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New law requiring medical approval after a student athlete suffers a concussion comes under debate


Adam Kemp September 9th, 2010

While the new laws are a much needed step, regulations regarding more head injury training for coaches, faculty and parents might be the next issues to be addressed.

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Justin Barney would be a senior this year.

He could have been a captain on the football team, a shoo-in for homecoming king or the star pitcher for Rush Springs, just waiting to play college baseball for his beloved Rice University Owls.

These were the dreams of a 14 year old, and with just 3:52 left in a junior high football game in the town of Washington, Okla., in 2007, these dreams were left kneeling on the field.

Coaches aren't 'medical professionals'
Getting your 'bell rung'
Praying against the gridiron
Brain trust


Anyone you talk to would say it was just an ordinary play.

Justin, a freshman at Rush Springs, made a tackle, lined back up correctly three more times and then tried to leave the field.

Jim Nottingham, his uncle and legal guardian, noticed Justin looked like he was lost as he was leaving the field; Justin began moving his right leg as if he was trying to walk up a set of stairs.

It wouldn't have been out of the ordinary if Justin were pulling a stunt to make his teammates laugh. He was known for being goofy and always having a smile on his face.

But his aunt and legal guardian, Heather Nottingham, knew better.

When Justin reached the sideline, he dropped to his knees. As coaches asked him questions, Heather Nottingham said you could see the fear in his eyes.

"You could tell he was scared that he couldn't process where he was or what he was doing," she said. "He was able to say his name, but that was the last thing Justin said."

Justin spent 10 days in the hospital in a coma and had surgery on his brain to remove a hematoma caused by a broken blood vessel on the left side of his head. The doctors were unable to stop the swelling of his brain. Justin died Nov. 2, 2007.

While his death was a blow to his family and the Rush Springs community, it has also shed a light on an increasingly frightening trend.

Coaches aren't 'medical professionals'
In the U.S., sports and recreation-related concussions are estimated to be more than 3.9 million every year, according to the U.S. Centers for Disease Control and Prevention.

The Oklahoma Athletic Trainers' Association estimates that 25 percent of student athletes in the state will miss time, either practice or competition, from a head injury of some sort.

These figures do not sit well with Ron Walker, OATA president and assistant professor of athletic training at the University of Tulsa.

Walker said he thinks coaches are thrust into situations out of their field of expertise and asked to make decisions they should never make.

"They have to make a call regarding a kid's health, and sometimes it's not so obvious," he said. "It's nothing against coaches " they are paid to coach. They are not medical professionals."

Walker began the initial push for a bill that would help coaches by taking the decision out of their hands when an athlete is returning to play.

He teamed with Sen. Patrick Anderson, R-Enid, who authored Senate Bill 1700. On May 17, Gov. Brad Henry signed the bill into law.

The new law requires all athletes playing under the Oklahoma Secondary Schools Activities Association to be removed from practice or competition if suspected of a head injury, and to have written approval from a doctor before they are allowed to return to play.

The bill was modeled after a law in the state of Washington that was widely regarded for having the most restrictive rules regarding athletes returning to play after a head injury.

It also requires athletes and their parents to read and sign a statement that they understand the symptoms of concussions, and what the consequences can be if an athlete returns to play with a concussion.

Rep. Joe Dorman, D-Rush Springs, took the matter a step further when House Bill 1658 was approved by the governor. That new law states that doctors can serve at sporting events as a volunteer and be free from lawsuits, except for extreme negligence, under the Good Samaritan Act.

Dorman said the feeling of helplessness during Justin's accident increased as it took nearly 50 minutes before he received any treatment from a certified professional.

"It was basically just coaches responding and doing what they could," Dorman said. "I got to looking into it and realized that it was a problem nationwide."

Getting your 'bell rung'
While the new laws are a much needed step, regulations regarding more head injury training for coaches, faculty and parents " plus new rules for equipment upkeep " might be the next issues to be addressed.

Heritage Hall quarterback Sterling Shepard knows just how important both of those issues are.

Following a midseason switch from receiver to quarterback last year, the sophomore suffered a concussion against rival Casady after his helmet was too loose and ended up flying off and knocking him on the head.

After a few minutes on the sideline, he said he felt ready to re-enter the game, but the Heritage Hall training staff quickly corralled him.

"I have gotten my bell rung a few times," said Shepard, son of the late Derrick Shepard, a former NFL player and Sooner standout. "It just didn't seem any different from that, but the trainers wouldn't let me because they recognized the symptoms."

He said the coaching staff took every precaution and held him out of the next three games, but the worst was yet to come.

In a match against John Marshall High School in the second-to-last game of the regular season, Shepard " who models his game after the Tennessee Titans' Vince Young " decided against giving the ball to running back Barry Sanders Jr., son of Heisman Trophy winner Barry Sanders, and instead scrambled toward the sideline, where he looked up just in time to see the opposing defensive back coming full steam.

While bracing for the hit, Shepard and the defender collided head-to-head, and Shepard was left unconscious on the field.

His mother, Cheri Shepard, said it felt like he was unconscious forever. She began to think the worst.

"It was probably only less than a minute he was down," she said. "I just cried, because I didn't know what to expect."

He came to in the locker room a few minutes later. Shepard said it felt like he had a bad headache for a few days, but he didn't suffer from any other symptoms, like nausea or depression, which often coincide with a severe concussion.

The Shepards said they learned only after the accident that his helmet wasn't properly inflated to help it cushion his head during violent collisions.

Cheri Shepard said her son is fortunate his school had the training staff able to recognize and assess his injury, because they have the resources to make changes to help prevent accidents like his.

"I have heard horror stories of kids going back in and suffering a second concussion and then getting brain damage because no one caught it," she said.

Praying against the gridiron
With its new law requiring a doctor's written approval, Oklahoma becomes one of a handful of states to pass the requirement, including Oregon, Texas and Washington.

But Oregon took its head-injury prevention to another level in 2009 when it was made mandatory that coaches in every school sport be trained annually on how to recognize concussion symptoms and how to appropriate medical treatment when they occur.

Sherry Stock of the Brain Injury Association of Oregon said originally, the bill was stronger and had regulations that helmets would have to be replaced every 10 years after the manufacturer's warranty had expired, but the article had to be removed for fear of bankrupting schools.

Stock said that when schools get their helmets reconditioned, they don't really know what they are getting back.

"They put new fiberglass on them and a coating, and the helmet could really be sitting there with a hairline crack," she said. "(It's) not protecting the kids, but they look perfect."

Oregon's legislators did approve the additional training for coaches, which is provided by The Oregon Center for Applied Science (ORCAS) through an online program called ACTive.

Jay Thompson of ORCAS said the plan was to make sure that ACTive was free, so the athletic association would not have any excuse for not using it.

"There is no reason anymore to say, 'Don't pass mandatory training for coaches because it's an unfunded mandate.' That's bullshit," Thompson said. "This is a free program that is clinically validated, that is evidence-based and is free. Get over it."

So far, zero coaches from Oklahoma have taken advantage of the free program, but Cache coach Barry Foster, who coached Justin at Rush Springs, said he thinks current training is adequate, and it's up to the athletes to be honest when they are injured.

"As coaches, we are not doctors. If we ask a kid if they are all right and they say, 'Yes,' that's all we got to go by," Foster said. "Football is a collision sport, so you are going to have kids' heads hitting all the time, and there is no way to avoid your head getting hit in football."

With so many measures being taken to avoid another situation like the Nottingham's, Justin's family said his memory is being honored.

"If we can take Justin's name and experience, and help save other kids, then that's what it's about," Jim Nottingham said. "It's not going to do Justin any good now."

The Nottinghams don't pay much attention to football season's kickoff. Baseball season is when they miss Justin the most.

"The time we went to Arkansas with him so he could play in the Little League World Series was the summer before he passed away," Heather Nottingham said. "They lost two games and were out, but he had a blast."

The Nottinghams both said that if their youngest son, James, wants to play football, they won't refuse.

"You can't stop them from living," Jim Nottingham said. "Before Justin, I probably would have encouraged my kid to play football, but now I pray to God he doesn't want to." "Adam Kemp

Brain trust
High school students shouldn't be old enough to be losing their memory already.

But Michael Paul Mason, author of "Head Cases" and vice president of the Brain Injury Association of Oklahoma, said that is exactly what is happening to kids that suffer from traumatic brain injuries while playing recreational sports.

Mason, who travels the nation documenting sports injuries, says it's usually not the first blow to the head that causes the damage, but the next one, after the athlete believes he or she is OK to return to play.

"Probably the most dangerous aspect about a sports concussion is a phenomenon known as second-impact syndrome," Mason said. "It takes the brain such a long time to heal before it can sustain another concussion, and so if it's not healed and takes a concussion too early " usually within six months of the first " the second one can have a much more pronounced effect."

Mason said his meeting with one former student athlete who had suffered from second-impact syndrome would shock most people.

"I talked to a young man who has about a five-to-10-minute memory now," he said. "His entire future has been put into question, and he can't complete any education like he had hoped, and his whole life has changed just because somebody let him back out on the field when they shouldn't have."

Mason said he believes the new laws regarding athletes requiring doctor permission when returning to play are a step in the right direction, but he believes more emphasis should be placed on equipment development.

"All the helmets that are currently in use in football aren't designed very well to prevent injury to the brain," he said. "What we have right now is very rudimentary, and personally, I would never trust one with my own brain."
"Adam Kemp

photo top Justin Barney middle, who died from a head injury sustained at a football game in 2007, stands with legal guardians, Heather and Jim Nottingham.

photo bottom Heritage Hall quarterback Sterling Shepard suffered two concussions last season. He is the son of the late Derrick Shepard, an NFL player and Sooner standout. Photo/Adam Kemp
 
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