sports injuries can cause athletes to take time off from their sport. Women’s soccer captain senior Erica Wheeler-Dubin (not pictured) was anxious to return to playing soccer after recently recovering from a foot injury. Photo by Nick Paris.

Senior Erica Wheeler-Dubin put down her crutches last week. The women’s soccer captain is slowly recovering from the foot injury she sustained this past July.

She played through her injury for the first part of the season, under the impression that the pain in her left foot was just a minor injury.

“I would just avoid kicking with [my left foot],” she said.

However, during a game against the University of Puget Sound, she was forced to clear a ball using her left foot, causing further impact injury to the ligaments in her foot. After Wheeler-Dubin sought medical attention she had to wear a cast for six weeks. She faced a recovery period of almost one year. She not only struggled with the physical effects of her injury but also with the consequences of putting her athletic career on hold.

“When I first arrived at school as a second-year captain, I had a mindset of being on the field and leading the team,” she said. “I had to switch my mentality from being supportive on-field to being supportive off-field.”

Wheeler-Dubin chose not to quit the team. Instead she kept her role as captain and continues to lead the team from the sidelines.

Although she went to almost every game, Wheeler-Dubin still found it difficult to be a part of the team with her injury.

“I had to let go of being in control, not scoring goals, to have trust in my team,” she said. “I had to emotionally let go.”

Men’s rugby team captain senior Michael Richtik has also been forced to overcome a serious injury. This will be his first season playing since recovering from a torn anterior cruciate ligament (ACL) his second year.

Like Wheeler-Dubin, he maintained a leadership role from the sidelines during his rehabilitation period.

“Even though I was injured I went to practice and I went to all the games,” he said. “I promised to be captain senior year and promised to prove it to [my team].”

Richtik tore his ACL in a preseason game against San Francisco State when an opposing player smashed into him, twisting his knee to the side. At that time he did not know the severity of the injury, and he continued to play for the rest of the season.

“I would play in the games, but after, my knee would be swollen, so I wouldn’t be able to practice during the week,” he said.

After his injuries, Richtik struggled to obtain respect from the teammates he could not play with. He suffered a drop in self-esteem during his recovery.

“I always felt invincible playing rugby, but to feel so vulnerable and fragile is scary,” he said.

Despite these feelings and the swelling in his knee, Richtik decided to continue playing in games.

“It was up to me,” he said. “The coaches have a lot of respect for me, the final decision [to play] came down to me.”

Tim Baldwin, one of the three athletic trainers employed by the UCSC athletic department for the Division III teams, understands the challenges an injured athlete faces.

“It’s never easy to tell an athlete they can’t play, but it’s all about what is best [for the athlete],” he said.

Baldwin has spent two years at UCSC and has worked with many student athletes who find it difficult to take time off from sports due to injury.

“I have to evaluate them individually and explain the consequences of continuing [to compete],” he said. “I also tell the coach. It’s very cooperative here at Santa Cruz. The coaches want what is best for the athletes too.”

For Wheeler-Dubin, the desire to play in the future is what kept her off the field. With nearly 14 years of competitive soccer on her record, this injury will not be the end of her athletic career.

She wants to begin running in three months and, after finishing her credits for graduation in Costa Rica, her plans are to play abroad.

“My dream is to play in Italy,” she said.

Wheeler-Dubin went through an extensive and painful rehabilitation. She began the recovery process with a cast and crutches, then slowly transitioned to an air cast.

She is now able to participate in low-impact activities like biking and swimming.

Unlike Wheeler-Dubin, who missed her whole season and is still recovering, Richtik has finished rehabilitation and will play again for UCSC. Richtik has missed his senior year pre-season, but is now rejoining the team as a starter.

“When you miss that much time recovering, it’s nerve-wracking to return,” he said. “But all those butterflies go away after the first game.”

Illustration by Kenny Srivijittakar.

Illustration by Joe Lai & Kenneth Srivijittakar.

His head was spinning. It had all happened in what felt like a split second — one minute he was sprinting past defenders toward the end zone, and the next his helmet flew off and he was lying flat on his back in the grass. Panting heavily, he scrambled to stand up and try to recover the ball, but before he knew it he could feel himself falling again as his vision quickly blurred. He tried to regain control, but it was no use — he was slipping into the black abyss of unconsciousness.

This scenario has become a reality for a growing number of collegiate athletes nationwide who have suffered a concussion while playing a contact sport. According to the Sports Concussion Institute, 1 in 10 athletes participating in contact sports in the United States sustain a concussion annually, which amounts to roughly 1.6 to 3.8 million sports-related concussions.

Thanks to extensive media coverage on the much-debated issue of how to treat concussions and other serious head injuries in the National Football League (NFL), this topic has made its way onto the playing fields of high schools and colleges across the country, as well as into the halls of state assemblies and House judiciaries. That’s because for a student athlete who sustains a concussion, the severity of the injury and the way they address it can have a huge impact on their immediate health and the sustainability of their body and brain later on in life.

What Is A Concussion?

A concussion, otherwise known as a mild traumatic brain injury (MTBI), can be caused by a bump or blow to the head, neck or body that prompts the brain to move rapidly in the skull. There are different types of concussions ranging from grade one (which is considered mild) to grade three (the most severe, which is characterized by a loss of consciousness for at least a few seconds).

Depending on the severity of the blow, a concussion can be a significant injury — it can change the normal function of the brain and lead to serious long-term health problems if left untreated, or if enough time is not allowed to pass before the athlete goes back to his or her everyday activities.

Young athletes who return to play too soon — these make up 41 percent of all concussion cases, according to the American Academy of Neurology — put themselves at risk for additional concussions and even death in some cases, although this is a relatively rare occurrence.

Athletes who sustain multiple concussions throughout their playing careers also risk facing long-term health defects when they age. The Center for the Study of Retired Athletes at the University of North Carolina Chapel Hill conducted a study, released in June 2007, in which they found that NFL athletes with a history of three or more concussions are more likely to experience depression and cognizance issues, both of which are often precursors of Alzheimer’s disease.

UC Santa Cruz head athletic trainer Primrose Pisares says that concussions are not something to be taken lightly, as they can lead to health problems later in life.

“Concussions caused by a sports injury or otherwise can be serious because they can affect motor and cognitive skills depending on the severity of the injury, which can range from mild to severe and even death,” Pisares said. “If an athlete returns to play too quickly, his or her symptoms can worsen and lead to more permanent damage to the brain.”

The Trickle-Down Effect

While concussions and head trauma have always occurred in contact sports, it wasn’t until recently that they began to receive widespread recognition. It first began in 2007, when the NFL began a study on the long-term effects of concussions in retired players. This did not receive significant public attention until last year, when an Oct. 28 hearing before the House Judiciary Committee eventually led the NFL to suspend its survey after intense scrutiny of poor statistical sampling and accusations of possible bias.

Shortly thereafter, NFL Commissioner Roger Goodell implemented an overhaul of their previous concussion policies, which included a new rule that bans players from returning to a game or practice in which they have shown significant symptoms of a concussion. The policy now requires the player to receive clearance from a neurologist not associated with the team before he returns to play.

Pisares attributes the peak in concussion interest on the collegiate and high school levels to the recent NFL attention.

“Having the NFL in the news regarding concussions is a big thing, because people notice it,” Pisares said. “A lot of it has to do with the media, because otherwise how would people know this is coming up?”

Chuck Messimer, general manager of minor-league football team the Monterey Bay Vikings, believes the NFL’s actions have led the mass media to exaggerate the concussion issue.

“For lack of a better term, it’s a gore factor,” Messimer said. “People like to get hold of something that’s wrong with society and blow it up out of proportion.”

Jesse Trumbull spent nine years as assistant coach before becoming the head coach of the Santa Cruz High School Cardinals four years ago. He says the increase in concussion diagnoses can be attributed to a growing awareness of the injury.

“There have been head injuries in all contact sports since they started, but now that we have more information about it there’s obviously more concern over it,” Trumbull said. “It’s definitely a point of focus now for coaches. The medical staff has become more involved with the team and players.”

Concussion Commonality in Santa Cruz

Although UCSC doesn’t have a football team, concussions still occur in other high-contact sports on campus — particularly rugby, basketball, and soccer. Pisares said that one or two concussions usually occur per season for sports such as soccer and basketball. But for sports that involve more physical contact, such as rugby, concussions are even more prevalent.

“They’re definitely somewhat common, unfortunately, especially since there are no hard helmets like in football,” said Alex McKenzie, head coach of UCSC women’s rugby. “I’ve seen several a year, ranging in severity. … It’s relatively common compared to non-contact sports.”

When an athlete from one of the National Collegiate Athletic Association (NCAA)-sanctioned teams on campus does get a concussion, he or she usually gets a medical evaluation from a UCSC athletic trainer, who uses a template called the Sport Concussion Assessment Tool (SCAT) to determine the severity of the player’s injury.

The SCAT card comprises several different components that test the athlete’s memory, cognizance, physical symptoms and demeanor. Depending on the results, the trainer will then suggest a treatment plan, which usually includes sitting out for a week to 10 days from when the player has stopped showing concussion symptoms.

The NCAA has a few general guidelines, but no set of requirements that specifically dictates how to handle a concussion.

Pisares says that since it is difficult to prevent concussions altogether, what is most important is ensuring that an athlete receives proper treatment when they do sustain a head injury.

“We don’t have sports that require helmets like football, so it’s just about more vigilance when they do get a concussion,” Pisares said. “[It’s about] making sure coaches are following our guidelines, making sure athletes don’t do any physical activity, et cetera.”

Coaches such as Todd Kent, head coach of women’s basketball, fully put their trust in the UCSC training staff when it comes to handling serious injuries.

“As a head coach, I do whatever the trainers and doctors tell me,” Kent said. “If a trainer tells me they’re still symptomatic, I don’t let a player practice. I trust their opinion of what they tell me a player can and can’t do.”

Coaches at the high school level, in particular, are becoming more aware of the dangers of head injuries. Young athletes are especially vulnerable to serious injury from a blow to the head because their brains are not as developed as older athletes’.

The commonality of concussions in high school sports has been well-documented, especially when it comes to football. According to the National High School Sports-Related Injury Surveillance Study, roughly 68,000 concussions occurred during the 2008 high school football season. Although this may not sound like a very high number, concern arises from the very kids to play with good, safe technique to make sure everyone gets off the field healthy.”

Coaches and Congressmen Take Action

From Santa Cruz to Sacramento to Washington, D.C., various organizations are considering imposing more specific guidelines and requirements that outline how a concussed athlete should be treated and when they should be allowed to play again.

California Assemblyman Jerry Hill (D-San Mateo) recently co-authored a bill that, if passed, would require a high school athlete to provide a doctor’s note to the coach upon returning to the team after suffering a concussion. Several other states, such as Pennsylvania and Washington, either have similar bills pending or have already passed them.

Hill says his personal experience playing sports in high school inspired him to propose this bill.

“I played high school football, I was hit a number of times and I’ve got the scars to show it,” Hill said. “I know from a personal standpoint that head injuries are serious and that high school sports, especially contact sports, can be violent.”

Trumbull says he fully supports Hill’s bill, as he already requires a doctor’s approval for returning athletes who have been injured.

“If anyone, especially with a head injury, receives notice from medical personnel that they shouldn’t play, we don’t let them play again until they are cleared by that same medical personnel,” Trumbull said. “I would support that as something that should happen everywhere.”

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports is currently reviewing its set of standards on concussions, but has not yet made any specific recommendations for stricter guidelines. Head trainer Pisares believes any changes they make will not occur right away.

“I think the NCAA might look into their guidelines again and see if they can do anything from their end, [but] it’s going to take a while because they can’t just say, ‘You have to do this’ and put it in their handbook,” Pisares said. “They have to do research first.”

Women’s basketball coach Kent hopes that the widespread attention this issue is getting will lead to an increase in awareness, regardless of whether rules are changed.

“From this, I hope, will just come a better knowledge and understanding to treat each head injury as if it’s severe so [the athletes] can get the best possible care,” Kent said.

Meanwhile, Monterey Bay Vikings general manager Messimer summed up why concussions should be taken seriously when they occur:

“You can fix a broken arm, but you can’t fix a broken brain.”