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
Indispensable Only Begins to Describe Vicksburg Athletics 'MVP' VanderKamp
By
Pam Shebest
Special for MHSAA.com
September 20, 2022
VICKSBURG — Reading, traveling, enjoying time with family and sitting by the pool are all on Rhonda VanderKamp’s retirement list.
But before she embarks on that journey in June, she is finishing her 21st year as Vicksburg High School athletic secretary.
One person not looking forward to that June day is Vicksburg athletic director Mike Roy.
“I keep waking up every day coming to work, and maybe she’ll tell me I’m going to do one more (year),” Roy said.
“Like the Tampa Bay Buccaneers when Tom Brady retires, they’re going to dearly miss him. That’s the best analogy I can give; that’s how important she is to the team we have here.”
Roy should know.
The two have worked together all 21 years, forming a work family that’s become an anomaly in the world of high school athletics.
Her own family is the reason VanderKamp landed at Vicksburg.
She left her job at Heco, formerly Hatfield Electric, in Kalamazoo, after 17 years because “I wanted to be on the same schedule as what my kids were,” she said. “This allowed me to have my summers off with them and Christmas and spring breaks. It’s been just fantastic.
“Both of them were athletes in school. My daughter was in middle school when I started. I think it was good for them to have me here when they were in high school.”
VanderKamp and Roy were hired into the athletic department within a month of each other.
She realizes how unusual their tenure is when she attends conferences.
“They’ll ask you to stand up, introduce yourself and say what school you’re from, how many years you’ve been an athletic secretary and how many athletic directors you’ve been through,” she said.
“It’s always such pride for me to say I’ve been an athletic secretary ‘X’ amount of years and I’ve only had one athletic director. That’s just not heard of these days.”
Roy, always quick with a quip, looked back at their first year working together.
“I told her from Day One: I’m like a new husband. You train me the way you need me to be,” he laughed.
He then got serious: “She’s the MVP. There’s so much stuff that gets done in this office behind the scenes, and it’s all because of Rhonda VanderKamp.”
Roy is not the only one calling VanderKamp “MVP.”
Seven-year wrestling coach Jeff Mohney echoes that sentiment, noting that his wrestlers call her Mrs. Rhonda or Mrs. V.
“She has never told me ‘no, I don’t have time for that,’” he said. “She handles everything from contracts, referee fees, cancelations, and student-athlete eligibility. She knows every student at Vicksburg and most of their parents.
“What separates her from others is her commitment to the coaching staff and the student-athlete. She is family-driven and lets us be a part of that. She shares stories of her family and asks about ours as well.”
Mohney said one portion of their tenures together stands out in his mind.
“Her commitment to us was not more evident than when masks were required at school,” he said. “We didn’t see her face for over a year. She was trying to keep her families safe to the best of her ability.
“Now the highlight of my day is seeing Mrs. Rhonda’s smile. Vicksburg wrestling would not be relevant without Mrs. Rhonda’s commitment to us.”
One of VanderKamp’s proudest achievements during her 21 years was the addition of 10 varsity sports: hockey, equestrian plus boys and girls clay target, bowling, lacrosse and skiing.
In addition to her athletic secretary duties, she is also in charge of coordinating attendance and discipline.
“All the sick kids, the late kids, the kids who need to leave early all come through my office,” she said.
“Discipline also comes through my office, although I have help with that now.”
Her typical day begins about 7 a.m., and she is usually greeted by the ringing of phones.
“The kids are coming in with notes they have to get out early, parents are calling for sick children, I’m listening to (phone) messages,” she said.
“Once school starts, it’s constant activity. I always make sure I confirm my refs scheduled for that day, make sure my rosters are ready to go.
“Mike always double checks transportation. It’s a cycle. You just know what needs to be done, and you go with it.”
She said the job has also become a lot busier with the additional sports including “entering every athlete into the athletic software, making sure they’re all getting their awards, keeping on top of coaches when they add athletes, submitting pictures once I receive them onto our website and to boosters so we can print a booklet for each season.”
Time to travel abroad
The travel part of her retirement will include a trip to the Netherlands to visit Suzan Hauwert, who lived with the VanderKamps during the 2001 school year, and to Germany to visit Annika Busch, who lived with the family in 2003. Both were exchange students.
In addition, “My husband spoke Dutch before he spoke English, so his parents came right over on the boat,” the soft-spoken VanderKamp said.
Her husband, Gerrit, was in the U.S. Army and stationed in Germany, so they also plan to visit some of his old bases.
While VanderKamp has never visited Europe, both exchange “daughters” have been back to Vicksburg several times to visit.
“Both were in my daughter’s wedding five years ago,” she said. “They’ll join us on vacations or come to visit. It’s such an intense bond we share with them.”
She also is looking forward to spending more time with 2-year-old granddaughter Presley, who lives in Portage with parents Andrea (VanderKamp) and Michael Prior.
Son Robert, and his wife, Shelby, live in Kalamazoo.
While she expects to leave her job in June, she said she does not need a lot of praise or attention – but deservingly is receiving it.
One of those praising her is Vicksburg’s 16-year volleyball coach Katrina Miller.
“Rhonda is a miracle worker” Miller said. “I swear she can do it all!
“As far as impacting my sport, it’s always nice for me to know that things are in order with my team and their paperwork and information.
“I have emailed her at odd hours looking for copies of physical forms or eligibility for tryouts and she is always right on it. She is going to be very missed, but we are happy that she will be able to have some time with herself and with her family.”
While her daily job may be over in June, VanderKamp and the Bulldogs will see each other again.
“I love the kids, I love my co-workers,” VanderKamp said. “I plan to sub if they need me in the office, so it’s not really goodbye. It’s ‘See you around.’”
Pam Shebest served as a sportswriter at the Kalamazoo Gazette from 1985-2009 after 11 years part-time with the Gazette while teaching French and English at White Pigeon High School. She can be reached at [email protected] with story ideas for Calhoun, Kalamazoo and Van Buren counties.
PHOTOS (Top) Rhonda VanderKamp sits at her desk as she begins her 21st year in the Vicksburg athletic department. (2) VanderKamp has worked all 21 years alongside athletic director Michael Roy. (3) The VanderKamp family, from left: son Robert VanderKamp, daughter-in-law Shelby VanderKamp, son-in-law Michael Prior, granddaughter Presley Prior, daughter Andrea Prior, Rhonda VanderKamp, husband Gerrit VanderKamp and father Bob Rainwater. (4) Rhonda VanderKamp has welcomed thousands of students during her time as athletic and attendance secretary. (Top two and bottom photos by Pam Shebest; family photo courtesy of Rhonda VanderKamp.)