Sean Osbourne never worried about getting a concussion.
But the former Dutchtown High football player knew something was wrong after one play during his redshirt freshman year at the University of Louisiana at Lafayette.
“We were playing Kansas State,” Osbourne said. “We looked at it on film and it didn’t seem like much. My head got a little low and the defensive guy came over the top.
“I remember being woozy and my legs felt like they had weights on them. I went to the trainers and they diagnosed it (concussion).”
Two more concussions followed and Osbourne, an offensive lineman, took the advice of doctors and gave up football.
The fact that football players like Osbourne suffer concussions is nothing new. The diagnosis and treatment of concussions is changing. The way physicians, athletic trainers, athletic governing bodies and government officials view them also continues to evolve.
Last summer, the Louisiana High School Athletic approved guidelines for concussions, defining them as “a traumatic brain injury that interferes with normal brain function.”
The LHSAA guidelines also set up a protocol for diagnosis, treatment and management of concussions. The rule provides a list of professionals qualified to diagnose, manage and determine when an athlete can return to action.
Earlier this year, the Louisiana legislature approved ACT 314, putting standards for schools to follow. The guidelines apply to all sports, with football at center stage.
ACT 314 states that before each athletic season, all public and private schools are required to provide “pertinent information” about the nature and risks of concussions and head injury to coaches, officials, volunteers, athletes, parents and legal guardians.
The new law also requires all coaches, including volunteers, to complete a concussion education course each year. Athletes and their parents/guardians are required to complete a head injury information sheet that provides “adequate notice of statutory requirements that must be met by an athlete with a head injury or a suspected head injury can return to play.
“Things have changed so much in terms of how we look at and treat concussions,” St. Amant High athletic trainer Scott Arceneaux said. “The science and knowledge continues to grow.
“The LHSAA has done a good job of being proactive when it comes to concussions and sports medicine. Unfortunately, things like this usually only get attention when something catastrophic happens.”
One of the nation’s foremost experts on concussions is Natchitoches native and LSU graduate Dr. Julian E. Bailes, a founding member of the Brain Injury Research Institute.
Bailes, a former team physician with the Pittsburgh Steelers, has served as a team physician for either an NFL or college team for more than 20 years. He is a key neurological consultant to the NFL Players Association and serves as director of the Center for Study of Retired Athletes.
Through his work as the medical director for Pop Warner Football, Bailes has enlisted the support of two prominent college coaches with Louisiana ties, LSU’s Les Miles and Alabama’s Nick Saban.
In 2002, Bailes and neuropathologist Dr. Bennet Omalu identified the first clinical instance of chronic traumatic encephalopathy or CTE, a cognitive deterioration disorder with symptoms that include mood swings, memory disturbance, dementia and Parkinson’s disease found by studying former NFL players.
One of the biggest issues regarding concussions is diagnosis. Unlike a knee or ankle injury, a concussion doesn’t cause swelling a medical professional can see.
Bailes points out that only a small percentage of athletes who suffer concussions lose consciousness. Osbourne said he is among those who never lost consciousness.
Some players, like former Pittsburgh Steelers offensive lineman Mike Webster, who was found to have CTE after his death, are never diagnosed with a concussion.
Bailes, who was team physician at West Virginia, said similar problems were found after former NFL player Chris Henry, a Belle Chasse native and an ex-WVU player, died in an non-football accident.
“A series of sub-concussive blows is a serious thing,” Bailes said. “It’s not just about the big hits people see or about head on collisions. You have linemen who are hitting people or who get hit on every play.
“Side impact hits that happen when a player doesn’t see it coming can be just as dangerous. We’re seeing this not only in football, but also in other sports, like soccer.”
Bailes, who played football for two years at Northwestern State, said concussions can never be eliminated. He noted helmets can only do so much to prevent a concussion.
A list of proactive measures starts with providing quality helmets that are in good condition and fit properly. Teaching proper technique and enforcing the rules already in place to prevent injuries are also keys to head injury prevention, Bailes said.
“Would I like to see the rules changed so that the chance of a head injury are reduced even more? Yes,” Bailes said. “I’d like to see linemen taken out of the three-point stance. But is that likely? Probably not.
“The No. 1 tool we have is education. Coaches, parents and athletes need to understand what the symptoms are and how serious they are. They need to understand that mood swings, fatigue and not doing as well in school can tell you something.”
Through his research, Bailes has become an advocate of using an Omega 3-based supplement with DHA. A natural substance with no negative side effects, research has shown that Omega 3 with DHA may help repair brain cells and is viewed as another preventative measure.
Locally, Dr. Jeff Burham, one of LSU’s team physicians, is helping lead sports specialized physicians who are looking to educate the public about concussions.
Burham said more people, including parents, should become familiar with Sports Concussion Assessment Tool 2 form approved by several international bodies, including FIFA, the International Olympic committee and the International Rugby Board. The form can be found online and is a tool athletic trainers use on the sideline.
“The SCAT2 includes 22 symptoms of concussions you check for,” Burham said. “There also are questions you ask to confirm whether the athlete knows where they are or what month it is. You test for coordination and physicals signs to get an overall score.”
Arceneaux said St. Amant is encouraging its athletes to use the Omega 3-DHA supplement. SAHS and Episcopal are currently the only local schools that do impact testing, a series of neurological tests that provide a baseline for later diagnosis of head injuries.
Gonzales-based St. Elizabeth hospital has stepped in to sponsor the 40-minute test that has athletes perform a series of cognitive and memory-related tasks, providing a baseline for testing after a suspected injury.
A New Iberia-based company, Concussion Solutions operated by certified athletic trainer Tommy Dean, does impact testing for 28 schools and is under contract to Iberia and St. Mary Parish schools.
Along with testing, which Dean said costs $25 per athlete, a protocol for treatment and for return to action is set up.
“To me, head injuries are the scariest things to treat because you can’t see swelling like you would if it was an ankle or knee,” Dean said. “What we’re trying to do is provide a tool.
“The key is getting this information in the hands of the right people, the doctors and trainers, who will make diagnosis and set up treatment.”
Burham favors a graded return to play over three to seven days for athletes with concussions. The process starts with letting the athlete ride an exercise cycle one day, followed by light jogging and drills. During each step, athletes are retested to see if symptoms remain.
“I like the use of impact testing and some of the other practices out there,” Burham said. “They’re tools in the toolbox we can use. In this case, you take advantage of all the tools you can.”
Just as the role medical professionals play in concussion treatment is changing, the part a young athlete plays in the process must also evolve.
Arceneaux and other athletic trainers know that high school players may be reluctant to identify concussion symptoms for fear of losing playing time or a position.
Osbourne said he was never diagnosed with a concussion in high school, but remembers one or two instances in which he may have suffered a “minor” concussion.
“You can put in all the safeguards you want,” Arceneaux said. “People - whether its coaches, athletes and parents - still have to follow them.”
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