is returning to action too soon.
Contrary to popular belief, concussions don't only occur on the gridiron. A study conducted at Ohio State in 2007 found women's soccer leads all other college sports in the number of concussions recorded. Data published by the American Academy of Neurology showed that females playing college soccer suffer concussions at rate greater than males in high school football.
A concussion is a brain injury. It can occur from a blow to the body as well as the head, and the individual may or may not lose consciousness. There have even been cases reported where an individual suffers a concussion from simply "heading" the soccer ball.
"It's sort of a whiplash injury where the brain gets forced in one direction and it has to come back and bang the inside of the skull," Kasik said. "Typical signs of a concussion would be a headache, blurred vision, nausea and balance issues. Some of the signs some people wouldn't think about would be irritability, loss of appetite, attention issues and the inability to concentrate."
Stephanie Rosehart has spent the last eight years as the athletic trainer for women's soccer at South Carolina. Standard protocol requires that any possibility of a concussion is treated seriously.
"We do an on-the-field evaluation where we question their memory and cognitive abilities," Rosehart said. "When we get them to the sideline, if they have any of the 22 to 25 symptoms of a concussion, then they're not going back in the game, and we'll treat them for a concussion. Our protocol is that we treat them until they are symptom free. Then we'll start them through our exercise progression and our neurocognitive computer test, known as our ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) system, to measure and make sure they're ready."
"As anxious as you are to get players back, you have to account for their health first."
Women's Soccer Head Coach Shelley Smith
Senior Taylor Leach suffered a concussion in last year's game vs. Clemson. The athletic training staff was out there immediately as she recalls being disoriented and feeling nauseas.
"They took me through all the steps," Leach said. "I sat out the next game. I had to do more tests the next week to make sure I was OK to play. They wouldn't just throw me back out there. Even though I wanted to play, I understood that I wasn't OK to play. I'm thankful for them now that they kept me out so I won't have any long-term head problems."
Student-athletes are treated daily after a concussion. When their symptoms start to subside, more ImPACT testing is done, and they have to meet certain criteria to be able to go back and play.
Just as an athlete with a sprained ankle will be told to stay off his or her feet for a while, an individual with a concussion is told to let his or her brain rest.
"We encourage them not to use their phones," Kasik said. "There's no texting, no playing games, no reading and no watching television. It's almost like an isolationism for the treatment. You need to let your brain recover and rest because if you're making your brain do a lot of work, it's like a muscle working, and it's going to take longer to heal."
South Carolina women's soccer coach Shelley Smith explains that while it is disappointing to lose a student-athlete for a period of time due to a concussion, she's not willing to risk their long-term health because of a big game on the horizon.
"I've never seen a student-athlete here come back before they were ready," Smith said. "We're not pushing them to get back in there. We tell the players to make sure they are honest with the athletic trainer when something's bothering them. That goes for any injury. As anxious as you are to get players back, you have to account for their health first."
Because there are so many different ways for the brain to suffer trauma, it is difficult to prevent every factor that would cause a concussion in soccer.
"You have to look at why there are more incidents in women soccer than men's soccer," Rosehart said. "Women tend to have less neck strength, so that could play a role. Our strength coach and I work together to make sure we're targeting neck strength and also teaching them proper form when going up for a header. Building strength and improving technique may lessen the risk to a certain degree, but you can't prevent everything."
There is not a one-size-fits-all timeline for an individual to return from a concussion. Similarly, there is not a particular number of concussions to determine whether someone must stop playing permanently. Unlike some other injuries, you cannot "play through" a concussion because the results could be catastrophic, and in some cases fatal.
"One of the other risks of going back too soon is having second impact syndrome," Kasik said. "That's when you get a concussion on top of a concussion, and that isn't twice as bad, it is exponentially bad. It could be 10 times as bad. We're not going to let that happen."
Rosehart explains that she has not had to medically disqualify a student-athlete from ever playing again due to a concussion, but she's not afraid to make that decision if the situation warrants it.
"You need the brain for the rest of your life, and they're going to have to go out, get a job and function in the world," Rosehart said. "You hear people say `it was only a slight concussion,' but you either have a concussion or you don't. All concussions are serious. It's hard to watch them go through all of it, but you do what you can to make sure you're doing the best for their health."