Experts: Rules enforcement and education key to limiting concussions

Experts discuss protecting players at unique lacrosse health conference timed to coincide with Face-Off Classic

March 11, 2011|By Kevin Van Valkenburg, The Baltimore Sun

Dr. Margot Putukian, the team physical for Princeton University, was on the sidelines of a Tigers' men's lacrosse game last year when two players smashed into one another, their helmets colliding. Each got to his feet, but was clearly dazed and possibly suffering from a concussion.

The game was being broadcast on ESPN U, so the audience was much larger than just those in the stands. Putukian, who is one of the most knowledgeable minds in the sport on the subject of concussions, received a text message almost immediately: "This is exactly the kind of thing we're trying to take out of the game."

The person who sent the text was Steve Stenersen, the president and CEO of US Lacrosse. He and Putukian have been working together for several years, trying to raise awareness about the growing number of concussions in the men's and women's games, and Friday at the Sheraton Inner Harbor, they got a chance to make their case to an audience of team physicians, orthopedic surgeons, trainers, and lacrosse administrators and coaches as a part of the 2011 Lacrosse Sports Medicine Conference.

The day-long conference, a unique gathering of the top minds in lacrosse timed to correspond with Saturday's Face-Off Classic at M&T Bank Stadium, covered a number of hot topics within the sport — eye injuries, conditioning, injury prevention — but the concussion issue is one that has become increasingly important in recent years, especially in youth sports. In 2006, a 13-year-old boy from Maple Valley, WA, suffered a life-threatening brain injury after he went back into a football game following a hard hit that sent him to the sideline. That spurred a number of changes in the way sports — including lacrosse — view concussions.

Concussions are becoming a problem, Putukian said, and research suggests that better helmets — a popular proposal — are not a realistic solution. Most blows to the head that result in concussions wouldn't be prevented no matter what helmet was being worn.

"The research data does not yet say that helmets minimize concussions," Putukian said.

Enforcing the rules, and getting better at diagnosing concussions, is the only way to insure the safety of the athletes.

"We need to change the culture of the game and the way it's played," Putukian said. "Especially the men's game, where we have athletes propelling themselves at one another like missiles."

Stenersen said he felt like he, Putukian and Dr. Richard Hinton of Union Memorial, were all seeing some of the research on concussions, but the general public didn't have access to it, which is why the Medical Conference was an important step in getting the word out.

"Concussions have really become the priority injury in the last three years," Stenersen said. "It's something that is on everyone's mind. ... We've learned a lot about concussive events. But there is a heck of a lot more that needs to be learned, and that's going to come with time and investment and greater research."

Putukian said, other than preventing big hits, one of the most important aspects of concussion education is knowing how to properly diagnose the symptoms, and make sure an athlete isn't allowed to talk his or her way back onto the field after an injury.

"Coaches always want to know 'How bad is it? How long is he out? Can he go back in the game?' " Putukian said. "In the past, we'd say 'Well, he lost consciousness and he's out for a month. That's what the guidelines says.' But we don't have that anymore. We need to start telling our coaches that we just don't know."

Stenersen said he feels like the sport is making progress — there are now greater penalties for big hits — but there is always going to be resistance and a need for education. And what coaches and administrators need to realize is, the game can't grow if it's not considered safe.

"Some people who have been in the game for a long time have their image of what the game should be, and haven't had the benefit of a broader perspective when it comes to injury and risk management," Stenersen said. "I'm 50 [years old], and when I played football, basketball and lacrosse, I probably had multiple concussions. But they weren't defined as concussions. Societal acceptance of risk is very different today than it was in 1978. There is a lot more accountability. And you can't ignore that as a sport. You need to evolve with it."

kevin.vanvalkenburg@baltsun.com

twitter.com/KVanValkenburg

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