On the mend: discussions on concussions and physical therapy

By Andrew Gelinas


Society’s collective understanding of concussions has drastically improved over the past 10 years. It’s evolved so much that merely discussing certain professional sports carry the burden that someone will almost certainly bring up rule changes that resulted from recent advances in research. But the place where concussion research meets reality is in our schools.

A concussion is an injury that affects the brain, and it can occur any time you hit your head. Some of the most prevalent symptoms include headaches, dizziness, and nausea, to slurred speech, loss of consciousness, and a general delay in responding to stimuli.

Now while a single concussion may affect an individual for a few weeks, there are also several potential long-term difficulties one may experience weeks, months, or even years after the initial injury. Perhaps the most serious is CTE, or chronic traumatic encephalopathy. CTE is an ailment where the proteins in the brain, called Tau, clump up and kill brain cells. It is a degenerative disease, and just like with Alzheimer’s, there is no known cure.

But that does not mean that simply getting a concussion or two will mean developing CTE. That’s simply not true. But what is true is that researchers are not quite sure what bridges the gap between getting a concussion and succumbing to CTE. In fact, there have been no confirmed cases of a living person with the disease, as all instances of it have been found in people who are already dead.

Something that has become more important as time has gone on is how children and teenagers are treated after they sustain a concussion. And while there used to be little to no oversight on these injuries, there is still a long way to go.

Samuel Frandino: Teacher

Samuel Frandino is currently a teacher in the Granville Center School District in Granville, New York. He vividly remembered the day that he was concussed for the first time.

“Fall 1972, I was just about to turn 17. I was a lineman on the football team playing defense. I actually now remember, even after all of this time, that the ball was snapped, I made contact with the guy across from me, but at the time I remembered nothing. It was like waking up from a sound sleep and finding myself playing football.”

Courtesy of Samuel Frandino

Frandino continued playing but was later ordered to go to the sideline to speak with his coach. He said that it was strange that “a bunch of high school boys in 1972 would actually be concerned.”

After his coach decided to keep him on the bench for the remainder of the game, he said, “there was no further inquiry that I remember. No doctor and no follow-up. My parents came to the sideline and asked, smiling, if I knew who they were.”

But  Frandino’s parents, like others,  didn’t know that their son was concussed. And even if they did, concussions weren’t viewed as being much of a big deal back in the 70s.

After he explained his own story, he started going into how he was still concerned for his own students.

“I don’t believe there is much of a concussion protocol. There are medical personnel available, and I suppose if it was very obvious, as in my case, there would be appropriate care, but I don’t see anyone taking a hard hit too seriously, beyond the cheering. Rural football will be a decade behind the NFL. I have had students who have said they “got a concussion” but they have all been self-diagnosed.”

That idea of self-diagnosing a concussion is certainly a theme echoed in a number of these stories below.

Samantha Delmer: Certified Medical Assistant

One individual who can agree with that is Samantha Delmer. While she currently works as a certified medical assistant at Virginia Mason Hospital in Seattle, Washington, she also took karate classes and played volleyball for much of her childhood and college life. She said that she had “three terribly bad (concussions)” that were diagnosed, but was “certain that I’ve had many more but being an athlete in college makes you hesitant to report anything you don’t feel is serious.”

Courtesy of Samantha Delmer

Some athletes don’t “want to be benched and lose out on chances” so they decide to forgo treatment in lieu of more playing time. This is justified in their own minds because they might be a major part of a team and they don’t want to miss a game because of something that is largely invisible. It’s this notion that weakness should be stored away and hidden from everyone.

Delmer said, “The first diagnosed concussion I had was when I was 16 when I was still doing self-defense and I was testing for my 2nd-degree brown belt. (In order) to teach me a lesson on humility and control, my instructor sparred with me, and for lack of better words, he rocked my world.”

She broke her nose and caused some short-term memory loss.

“I remember having to ice my face a lot and sleeping. But that was almost a decade ago and I don’t remember how long it affected me for.”

She blames this and other concussions afterward for her “terrible recurring headaches,” as well as the fact that her “ability to speak has been affected” as well as her memory. She also said that “(I) stutter and (it) takes me longer to formulate sentences. Short-term memory is hit or miss and my long-term memory takes me longer to recall.”

Drew Robinson, Theater Education Student

Drew Robinson is currently working to complete a master’s degree in theater education at Emerson College. He has had a long history of concussions, saying, “(I’ve had) more than one single person should have.”

Robinson’s first concussion took place when he was in high school. He vividly remembers the moment when it happened.

“I was the goalie for my high school varsity soccer team back in 2006. During a match, I saved the ball from going into the goal by diving on the ground for it. The player who was attempting the goal continued to come at me and kicked me right in the face with their full cleat.”

Courtesy of Drew Robinson

After sustaining the full-on collision, Robinson continued playing in the game after only complaining of a headache. He was surprised to notice that he had no other immediate issues for the rest of the match.

And while he said his school’s “guidance counselor talked to my teachers after I brought a note in from the doctor,” the athletic trainer failed to do anything more than give him an ice pack.

Robinson said that while he did feel some symptoms indicative of a concussion including a headache, dizziness, and loss of memory of events surrounding the collision, the worst was yet to come.

“Lasting effects suck. I’ve developed a bit of a stutter when I get nervous, my speech sometimes gets slurred when there are certain letters together, I get migraines, I now have a deviated septum which causes sinus problems, I forget things a lot more than normal.”

But on the bright side, Robinson has since become more serious about his brain health than much of the population. He confirms whether or not any moderately severe head injury is documented and he treats his sinus problems with antibiotics.

Marisa DeFranco, Journalism Student

Marisa DeFranco is currently a student in Emerson’s journalism department as an undergraduate. She has had a long history with concussions that all started when she was in a car accident back in December 2010.

Courtesy of Marisa DeFranco

She said that “I remember wanting to close my eyes, they felt so heavy and my energy felt drained. (My Mom) knelt beside me while we were waiting for the ambulance, asking me questions and talking to me, trying to keep my eyes open. Once the ambulance came I was carried out of the car on a stretcher and rushed to the hospital.”

DeFranco added that her mother is an experienced athletic trainer. She also said that while she was forced to drop some courses, she did receive some help from her school.

“Once I was able to be in the school, I basically lived at the nurse’s office. They were so caring about how I felt and made sure everything was for the best for me. If it was leaving class or going home, whatever would help.”

DeFranco’s treatment extended outside of her school and at home, where her mother “kept me away from electronics.”

And that is helpful because reports indicate that the use of electronics after a concussion may double recovery time. This is because we need to concentrate while we view things like a computer screen. This focus could inhibit our body’s ability to heal ourselves.

Ron Hutchins, Athletic Trainer

Ron Hutchins has been a certified professional athletic trainer since August of 2000 and is currently the head athletic trainer at Wooster School in Danbury, Connecticut. Ron described his experience helping students with concussions back when he started.

He said, “Concussions were viewed as a serious injury but what qualified as a concussion was much more serious. If an athlete had the mechanism of injury plus symptoms we would remove them from activity and monitor symptoms for 15 minutes. If symptoms resolved in that time and they could pass a series of short exercises without symptoms recurring they could go back to play that same day.”

The mechanism of an injury is the circumstance that leads a person to get any injury, in this case, a concussion.

Ron also said, “For those deemed to have suffered a concussion lasting for longer than 15 minutes, then treatment was rest and removal from activity until symptom-free for seven days. They could then return to activity.”

But Ron has changed how he has helped students as new research has come out over the past 18 years, but there was one fact that really caught him off guard.

“The recent discovery that even subconcussive blows cause neurological damage is pretty damning and supports this more conservative approach.”

A subconcussive hit may impact the brain a little bit but they don’t do enough damage to be considered a full concussion. Many athletes are susceptible to these injuries because they cannot be documented nearly as easily, so they continue to play on. And while they aren’t immediately known to be immediately dangerous at this point, there is a possibility that these hits can cause long-term effects, like CTE.

A  look back 10 years ago would show marked improvements in concussion treatment protocol today. Now, after a string of subconcussive blows to the head, a trainer or coach can determine whether an athlete can enter a game or a student can enter a classroom. And while there are those who will still feel pressured to brush it off,  many others  are learning about concussions and making safer decisions.

About Andrew Gelinas 4 Articles
Andrew Gelinas is a Graduate Student in the Journalism department at Emerson College in Boston. He got his Undergraduate Degree with a double major in History and Communication Studies at Manhattanville College in Purchase, NY. He hopes to write about sports, particularly soccer, after receiving his degree.