Staying Ahead on Head Safety
July 6, 2015
By Rob Kaminski
MHSAA benchmarks editor
Three stacks of concussion-related material offered precious little space on MHSAA Executive Director Jack Roberts’ desk, and perhaps consumed even more room in his head as he tried to wrap his mind around the seemingly daily “latest and greatest” documents outlining signs, detection and return-to-play elements involving head trauma.
Without a doubt, the scene is quite similar on any given day in the offices of his cohorts across the country as school sports leaders are faced with the daunting, dizzying task of devising plans to address concerns aimed at the health of their games.
Lawmakers, rules makers, medical experts and the court of public opinion all want the same thing for student-athletes: a reduction in the chances of head-related injuries. And they all are perfectly willing to offer instant fixes to those in charge.
They often expect those in Roberts’ position to analyze, digest and create action plans as soon as possible without considering the research and resources it will take to get there.
“All parties involved want the same thing. We all want to provide the safest environment for educational athletics through protocols and practices that will offer the most minimal risk of injury,” Roberts said. “But, this can’t be accomplished through unfunded mandates which would stifle the already struggling athletic budgets in many schools.
“Changes have to occur through training and education, orchestrated through state offices and executed locally. And, it takes time to research the best and most effective means. There is so much information, and so many devices in the field today that those in athletic leadership roles almost have to have a medical background as well.”
For instance, there are documents which list as few as five symptoms for concussions, and those listing as many as 15. There are sideline detection methods which purport to take 20 minutes and those which claim to determine concussions in 20 seconds. There are as many return-to-play protocols as there are state associations.
Increasingly, state high school associations are seeking opinions and expertise from local medical personnel. In March, in one of many such meetings, Roberts and other MHSAA staff welcomed several from the Michigan Department of Health and Human Services to their office to discuss sideline detection methods and return-to-play issues.
“There are two areas that concerned us most,” Roberts said. “One, sideline detection of head injuries is inconsistent across the state in terms of both results and resources. Two, we need methods which generate immediate reports and permanent records.”
As the group which convened in March discussed the topic, potential hurdles and new perspectives on sideline management came to the forefront.
On the money and manpower front, who would be responsible for administering sideline tools? Most ideally they would need to be overseen by medical personnel rather than coaches or team managers.
From a perspective standpoint, an interesting view was volleyed out to the group: could sideline detection actually speed up a student’s return to play rather than slow it down? Current protocol prescribes that if competition continues while an athlete is withheld for an apparent concussion, that athlete may not be returned to competition that day but is subject to the return-to-play protocol. And, clearance may not be on the same date on which the athlete was removed from play. Only an M.D., D.O., Physician’s Assistant or Nurse Practitioner may clear the individual to return to activity. With immediate sideline detection, are parties more vulnerable should a student pass immediate tests, only to have undetected effects of the incident increase over time?
“The group shed a different light on the various scenarios, which was a primary purpose for the meeting,” Roberts said. “As one can see, there are so many variables to consider when attempting to determine the next plausible and practical steps toward minimizing and detecting head injuries.
“Further, we have to take into consideration practice sessions as well as competitions, and all sports, not just select sports.”
Adding to the challenge is simply the nature of athletics. Competitors at any level are just that: competitive. Often, students – or their parents – will attempt to hide symptoms or be reluctant to come forward with injuries, particularly head injuries which can’t be seen.
In more cases, perhaps the symptoms simply are not recognized, which is why education is paramount.
First, association leaders have to tackle the due diligence of researching issues and potential solutions to situations currently threatening the well-being of scholastic sports. Considering that some 1,620,000 results are offered when “sideline concussion detection tools” is typed into a search engine, this is a laborious and continual chore.
Such information then needs to be packaged and presented to leaders at the local levels – athletic directors – to pass on to coaches, the individuals who have as much or more influence on students that perhaps any other adults, including parents in some cases.
This is why MHSAA rules meetings, Coaches Advancement Program sessions and other statewide forums continue to bang the drum on health and safety issues; to make sure the messages and procedures reach the student-athletes.
And, it’s why the MHSAA is asking coaches and ADs to be accountable in verifying that the plans in place are being carried out.
Less Could Mean Less
There are times when it’s good to say, “less means more,” but in the case of contact sports, practices and competitions, the idea is for less to mean less. As in less time for collisions to occur yielding fewer injures.
It’s early yet, and one year does not constitute a large sample size, but the MHSAA Football Practice Policy instituted last August could be one step toward reducing head injuries.
Beginning this past football season, the number of practices with helmets, shoulder pads and full pads were limited to start the season, and preseason “collision” sessions were limited to one per day. During the season, such practices were limited to two per week, while the length of practices was also regulated.
Dr. Steven Broglio of the University of Michigan Neurosport department is conducting a three-year study of the Ann Arbor Gabriel Richard football program with the assistance of Richelle Williams to determine the “Effects of Concussion and Sub-Concussion.” The study began in 2013, one year prior to the new MHSAA guidelines.
Research in 2013 showed approximately 650 “impacts” per player. In 2014, the number dropped to approximately 500 impacts per player. Impacts are defined as greater than 10 gs of acceleration. Williams stated that a slap on the back is 4 g, coughing is 3.5 g. On average, a helmet hit is 25-45 g. Concussions usually happen (roughly) between 80-150g.
An encoder is embedded into each football athlete’s helmet which monitors head impacts and exactly where the impact is located. Williams sits at each practice and game and through a pager identifies the player’s number and impact from a hit of 90g or more.
They are also looking at those who do not sustain an impact concussion, but rather sustain multiple head impacts and whether those multiple head impacts lead up to brain changes (measured through EEG).
The initial findings, as submitted by the study team, indicated two reasons why there were fewer overall impacts from 2013 to 2014:
Primary reason: The MHSAA adoption that became effective in August 2014 with new limitations that were placed on “collision practices” and conditions that full pads could not be worn until the fifth day of team practice.
Secondary reason: Fewer players evaluated in 2014 than 2013.
Fit for a King?
Editor’s Note: There are many sideline detection tools on the market, as a quick Google on the topic will reveal. The following, the King-Devick test, is among the highly recommended tests, summarized here simply to provide an idea of the types of systems available and how they operate. The following is from King-Devick’s website.
The King-Devick Test is an objective remove-from-play sideline concussion screening test that can be administered by parents and coaches in minutes. The King-Devick Test is an accurate and reliable method for identifying athletes with head trauma and has particular relevance to: Football, Hockey, Soccer, Basketball, Lacrosse, Rugby, Baseball, Softball and Other Collision Activities.
King-Devick Test is an easy-to-administer test which is given on the sidelines of sporting events to aid in the detection of concussions in athletes. King-Devick Test (K-D Test) can help to objectively determine whether players should be removed from games. As a result, King-Devick Test can help prevent the serious consequences of repetitive concussions resulting from an athlete returning to play after a head injury.
How King-Devick Test Works
Concussions are a complex type of brain injury that is not visible on routine scans of the brain, yet are detectable when important aspects of brain function are measured. King-Devick Test (K-D Test) is a two-minute test that requires an athlete to read single digit numbers displayed on cards or on an iPad. After suspected head trauma, the athlete is given the test and if the time needed to complete the test is any longer than the athlete’s baseline test time, the athlete should be removed from play and should be evaluated by a licensed professional.
Remove-From-Play vs. Return-To-Play
Both remove-from-play and return-to-play decisions are crucial in concussion recovery. It is critical to remove a concussed athlete from play in order to prevent further damage. It is also extremely important to keep the athlete from returning to play until they have made a full recovery. There are tools to assist in making both remove-from-play and return-to-play decisions.
King-Devick Test for Remove-From-Play Decisions
- Quick, objective sideline testing
- Measures impairments of speech, language and other correlates of suboptimal brain function
- Instant screening feedback in minutes
- Administered by parents, coaches, athletic trainers and medical professionals in remove-from-play decisions
- Neurocognitive Testing for Return-To-Play Decisions
- Computerized concussion evaluation system (in the computer lab)
- Measures verbal and visual memory, processing speed and reaction
- Tracks recovery of cognitive processes following concussion
- Assists clinicians in making return-to-play decisions
Turnaround Coaches: Study their Steps
April 27, 2016
By Scott Westfall
MSU Institute for the Study of Youth Sports
Turnaround leadership is often a popular topic within sports conversations, as many coaches are revered for their ability to transform a struggling team into a “winner.”
Turnarounds often are discussed in platitudes such as, “That coach has what it takes to turn this program around.”
While often talked about during the offseason, especially in the face of coaching vacancies, turnarounds are difficult to achieve. After all, if transforming a failing team into a successful one were an easy task, there would not be such an abundance of teams that struggle year-in and year-out.
As much as turnaround coaches are celebrated for their abilities to turn a losing program into a winner, very little scientific research has been devoted to analyzing coaches who have proven themselves as turnaround specialists. The steps and intangibles necessary for achieving a coaching turnaround have remained undetermined as this topic had never been examined from a scientific perspective – until now.
For the past year and a half, I have devoted the majority of my time to researching turnaround leadership in high school coaching, undertaking this study as the topic of my doctoral dissertation project. Research participants in this study included 11 high school football coaches from the state of Michigan who led dramatic turnarounds at their high schools within the last decade. The criteria for participant selection were:
• Prior to the coach’s arrival or appointment as head coach, the team finished (at least) three of the previous four seasons with a losing record (below .500 winning percentage), including a losing season immediately before the coach’s arrival or appointment.
• Within five seasons of the coach’s arrival, the team enjoyed (at least) three winning seasons (above .500 winning percentage).
Before their turnarounds occurred, these high schools had not experienced a winning season (on average) in 7.2 years, while five of the 11 schools had never qualified for the MHSAA Playoffs. However, upon being hired, the average time it took the coaches to achieve a winning record was 1.73 seasons. Moreover, the average time it took the coaches to qualify for the MHSAA Playoffs was 1.82 years. On top of this, each of the 11 teams qualified for the playoffs within three years of hiring their new coach.
The circumstances these coaches faced when they arrived were challenging to say the least, as all of the coaches entered a negative situation with poor team culture. These situations were characterized by losing streaks, cancelled seasons, dilapidated facilities, poor role models on the previous coaching staffs and a significant amount of parental pushback. Players and community members often were embarrassed by their football program. One coach described the situation by recounting, “During that time they were a doormat; everybody’s homecoming, a laughing stock. They were like the Bad News Bears.” Additional problems included low numbers, very little player development, and a low amount of commitment to the overall program.
One coach that I interviewed compared entering a turnaround situation to building a well. He stated, “You may not have success on the surface initially, but if you dig nice and deep and build the well right, there is water down there. It’s going to be some work and it might not come up right away – it takes some pumping. But if you build it right, it will happen.” In this article I will attempt to encapsulate 16 months of research, 191 pages of interview transcriptions, 2,278 miles driven across the state of Michigan, and countless hours spent with 11 turnaround coaches, in order to present to you the nucleus of what it takes to turn around a failing high school program.
The coaching philosophies of the majority of the coaches were characterized as “educational athletics.” This involved coaches striving to do things the right way, viewing their job as an extension of the classroom, implementing a character development program, and using football as a vehicle to teach life skills to players. Furthermore, their greatest strengths were revealed to be coaching/leadership skills, along with the ability to develop strong relationships with their players.
Coaches unanimously agreed that upon their arrival immediate changes needed to be made to the team’s culture. These changes included prioritizing team workouts, altering visible elements like the organization of practices, offensive and defensive schematics, team logos, along with placing positive role models in front of the players. Other changes to team culture happened through improved coach-athlete relationships, giving players a better football experience, and purging the program of negative people. One coach used the term, “Weeding the roses,” which means getting rid of the negative people in the program in order to let the better parts grow and prosper.
All of the coaches developed some type of vision for their program. The most common visions involved transforming their team into a top-level program, and for their players to conduct themselves as quality human beings. Winning games, competing with the best teams in their division, and playing for MHSAA championships marked becoming a top program. While winning was a major component of the coaches’ visions, developing quality human beings was revealed to be just as essential. This was evident as several coaches remarked that their most well-behaved kids were also their most productive players, and that doing things right in school and in the community often equates to wins on the football field.
To build upon their visions, each of the coaches formulated some type of plan or “blueprint” to execute their turnarounds. The majority of the coaches’ plans were constructed around developing positive coach-athlete relationships and employing off-season strength and conditioning programs. While all of the coaches’ plans eventually yielded a great amount of success, not all parties bought into them initially. Some of the players needed to see proof that the team could win games before they were completely sold. In order to create buy-in, the coaches used various approaches to connect with players and sell their plan. These methods included team activities, cultivating relationships with players, continuously selling their vision, hiring/retaining quality assistant coaches, and entering the situation with some sort of previous expertise. Although it may take time, the coaches stressed the importance of the players buying into their vision. As one of them decreed to his team, “The quicker you buy in, the quicker we win.”
Early indicators that a turnaround was commencing included winning games or making significant strides off of the field through positive coach-athlete relationships. Sources of sustained changes included a win streak or an increased level of commitment from the players. Clear indicators that the program had undergone a turnaround included the players adopting a new mentality filled with trust and confidence, along with the program reaching unprecedented levels of success, such as competing with the best teams, completing an undefeated season, and/or making the playoffs consistently.
Character development emerged as a strong component of this study, as 100 percent of the coaches reported that it played a significant role in fostering turnarounds. The coaches also indicated that they deliberately teach character in practice and use coaching as a platform for character development.
In hindsight, an outside observer may assume that these coaches were destined to succeed and their plans were met with little resistance. However, after examining their roads to turnaround success, most of them met several barriers along the way. Early obstacles included widespread mental challenges among players such as a lack of confidence and/or trust. Other early barriers included parental pushback and some cases of overt interference. After the turnarounds were complete, the coaches’ problems did not disappear; they simply changed form, as complacency became the new problem on the team. A potential root of this complacency was the addition of younger players who thought that success would happen automatically simply because of the program’s prior achievements.
The coaches were quick to acknowledge that the turnarounds would not have been possible without the excellent support they received. Their greatest source of help came from their assistant coaches who contributed both tangible and psychosocial support. Tangible support was seen through the assistants performing administrative duties and overseeing strength and conditioning sessions. Meanwhile, psychosocial support came in simple ways, such as listening, giving advice, and showing belief in the head coach. As one coach stated, “You’re only as good as the people you have around you.”
Team turnarounds are not officially complete until a team maintains the success it has built. In order to avoid complacency and sustain momentum, the coaches recommended that coaches and players find ways to keep reaching higher. In order to do this, coaches recommended talking to players about their team goals and what they want their legacies to be. To help sustain momentum, coaches stressed that it is often the little things that matter the most, such as effort, team discipline, player accountability, and positive attitudes.
The strongest theme that emerged from this study was the importance of coach-athlete relationships. All of the coaches believed that relationships are imperative to fostering turnarounds. It was also emphasized that relationships are crucial for sustaining long-term success. In essence, coaches may experience some momentary success by taking shortcuts with superior talent, however, strong relationships are the “X-factor” that will sustain the program over the long run. While the approaches of building relationships were diverse, what mattered most was coaches spending time with players in both structured and unstructured team activities, and simply showing players that they cared about them as people as much as they did as football players.
Steps of a Turnaround
(When turnarounds happen, they usually happen in this order)
1. Establish new leadership
2. Assemble a staff of positive role models
3. Gather information about the program
4. Create the vision
5. Make a plan and communicate it
6. Create buy-in from players and other key people
7. Change behavior – This is the impetus of the turnaround
8. Create and celebrate early wins
9. Don’t let up – Keep setting new goals and reaching higher
10. Complacency is the enemy: Make sure change sticks!
Intangibles Checklist
(These are the little things that people cannot see or do not talk about, yet they often matter the most)
1. Positive relationships between coaches and players. Build these by spending time with players and showing them you care about them as a person.
2. Establishment of a strength and conditioning program. All successful turnarounds were led by coaches who implemented a respectable offseason training program.
3. Display an undeniable belief that your vision and the plan will produce successful results. Continuously sell your plan and give players the reasons behind why you do what you do. Be prepared to stand tall and adhere to your vision when adversity strikes.
4. Generate player buy-in through team activities. Remember that sports are supposed to be FUN. Plan structured and non-structured activities to generate fun, excitement and team cohesion!
5. Demand excellence of your players off the field. Promote educational athletics and use your platform as a coach to teach character and life lessons to your players.
6. Outwork your opponents in everything you do. Arrive earlier. Stay later. Go above and beyond what your competitors are doing. Set the tempo that hard work is the new norm and it starts with you.
7. Remember that the little things matter. Take the time to ensure that your team always has the right effort, attitude and discipline, as well as accountability to the program and each other.
Scott Westfall spent 10 years as a teacher, coach, and athletic director in Fort Collins, Colo. He is currently finishing his Doctorate at Michigan State University, with an emphasis in Sport Psychology and Athletic Administration, and assisting the MHSAA with its student leadership programs. Westfall is a former athlete who participated in football, wrestling, tennis and cross country at the high school level, and rugby at the collegiate level. Please feel free to contact Scott if you would like a copy of his full dissertation. Scott also performs speaking engagements at conferences on various topics within educational athletics. He can be reached at [email protected]