Concussions continuing to plague high school football players, families

Corey Lacanaria doesn’t remember much about the hit that caused his concussion.

He doesn’t remember the play or what happened the rest of that football game last season.

Weeks after the hit, he had to relearn plays before returning to the field because he had forgotten half the Birmingham Brother Rice playbook.

Now a freshman wide receiver at Ball State University in Muncie, Ind., Lacanaria said there are only a few things he remembers following his concussion.

The most vivid memory was waking up from a nap in a pool of sweat after a spinal tap to collect and analyze the fluid in his spine. “It was very scary waking up and (being) completely hot,” he said. “My mom was freaking out.

Football is a violent sport, even at the high school level, and will never be injury free. But stories such Lacanaria’s deeply concern parents and coaches of prep players as another season is set to begin. And for good reason.

The Centers for Disease Control and Prevention reports show that concussions have doubled in the past decade. The American Academy of Pediatrics has reported that emergency room visits for concussions in children ages 8 to 13 years old has doubled, and concussions have risen 200 percent among teens ages 14 to 19 in the last decade.


Last October, the National Academy of Sciences released a 306-page report funded by the National Football League which showed high school football players suffer concussions at a rate of 11.2 per 10,000 “athletic exposures,” almost twice the rate of college football players.

“Concussions are the No. 1 concern among coaches and parents,” said Joe D’Angelow, head football coach at Bloomfield Hills Cranbrook Kingswood. “I think that is why there is a drop-off in kids playing football.”


According to the Centers for Disease Control and Prevention, a concussion is a traumatic brain injury caused by an impact — a bump, blow or jolt to the head, or a blow to the body — that changes the way your brain normally works.

According to the Sports Concussion Institute in Los Angeles, the impact causes the brain, which is floating in fluid, to move quickly back and forth striking the inside of the skull and damaging delicate neural pathways.

Symptoms include headaches, nausea, difficulty concentrating, lost memories, irritability, sadness, sleep disturbances, changes in appetite and energy levels. Research shows repeat concussions can lead to long-term neurological damage, including memory loss, depression, personality changes and other serious illnesses such as progressive dementia.

SCI notes on its website that repeat concussions for adults are 2-4 times more likely after an initial injury. The adolescent brain is even more at risk for repeat concussions.

D’Angelo witnessed the problem firsthand last season when two of his players suffered concussions.

One of them, lineman Mac Woodbury, suffered two concussions: one during a preseason practice and another during a game.

“It was hard to focus, I had a hard time sleeping and I had a lot of headaches,” said Woodbury, a sophomore at Cranbrook. “I couldn’t really run around.”


While there are no helmets, mouthguards, bylaws or coaching methods that can completely eliminate brain injuries in any level of football, there are ongoing efforts aimed at reducing the risks and preventing as many concussions as possible.

Dr. Jeffrey Kutcher is an expert on the brain. He’s the director of the Michigan Neurosports Program and an associate professor of Neurology at the University of Michigan’s medical school.

He also is a team physician for the university’s athletic department and has served as director of the National Basketball Association’s concussion program and provided neurological care to all U.S. athletes and National Hockey League players at this year’s Winter Olympics in Sochi, Russia.

Kutcher said helmets are not actually designed to prevent concussions.

“The role is to prevent a skull fracture and internal hemorrhaging,” Kutcher said. “A concussion occurs when the brain experiences a quick movement or a quick lack of movement. It doesn’t matter to your brain whether something hits your skull or hits your helmet.”

But Kutcher said where helmets really provide a service is in the long-term impacts on an athlete’s brain when a concussion is suffered.

“The overall concern isn’t necessarily preventing concussions but preventing long-term consequences,” he said. “You do want helmets to let the least amount of force through to the brain. What we don’t know is how much force we have to account for.”

The lack of research could soon change. Earlier this year, President Barack Obama hosted a youth sports summit at the White House and encouraged researchers to focus on understanding concussions and asked for tools to help parents, coaches, clinicians and young athletes to prevent, identify and respond to concussions.

Among the efforts announced during the summit:

The NCAA and the U.S. Department of Defense will spend $30 million for concussion education and a comprehensive concussion study involving up to 37,000 college athletes;

NFL will spend $25 million to create health and safety forums for parents and to get more trainers at high school games;

National Institutes of Health, with $16 million from the NFL, will study the chronic effects of repetitive concussions;

National Institute of Standards and Technology will spend $5 million to develop advanced materials to protect against concussions in athletes, troops, and others.

“We’ve got to have better research, better data, better safety equipment, better protocols,” Obama said. “We’ve got to have every parent and coach and teacher recognize the signs of concussions. And we need more athletes to understand how important it is to do what we can to prevent injuries and to admit them when they do happen. We have to change a culture that says you suck it up.”

Outside the government, researchers are focusing on youth concussions, too. The Washington Post recently profiled Bob Gfeller, director of a pediatric trauma institute at Wake Forest Baptist Medical Center in Winston-Salem, N.C., and father of Matthew, a 15-year-old football player who died in 2008 after a head injury. Gfeller told the Post that 70 percent of football players are younger than age 14 and they are the least studied. His institute is in the third year studying 9-to-12 year-olds tracking the cumulative effect of head contact.


In May, Virginia Tech University released its latest ratings of the safest football helmets available, using analysis of helmet-mounted sensors and impact testing. The best helmets, of 23 models evaluated in 2,700 lab tests, reduced head accelerations and thereby lowered concussion risk. The best helmets earned a five-star rating. (See chart of best helmets).

The Oakland Press surveyed coaches and athletic directors from all 52 Oakland County schools with football programs. We asked what helmets models they use, how often the helmets are reconditioned and how much the helmets cost.

The answers were consistent from the 45 schools that responded. All use the four- and five-star rated helmets made by Schutt, SG, Ridell, Rawlings and Xenith and identified in the Virginia Tech study.

Every school that responded said they recondition helmets every year and purchase replacements for $250 to $350 each, depending on the manufacturer, bulk discounts and the size.

It’s clear that school athletic departments spend thousands of dollars each year to provide top-rated head protection to their football programs alone.

Jim Sparks, Clawson’s head football coach, said it costs $40 per helmet each year to have them reconditioned, and the Trojans are one of the smaller programs in the county. Reconditioned helmets are returned to the manufacturer, sandblasted smooth, repainted, and pads, faceguards and hardware are removed and replaced.

New helmets can easily cost schools $10,000 to $15,000 a season.

Many teams rely on booster club fundraisers, parent purchases and charitable donations to pay for new and reconditioned helmets each season.

“I think prevention is the best it has ever been,” said George Porritt, head football coach and athletic director at Orchard Lake St. Mary’s.


While helmets get lots of attention from concussion researchers, the kind of mouthguards young athletes use are just as vital to prevention efforts.

Dr. Jack Winters is a pediatric dentist in Findlay, Ohio, who is very close to the game of football. He was a Mid-American Conference referee for 20 years and currently scouts potential referees for the NFL.

He is also member of the Academy for Sports Dentistry and recently published an article in The Journal of General Dentistry focused on mouthguards and their role in preventing concussions in high school football players.

Winters studied six football teams in western Pennsylvania.Three were fitted with custom-made laminated mouthguards of various thicknesses and three used “boil and bite” over-the-counter mouthguards.

The study showed eight concussions suffered by players wearing the laminated mouthguards and 16 concussions suffered by players wearing the over-the-counter mouthguards.

In a phone interview, Winters said mouthguards help players absorb blows below the chin, where impacts vibrate through teeth and jaw bones and into the skull, jostling the brain. The correct fit and varying thickness of the laminated guards were important to reducing the vibrations and resulting brain trauma.

How a mouthguard is treated also affects how well it can do its job. As a referee for 20 years, Winters said he saw players take mouthguards out between plays and put them on their helmets.

“That’s really a no-no,” Winters said. “It destroys the mouthguard by doing that.”

Like helmets, the safest equipment is also more expensive. Winters said a fitted, laminated mouthguard runs $40-$50, while an over-the-counter mouthguard can cost $5-$30.

One person who is making laminated/fitted mouthguards in Oakland County is Ed Santangelo, CEO of Waterford-based VB Sports, a company that provides training and equipment to local athletes in a variety of sports.

Santangelo traveled to Findlay last year to learn from Winters how to make the fitted mouthguards. He is hoping to partner with Winters to mass produce them.