High School Athletes' Concussion Care Expedited Return to Sports

University of Michigan

PAW PAW-Catherine Vick back spotted a flyer in cheer practice last fall when she felt the girl's elbow strike her head … once, twice, three times and again in the very same spot.

She didn't realize it then, but she had a concussion. Her first reaction was to play it down, shake it off.

Catherine Vick, a 10th grader at Paw Paw High School and member of the cheerleading team, followed protocols developed by the University of Michigan to heal after she sustained a concussion at cheer practice, and her father John Vick. Image credit: Erin Kirkland, Michigan Photography
Catherine Vick, a 10th grader at Paw Paw High School and member of the cheerleading team, followed protocols developed by the University of Michigan to heal after she sustained a concussion at cheer practice, and her father John Vick. Image credit: Erin Kirkland, Michigan Photography

"I'm like, it's nothing. But then as the days kept on going, the headaches were worse," said Vick, a 10th grader at Paw Paw High School. "My head was constantly hurting, but it was the start of the season, so I was like, 'I don't want to be out, so I'm not going to mention anything until about a week after it happened if it's still hurting.'"

After a week, Vick told her coaches who started her on concussion protocol. That meant daily check-ins from her coaches, making sure she was drinking enough water and eating right, and modifying workouts for her until she was fully recovered.

"My coaches were really great about it," she said.

Vick's coaches earned the Michigan Sports-Related Concussion Training Certificate, developed by the University of Michigan Concussion Center to satisfy a state-mandated requirement for concussion training for all coaches and volunteers working with Michigan High School Athletic Association athletes.

The training course provides practical up-to-date concussion knowledge for athletes, parents, coaches and others involved in youth sports.

U-M research found that 1 in 4 adolescents self-reported at least one concussion in 2020, up from about 20% in 2016. During that same time period, youth who reported one concussion rose from roughly 14% to 18%, and those who reported at least two concussions increased from about 6% to 7%.

Steven Broglio, director of the U-M Concussion Center. Image credit: Eric Bronson, Michigan Photography
Steven Broglio, director of the U-M Concussion Center. Image credit: Eric Bronson, Michigan Photography

Steven Broglio, director of the U-M Concussion Center, said the partnership with MHSAA started five years ago to help erase some of the misinformation about concussions with the ultimate goal of protecting athlete health and well-being.

"There's still a lot of misinformation around concussion-what the signs and symptoms are, how to best manage the injury," he said. "And so we feel that we're filling the need within the state of informing athletes and informing parents, coaches and administrators of what those are-how to seek help, where to get treatment. And then put them on the right path so that they can get back to the things that they love to do the most."

Broglio said that as many as 10% of high school athletes will sustain a concussion in their time of being an athlete.

"Athletes in contact and collision sports such as football or ice hockey are most at risk, but we see almost identical numbers in women's soccer and other contact sports that our female athletes are playing," he said.

Stefanie Miller, Paw Paw high school math teacher and cheerleading coach, who has been involved in cheerleading since she was in middle school, said when she started
Stefanie Miller, Paw Paw high school math teacher and cheerleading coach, who has been involved in cheerleading since she was in middle school, said when she started "concussion wasn't a word that anybody ever really said." Image credit: Erin Kirkland, Michigan Photography

Stefanie Miller, Paw Paw High School math teacher and cheerleading coach, has been involved in cheerleading since she was in middle school. Back then, "concussion wasn't a word that anybody ever really said."

In the past 10 years, however, concussions have been taken more seriously.

Stefanie Miller, Paw Paw high school math teacher and cheerleading coach. Image credit: Erin Kirkland, Michigan Photography
Stefanie Miller, Paw Paw high school math teacher and cheerleading coach. Image credit: Erin Kirkland, Michigan Photography

"I feel like the whole 'getting your bell rung' is not a thing anymore, which is great," she said.

Miller said that the concussion training and protocols provided by MHSAA and the U-M Concussion Center have helped coaches, parents and students understand what happens when injuries occur around the head and neck. With this information, parents can help look for the signs of a concussion in cases when the student doesn't inform the coaches.

"I think that the fact that the MHSAA is using the University of Michigan's research to guide them in their protocol is phenomenal," she said. "I think it validates what we're required to do. And I think people take it more seriously because it's research based."

MHSAA executive director Mark Uyl said that connecting with the Michigan Concussion Center has given the organization the expertise it needed.

"We're not medical experts, so working inside of our own silo when it came to concussion wasn't going to be as effective as it needed to be," he said. "We know what we're good at and that's building up the systems to communicate with 750 member high schools in our state.

"We needed to find experts in the field of concussion. And that's why the relationship with the University of Michigan's Concussion Center has literally been a home run for us."

The St. Joseph High School football team at a practice. Image credit: Eric Bronson, Michigan Photography
The St. Joseph High School football team at a practice. Image credit: Eric Bronson, Michigan Photography

Andrew Pratley, assistant principal and head football coach at St. Joseph High School, said the training and raised awareness around concussions has changed mindsets and made games safer than ever as risks are minimized.

Andrew Pratley, assistant principal and head football coach at St. Joseph High School, says concussion awareness and training has made games safer. Image credit: Eric Bronson, Michigan Photography
Andrew Pratley, assistant principal and head football coach at St. Joseph High School, says concussion awareness and training has made games safer. Image credit: Eric Bronson, Michigan Photography

"Certainly, anyone that's on our sidelines and recognizes those symptoms knows it's not OK to put a kid back in until they're cleared by a doctor," he said. "So I think all of those things are really beneficial to the game and beneficial to our student athletes, which is really the most important."

Vick's father, John, who is a physician assistant and former athletic trainer, said the protocol followed for her concussion was great. Because of his medical training, he was able to do a concussion assessment when Catherine's headache didn't go away.

He sent her to the team's athletic trainer, who stopped her training with the cheer team and started monitoring her symptoms on a daily basis. While concussion recovery varies by person, Vick's persisted for six weeks and then she was eased back into her routines going to school for half days.

Her symptoms subsided after winter break and she was able to get back to training and participated without injury for the rest of the season.

"I thought it was handled absolutely appropriately, not only from a parent perspective, but also from a medical professional perspective," John Vick said.

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