Maddie Hastings doesn’t remember much about the concussion she suffered on the soccer field two years ago. After her team scored a goal Hastings, 15 at the time, returned to the center line and as the other team restarted the ball, Hastings did what any center mid-fielder would do — she charged. Only instead of stopping the team from advancing, Hastings ended up taking a hard ball to the face, breaking her nose.
“The impact of the ball made me fly backwards and I nailed my head on the turf, “ Hastings said. “That’s what I was told at least.”
Hastings said after the impact she blacked out for a minute, but then tried to get up and continue playing. “I played for another minute until my coach took me off,” she recalled.
Coming off the field is one of the last things Hastings remembers from that day. “After that it’s pretty much all kind of a blur,” she said.
Incidents like the one Hastings suffered are the reason Minnesota passed a concussion law requiring all coaches and officials receive concussion training and education every three years in an effort to eliminate continued play after a concussion has been suffered, and subsequent re-injury in players who have suffered a concussion.
The law requires coaches to remove an athlete from activity if they exhibit any signs or symptoms consistent with concussion.
An athlete that has been removed from play due to concussion symptoms cannot return to the playing field until they have been cleared by a doctor to resume play.
Brainerd varsity girls soccer coach Ricky Lacerte said he is in favor of the new requirements for concussion training and plans to require his players to undergo the video training sessions provided by the Center for Disease Control (CDC), so that they too are educated on the signs and symptoms of concussion. “We want to try to get a baseline of understanding from all our players,” Lacerte said.
When Maddie Hastings suffered her concussion, Lacerte was among the coaching staff that decided it was best to pull Hastings — against her will — from the game. “I was kind of stubborn,” Hastings recalled.
Lacerte said coaches need to understand how to handle an injured player who doesn’t want to leave the field.
“For a player it’s about being put in the spotlight,” Lacerte said. “They don’t want to be that player, but at some point it’s not their decision.”
Lacerte, who also acts as the coaching director for the Brainerd Lakes Area Youth Soccer Association (LAYSA), said beyond high school sports, LAYSA is requiring concussion training for all coaches at every level of play.
The required training is for good reason. The CDC said soccer player players suffer the highest number of head injuries in all sports, second only to boxing.
Lacerte said he believes the high number of head injuries in soccer has a lot to do with improper training. “The majority of heading is done improperly,” he said. “Plus, the more popular the sport becomes, the more aggressive it becomes. That means more injures.”
Lacerte said the biggest issue he faces as a coach of a player with a concussion comes with games away from home. “Do you spend two hours on a bus with a kid who has a concussion,” he said. “Getting them the care required is a logistical nightmare.”
Dr. Arden Beachy, who practices family and sports medicine with Lakewood Health System in Staples said proper care for concussion injury is crucial for young athletes.
Beachy said an athlete who suffers a concussion undergoes a traumatic functional injury, as opposed to a structural injury. “That can be hard for people to be understand.”
Concussion causes neurons to misfire affecting a person’s personality, behavior and memory, but a structural change is rare.
Beachy said 65 % of concussions occur in kids ages 5-18 largely because a child’s developing brain does not recover as quickly as an adults. Like Lacerte, Beachy blames poor technique for a lot of the concussions he sees. “Some of those kids can hit really hard,” he said. Beachy, a high school basketball coach, said he sees athletes from all sports including football, hockey, soccer, baseball, BMX and motocross.
He said over the years he has seen a lot of change in how concussion symptoms are treated on the playing field when it comes to making the decision to pull a player from the game.
“The thing people need to know is that a mild concussion is still a brain injury,” Beachy said. “That gets people’s attention.”
“If there’s any question at all — hold them out of play.”
Once a coach makes a decision to pull a player, Dr. Beachy said it is important for the player to see a physician within the first 48 hours to evaluate symptoms and then to refrain from playing until the player has made a full recovery.
Beachy said it often takes time to determine the severity of the injury and coaches, parents and athletes need to work together to make sure the player does not return to play before they are ready.
“If you don’t let something heal, the chance of re-injury is greater,” he said.
For Madeline Hastings, recovery was slow. Hastings said the morning after the injury occurred she woke up with two black eyes and a broken nose, but was more concerned about the game she would be missing that day due to her injury.
Hastings’ evaluation with her doctor showed she had suffered a concussion and would be off the playing field for weeks. Over the first few days, her recovery meant no school, no texting, no TV, and no homework. “I sat in a dark room by myself and basically stared at the wall,” she said.
Once she was feeling well enough to return to practice, Hastings said her reintegration into full contact play was slow. “I wasn’t really allowed to play in any of the games at first,” she said. “Even when I was allowed to play it wasn’t full games — just a little at a time.”
Hastings is still playing soccer, but said since her injury, she now thinks twice before charging the ball.
“Every time I’m against the ball or one-on-one with a player I’m terrified they’re just going to nail me,” she said. “One-on-ones are kind of stressful.”
Like many athletes her age, Hastings participates in multiple sports in addition to playing soccer. Hastings spent a number of years playing hockey.
Dr. Beachy said it is the lack of rest and recovery kids are allowed between sports that contribute most to improper technique and slow reaction that often contribute to traumatic injury. “There’s not a lot of rest,” he said. “The odds of (concussion) just go up. I don’t know how to change that.”
Beachy said his he’d like to see coaches work on developing strength training programs to develop the whole athlete — not just the sport. “Not enough kids spend time doing the fundamentals,” he said. “Kicking the ball into the net 50 times is not going to give you a concussion.
“The better you get at the sport you do the less likely you’ll cause or suffer an injury.”
Dr. Beachy and coach Ricky Lacerte both agree that the bottom line in most sports is safe play on and off the field, and that starts with coaching.
“You can’t account for every single play in a game,” Lacerte said. “But you can teach safe smart play.”
For Beachy, safe play goes beyond the playing field and should to be considered part of the bigger picture — eventually athletes stop playing sports and have to be able to function in society.
“You’re not going to stop concussions unless people stop playing sports,” Beachy said. “The goal is for players to grow into adults who can function, hold down a job at the age of 25. To me, that’s the big thing. Some of that responsibility should fall on coaches.”
SARAH NELSON KATZENBERGER may be reached at firstname.lastname@example.org or 855-5879.