Parker Holcomb got an unexpected birthday present during high school wrestling practice in April.
“I got dropped on my head,” the 15-year-old says matter-of-factly.
Not knowing differently, Parker, now a sophomore at Union Pines, continued to practice.
“I just thought I had a hard practice,” Parker said.
But when his mother, Tiffany, picked him up from school after practice, she noticed him holding his head, and knew immediately something was wrong.
She began asking questions.
“He had a headache and emotionally he was a little off,” Tiffany said. “He was more sensitive. He just had a whole slew of symptoms and we realized he had a concussion.”
Concussions and their implications for athletes have been at the center of professional and collegiate sports the last few years, but awareness is increasing at the high-school level. Local health care providers are seeing more youths coming in with concussions, and schools are increasing their awareness of the symptoms and how to respond.
Still, there is no formalized testing or recovery programs among doctors and schools in Moore County. That makes it tough to know that all students are receiving the same treatment and care from the time a concussion is suspected.
“We have bits and pieces but a more formalized program would be nice,” said Jill Botnick, the director of Outpatient and Regioal Rehab Programs at FirstHealth.
Concussion symptoms can vary in each case. Parker’s symptoms included a sensitivity to light, constant thirst, being tired or sluggish and significantly changed sleep patterns.
Other common symptoms may include: dizziness, difficulty with balance, fatigue, double or blurred vision, sensitivity to light and sound, memory loss, confusion, slowed processing, fogginess, irritability, restlessness, anxiety, depression, mood swings and decreased stress tolerance.
Parker missed a couple of days of school, but when he returned the “straight-A student” was “having a hard time in school,” his mother said.
“I had headaches for days, and I had a hard time focusing,” Parker said. “I had a hard time remembering new information.”
According to the Center for Disease Control and Prevention, each year emergency departments across the United States treat an estimated 173,285 sports- and recreation-related traumatic brain injuries, including concussions.
Locally, Mandy Martin a nurse practitioner at FirstHealth Family Care Center in Seven Lakes said her office has seen an increase in the number of high school-age patients with concussions in the last 18 months.
Martin said concussed athletes are typically between the ages of 15 and 18 and play a variety of sports, including football, soccer and wrestling.
Someone who suffers a concussion can, but doesn’t always, lose consciousness, Martin said.
Student-athletes who suffer concussion must complete a return-to-play protocol that is outlined in the Gfeller-Waller Concussion Awareness Act, which was signed into law in 2011.
There are three major areas of focus in the law: education, emergency action and postconcussion protocol implementation, and clearance/return to play or practice following concussion.
According to the law, any student-athlete who exhibits signs of symptoms consistent with a concussion — even if not formally diagnosed — must be removed from play and is not allowed to return to play, practice or conditioning on that day.
Following the injury, the athlete must be evaluated and treated by a medical professional with training in concussion management.
“Cognitive and physical rest are the cornerstone of treatment,” Martin said.
In order for a student-athlete to return to play without restriction, he or she must have written clearance from appropriate medical personnel.
“The student-athletes must be symptom- and medication-free before activities start again,” Martin said.
In October 2013, a study by the National Acaemy of Sciences found that high school students-athletes remain at risk for concussions and may be their own worst enemies when it comes to reporting concussions and following treatment protocols.
Funded in part by the National Football League, the study was released by the Committee on Sports-Related Concussions in Youth, which is affiliated with the National Academy of Sciences. It found high school athletes who played football, lacrosse, soccer and baseball were more likely to experience concussions than college-age players.
The report also found that girls playing soccer and basketball were more likely to have concussions than boys. In fact, girls seem to have higher rates of concussion overall.
In addition to seeing a doctor, Parker Holcomb also participated in concussion rehab with Brandi Bossinger, a physical therapist trained and certified in concussion management. Bossinger works closely with patients and their doctors to help guide them back to sports and regular activity.
Why is proper treatment of and recovery from a concussion so important? Studies have shown that a person who has suffered a concussion is five times more likely to sustain a similar injury.
“If they come back too early, they can re-irritate the condition and be at greater risk for chronic damage,” Bossinger said.
Bossinger said parents and coaches are becoming more aware of and informed about concussions and are no longer rushing kids back to the playing field.
“Even five years ago you were a wimp if you couldn’t get back out there right away, but this isn’t a sprained ankle, this is a brain injury, and your brain needs time to heal,” she said.
She said she thinks student-athletes still are wary of admitting they may have a concussion.
“I think it is hidden more by athletes becase they know, ‘If I have a concussion I’m being pulled out (of the game or practice.),’” Bossinger said.
But athletes who try to fake it won’t get far.
“You can always tell if they are faking,” Bossinger said.
Slowed eye movement, and facial features exhibited when they struggle to answer questions are two dead giveaways that full recovery hasn’t taken place.
Recurring concussions can prematurely end a student’s athletic career.
“People don’t understand the long-term consequences (of concussions),” Martin said. “Sometimes we have had to pull people out of high-contact sports.”
Most concussions are resolved in 48 to 72 hours but in some cases symptons can last longer.
Parker Holcomb rehabbed for two weeks before being cleared.
Parker said the work he did with Bossinger helped him become more aware of symptoms and the complexity of a concussion and how it can affect numerous areas of his life.
“I didn’t think it would affect that many things,” Parker said. “I thought it was just a headache.”
Bossinger said that statement is “typical of every athlete.”
One of the best things parents can do for their children who play sports is to get a pre-season test to establish baseline brain function, including learning, memory skills, ability to pay attention or concentrate, and how quickly he or she thinks and solves problems.
Those tests can be used as a comparison baseline test if the student is suspected of having a concussion. For more information about baseline testing, contact Bossinger at 715-2600.
It's been four months since Parker suffered his concussion and he said today he feels “back to normal.”
Still his mother worries about his future.
“I was most scared of a re-injury,” Tiffany said. “And I still am.”