Back-to-school screening

School physical. Check. Immunization record. Check. Emergency contact. Check. Head examined. Huh?

Back to school means back to sports for many student athletes, but before they get their heads in the game, a greater number of them will be getting baseline concussion scans, which can improve treatment if they suffer a blow to the head.

Several recent high-profile sports-related head injuries, including the one sustained by former Florida Gators quarterback Tim Tebow, have highlighted the importance of proper concussion management. As a result, more high schools, and now a leading sporting goods retailer, are stepping up to the plate to make sure athletes receive baseline testing in time for fall sports.

In 2005, only five Florida high schools offered baseline screens to athletes, now 50 do, said Mark Lovell, founder of ImPACT, a computerized concussion-evaluation system. ImPACT provides screening software for professional teams, universities and schools, including 18 high schools in Central Florida.

Those numbers are about to shoot up. This month, Dick’s Sporting Goods, in partnership with ImPACT, is targeting an additional 1 million screenings for youths nationwide.

Lovell estimates that 16 percent of the nation’s 40,000 high schools offer the screening, which costs less than $1 per student. Dick’s effort will add 3,300 schools, meaning almost one in four high schools will offer student athletes the program.

Though concussions most often occur in football, they’re also common in other impact sports such as soccer, horseback riding, gymnastics, cheerleading and field hockey. Nearly 4 million activity-related concussions occur in the United States each year, mostly in teenagers, according to the American Academy of Pediatrics.

Initial concussions aren’t usually serious. It’s the second ones that do real damage, especially if they occur before the brain has recovered. If an injured brain has a repeat injury too soon, permanent brain damage – and even death – can result, experts say.

After an injury, the brain needs time to heal. Until it does, it is prone to more serious injury the second time, according to the American Academy of Neurology, which has long warned coaches about the consequences of “second-impact syndrome.”

Baseline screenings help make sure the athlete doesn’t go back in too soon.

When students have a baseline test, full recovery is easier to assess, said Michael Dougherty, an athletic trainer and manager of the Sports Concussion Program at Florida Hospital. Last year, the program administered baseline tests to nearly 6,000 Central Florida athletes.

“Having a baseline scan really helps us assess the injury right after impact, analyze recovery progress and make safer judgments about when the athlete can return to play,” said Dougherty.

“Without a baseline, you’re comparing the athlete against average baseline norms, which can vary widely, making treatment far less accurate,” he said.

When athletes suffer a concussion, doctors typically advise them to wait a week before resuming any sport, said Dougherty. But when it is safe to return varies widely.

“Most kids recover in a week, and I’ve seen some recover in three or four days,” he said. “But in 15 percent of cases, the athlete really isn’t ready for a month.”

The 20-minute baseline test measures memory, reaction time, processing speed and problem-solving skills to establish an athlete’s normal function.

Objective data is important in situations where kids, coaches and parents are all rooting for the athlete to get back on the field.

“Kids often say ‘I’m fine’ the way drunk people say ‘I’m fine,’ ” said Dougherty. “They really believe they are.”

Good data can put the brakes on that potentially harmful momentum.

Lia Whitmore, a rising junior at Oviedo High School, has learned that lesson. The 16-year-old plays club level and varsity soccer, and has suffered several concussions during her sports career, including two in the past year.

In a match just before Thanksgiving, she suffered one. Then, a couple of months later, “I collided with a girl in a corner kick,” she said. The next thing she remembers was the coach walking her off the field.

“It was worse the second time,” Whitmore said, “probably because I went back too soon.”

Though Whitmore was offered baseline testing at her school, she admits she blew it off “because practice was starting. I should have taken it more seriously.”

She has since been working with the Florida Hospital Concussion Program to play it safe. Her doctor ordered her to wear a head brace whenever she plays.

“If I get another concussion, I have to quit playing,” said Whitmore, who still suffers the effects of her impacts.

“I still get a lot of headaches, and don’t sleep well.” Her grades also took a hit, because she had trouble concentrating in class.

Currently 15 states have laws preventing coaches from letting kids return to play the same day they have suffered a suspected concussion.

Florida has not yet passed such a law.

However, the Florida High School Athletic Association issued a guideline for the coming school year stating, “Any athlete who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest or practice and shall not return to play until cleared by an appropriate health-care professional.”