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
'Larger-Than-Life' Pennfield AD Admired for Statewide Service
By
Pam Shebest
Special for MHSAA.com
April 14, 2021
BATTLE CREEK — To many Battle Creek sports enthusiasts, Bernie Larson was known as “Mr. Pennfield.”
But for two former athletes, twins Chris and Cam Larson, that was not the case.
“I never knew him or thought of him as Mr. Pennfield; he was Dad,” Chris said.
Larson, 78, who served as athletic director at Pennfield for 29 years, died March 14 after an extended illness.
A memorial service is being planned for May 15 at a time and place to be determined.
“A lot more remembrances come back when someone passes,” said Chris Larson, who lives in Virginia. “You hear so many stories from people who remember him, including former students and coaches.
“It’s great to hear the impact he had on so many people that you never knew about.”
Stories are plentiful when it comes to Bernie Larson.
“He was a heckuva golfer,” said Karen Leinaar, the current executive director of the Michigan Interscholastic Athletic Administrators Association (MIAAA) who during an early stop served as athletic director at Delton Kellogg, which with Pennfield for a time was part of the Kalamazoo Valley Association. “If you needed golf balls on the course, everyone said, ‘Just ask Bernie.’ He always had them.”
The reason?
“If he had one ball in his bag, he had 50 or 60 in his bag,” said Larry Wegener, former Battle Creek Central athletic director. “He had milk crates full of golf balls in his garage” that he found on the course or fished out of ponds.
Championship City
When Larson was named Pennfield’s athletic director in 1970, it became a family affair.
“I had no clue, no clue,” said Joni, Larson’s wife of 56 years. “We never trained to be wives of athletic directors. We learned the most from other wives.”
She became involved in the job, selling tickets at home games. When their sons were old enough, they helped out with the field.
“They knew where the flag was kept and how to play the national anthem. They learned how to keep score” and were active in playing sports, she recalled.
“Cam (who lives in Minnesota) played football, baseball and basketball,” Chris Larson said. “I played tennis, golf and basketball. We grew up playing little league baseball and football.”
One family favorite was the yearly athletic directors conference at Grand Traverse Resort.
“He was there for business; we kids were there for fun,” his son said. “As we got older, we went to the auditorium that was filled with booths with sports-related things.
“As a kid we went around and grabbed the swag. It was a kids of athletic directors thing.”
It was not all fun and games.
“Bernie Larson was instrumental putting Battle Creek on the map athletically,” Leinaar said. “Four of (the ADs), Bernie, Ralph Kenyon of Harper Creek, Glen Schulz of Lakeview and Larry Wegener of Central put on the tournaments and had crews of people every year right there helping.
“Their hard work and commitment to the MHSAA, running perfect tournaments, made Battle Creek a stop for athletics for many, many years. Many times, Bernie led the pack.”
In spite of his willingness to help others, there was a caveat, Leinaar said.
“He would say to me, ‘Karen, I’ll help you out however I can, but remember, Pennfield is going to win.’
“Pennfield joined the KVA in the late 1980s, so we saw each other quite a bit. Our football games were always barn burners as were track and field.”
Wegener recalls those days full of tournaments and 65-hour work weeks.
“We did so many MHSAA events, I think a lot of people thought we were on the staff,” he said.
Those tournaments included more than 50 state championships in baseball and softball, team and individual wrestling, volleyball and girls basketball.
Brett Steele, Pennfield’s current AD, said Larson “was still a strong presence in the athletic department and community as a whole even after he retired.
“Up until last winter, Bernie still helped out at football and basketball games as our officials host. He knew most of the officials in those sports and was a familiar face to many when they worked games at Pennfield.”
Larson had served as an MHSAA basketball and baseball official. He also helped found and is a member of the Pennfield Hall of Fame and coached both girls and boys golf.
He received the MHSAA’s Allen W. Bush Award in 1997, the MHSAA’s Charles Forsythe Award in 1999 and was the MIAAA State Athletic Director of the Year for 1991-92.
All About Family
In spite of the hours spent with his job, Larson was a good family man, Wegener said.
“He spoke highly of his kids,” he said. “Chris and Cam were the pride of his life. Joni was a real good fit for him.”
Wegener said Larson was a larger-than-life guy.
“If you were going to run a tournament and you brought a notebook full of stuff for your tournament, Bernie brought a briefcase.
“If you brought a briefcase, Bernie brought a suitcase. He just believed in being prepared for everything.”
One thing the athletic directors did a lot was frequent restaurants, and Larson had his favorites.
“Perkins whenever he traveled, the Pancake House every Sunday and the Irish Pub,” Chris Larson said.
A person could always spot Larson. He was with one with the napkin tucked over his shirt.
“He always wore a suit and tie and would use a napkin as a bib because he was always spilling something on his necktie,” Joni Larson said.
Another thing her husband was famous for was his jokes.
“He always had a favorite joke that I’d hear 27 times,” she said, laughing. “It was like he had a joke of the week, and everybody had to hear it.”
During summers, Larson taught driver’s education at the school, something Chris Larson remembers well.
“I remember on the last day of driver’s ed, you drove for 45 minutes,” he said. “My brother and I and one other kid were in the car, and I drove to Lansing to the MHSAA and we sat in the parking lot while my dad went inside.
“I know the MHSAA through his eyes and through my own eyes.”
Larson’s love of sports transferred to his sons.
“We all share a love of golf and would play together any chance we got, but over the past years his health wouldn't allow him to play,” Chris Larson said. “I miss that very much.”
Another tradition is being carried on by his son, but it evolved in an unusual way.
The twins were a Christmas surprise for Bernie and Joni.
“They didn’t do ultrasounds routinely back then (1974) so we didn’t know,” Joni Larson said. “We had Bernie’s middle name, Leon, picked out as a first name,” Joni Larson said.
“When we found out there were twins, we gave Chris ‘Leon’ as his middle name and Cameron ‘Noel’ which is Leon backwards, so both had dad’s middle name.”
Chris Larson has continued the tradition, giving his oldest son, Joshua, Leon as a middle name.
Chris Larson echoed the thoughts of many who knew Mr. Pennfield as a people person.
“In my opinion, he was the most Christian man I knew. He lived a Christian life and he shared it with others,” Chris said.
“He was chaplain for some baseball and basketball teams. He knew somebody everywhere no matter where we went in the state.”
Chris Larson paid a special tribute to his father after the funeral.
“He had a parking spot in the circle of the old Pennfield High School right in front of his office,” he said. “His van was there all the time.
“One of the things I did after the funeral was just hang out there for a while.”
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) Longtime Pennfield athletic director Bernie Larson also raised his family in the district, with sons Chris (left) and Cam among those to wear the uniform. (2) Bernie and Joni Larson were married 56 years. (3) Among Larson’s longtime colleagues were former Delton Kellogg athletic director Karen Leinaar and retired Battle Creek Central athletic director Larry Wegener. (4) The Larson family, more recently, from left: Cam, Joni, Bernie and Chris. (Family photos courtesy of the Larson family; head shots by Pam Shebest.)