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Colt McCoy Proves Difficulty of Regulating Student-Athlete Head Safety

If you're wondering why concussions have become such a major health problem for athletes of all ages, look no further than what recently transpired with Cleveland Browns quarterback Colt McCoy.

Two weeks ago, Pittsburgh Steelers linebacker James Harrison leveled McCoy with a helmet-to-helmet hit, causing McCoy to crumple to the ground, holding his head. The Browns' medical staff rushed onto the field and escorted McCoy to the sideline.

Less than four minutes later, McCoy re-entered the game.

The team revealed after the game that McCoy had sustained a concussion from the hit by Harrison. The only problem is, the Browns' medical staff didn't test McCoy for a concussion before allowing him to return to the game. They somehow didn't realize how severe the hit was, Browns President Mike Holmgren said last week.

McCoy isn't the first football player to re-enter a game after sustaining a concussion, unfortunately, and he likely won't be the last. His story is yet another reminder that no matter how many rules are put in place to protect athletes (at all levels) against concussions, the athletes have a unique advantage when it comes to getting around the rules: They can try and hide their symptoms.

The Browns' coaching staff said that McCoy didn't start displaying symptoms of a concussion until after the game, justifying their decision to reinsert him so quickly. But McCoy's father, Brad, told the Cleveland Plain-Dealer that his son didn't remember anything about the game after taking the shot from Harrison.

"I talked to Colt this morning and he said, 'Dad, I don't know what happened,' " Brad McCoy said. Colt was also reportedly sensitive to lights in his postgame interview—another tell-tale sign of concussion.

This incident occurred in a league that's become one of the most proactive forces in battling concussions over the past few years. Coincidence or not, less than two weeks after this incident, the Associated Press reported that the NFL will likely look at expanding the ban on players launching themselves when making tackles and helmet-to-helmet hits.

The bottom line is, concussions are an inevitable part of a violent, physical game like football. The best that medical professionals and the league can hope for is to respond appropriately when a player may have a concussion.

Therein lies the fundamental difficulty with concussions for the time being. Unlike a broken bone, which will show up on an X-ray, concussions aren't diagnosable with any electronic imagery. And that makes it all too easy for athletes to hide their symptoms and try to continue playing.

What Can Be Done?

Baseline tests are currently one of the most valuable tools medical professionals have at their disposal when it comes to diagnosing concussions. Athletes take the test before ever being cleared to practice, to record their healthy level of brain activity, then retake the test after potentially suffering a concussion to see how the results compare.

If an athlete takes substantially longer to answer the same questions, or his or her responses vary wildly between the two tests, a doctor would then likely suspect that he or she had sustained a concussion.

There's only one problem. Not only have athletes been known to hide their concussion symptoms to try and get back into a game, but there's also a rising suspicion of athletes attempting to "game" their baseline tests by deliberately doing poorly on the preseason version. That way, if and when they do sustain a concussion, they've essentially given themselves some breathing room on the second test.

At the National Athletic Trainers' Association's recent Youth Sports Safety Summit, I asked Dr. Kevin Guskiewicz about that very fear about baseline tests. (Guskiewicz, based out of the University of North Carolina-Chapel Hill, received a $500,000 "Genius Grant" from the MacArthur Foundation earlier this year for his work with sports-related concussions.)

Guskiewicz said that while the concern about baseline tests has merit, medical professionals can examine the standard deviations of a player's test results to double-check that they're relatively accurate. At UNC, Guskiewicz said, any student-athlete who scores below 2 deviations of what a typical test score should be will get retested, or referred for ADHD or further medical examination.

The bottom line is, concussion prevention and treatment, for the time being, relies first and foremost on education. Coaches, parents, players, game officials, school nurses, athletic trainers, and school administrators, at this point, all should be knowledgeable about concussions, experts say.

Many states' concussion laws already require parents and coaches to educate themselves about concussions before involving themselves or their children in youth athletics. Advocates say many can go further in their scope.

It took the Cleveland Browns nearly two weeks to admit that its system failed when doctors didn't examine Colt McCoy for a concussion. All NFL games have league observers sitting in the press box specifically watching for concussions (as of recently), and McCoy still slipped through the cracks.

To prevent student-athletes from doing the same, educating anyone involved with youth athletics about the dangers of concussions seems to be one of the safest routes.

UPDATE (1:45 p.m.): Five minutes after I published this post, I noticed a story on ESPN's front page about an NHL player who recently hid concussion symptoms from his team for two days.

Colby Armstrong of the Toronto Maple Leafs was injured against Vancouver on Saturday night, but didn't alert his team's medical staff until Monday afternoon. He's now sidelined indefinitely with a concussion.

"It took us all by complete shock because we had no idea that he had his bell rung the other night," Leafs coach Ron Wilson said Monday night. "He kind of kept that from us."

Once again: If it can happen in a professional sports league, it can happen in a youth sports league. Adults presiding over youth sports need to underscore the importance of admitting concussion symptoms to their athletes.

It's no exaggeration to say that removal from play can be the difference between life and death for an athlete with a concussion or other brain injury.

Photo: Trainers tend to Cleveland Browns quarterback Colt McCoy after he was hit by Pittsburgh Steelers linebacker James Harrison in the fourth quarter of the NFL football game in Pittsburgh on Dec. 8. (Don Wright/AP)

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