BY JOE ALBERICO, Senior Staff Writer InjuReplay
In an office in Lincoln, Nebraska, Blake Lawrence sits at his desk, staring into a computer screen without the focus he once had.
Nearly 300 miles away, in Hannibal, Missouri, high school senior Devon Thomas is on his way to a local hospital, unable to understand why.
Lawrence, a 26-year-old entrepreneur and former linebacker for the University of Nebraska football team, now enjoys a life free of violent hits and head trauma. After four football-induced concussions suffered in a 16-month span, the former Cornhusker walked away from the game in 2009, sidestepping potentially serious neurological consequences.
Now, however, Lawrence deals with attention deficit disorder, a setback he admits surfaced after football. But getting the Overland Park, Kansas native to admit repeated head trauma could be the culprit is a different story.
“I don’t want to admit that concussions have affected my brain to the point where I need medication to concentrate,” Lawrence said. “ … but that might be the case.”
Thomas, an 18-year-old linebacker for Hannibal High School, suffered his first concussion during an important home game on Aug. 28. A head-to-head impact left the young athlete a mess on the bench.
“I was really emotional … I started crying on the sideline,” Thomas said. “ I don’t know the buildup (to what happened), or much after. I remember the first quarter, partway through the second quarter and going to the sideline and talking to the trainer.”
Thomas also recalled listening to parts of his team’s game on the radio on his way to Hannibal Regional Hospital.
“The number one thing on my mind was ‘What’s the score of the game,’” Thomas said. “I kept wanting to know the score of the game. I wasn’t even thinking about my injury. I wanted to get the win.”
As is the norm with concussions, Thomas said he later experienced headaches, light sensitivity and nausea at the hospital. Still, he was unaware of what had occurred.
“It didn’t really hit me immediately,” he said. “I never took concussions that seriously, so I didn’t really know what was happening.”
Per Missouri state law and Missouri State High School Activities Association regulations, Thomas was required to undergo a concussion recovery protocol. By rule, he was forced to miss one game while passing the necessary steps to return to practice and live games.
According to the MSHSAA, those steps are as follows:
• 1. Light cardiovascular exercise.
• 2. Running in the gym or on the field. No helmet or other equipment.
• 3. Non-contact training drills in full equipment. Weight-training can begin.
• 4. Full, normal practice or training (a walk-through practice does not count as a full, normal practice).
• 5. Full participation. Must be cleared by MD/DO/PAC/LAT/ARNP/Neuropsychologist before returning to play.
Thomas returned to play on Sept. 11 after receiving the green light from a family physician.
The steps for clearance, however, don’t tell the whole story says Dr. Benjamin Bixenmann, a Nebraska neurosurgeon with a rooted interest in traumatic brain injuries. In cases like Thomas’, where an athlete downplays the significance of a head injury in favor of a quick return, Bixenmann said a lack of hard evidence often makes explaining the significance of concussions a challenge.
“There is no physical, objective test to show athletes that they’ve actually had an injury,” Bixenmann said. “If an athlete breaks a bone, we can take an X-ray and show them the picture. But with concussions, we can’t do an MRI or a cat scan to diagnose an injury.”
Bixenmann went on to say that states with return-to-play and return-to-learn laws are on the right track, but added that these protocols can’t guarantee athletes are 100-percent ready to put their brains through further turmoil – both on the field and in a classroom – even after successfully completing the steps to return.
“We don’t have any great tests to tell athletes when it’s safe to go back to play,” Bixenmann said. “Unfortunately, we’re limited to subjective answers to basic questions: ‘Are you sleeping OK? Are you eating OK? Are you having headaches?’ And honestly, an athlete could hide all of their symptoms.”
While Lawrence no longer deals with concussion symptoms, his battles with ADD may be a longterm side effect. But Bixenmann says Lawrence, and millions of others worldwide with a history of concussions, are left linking side effects to brain traumas on their own.
“Right now there really are no known side effects of concussions,” Bixenmann said. “We’re left with autopsy examinations after someone dies. Then we can look back to see if a person had concussions.
“Repeated injuries can’t be good, but we currently don’t know of any neurological conditions that can occur after one concussion, two concussions, and etcetera.”
Much like Thomas, Lawrence admitted he failed to accept the serious nature of concussions. It wasn’t until former Nebraska head coach Bo Pelini made a startling revelation that Lawrence began reconsidering his future.
“After my third concussion in 2009, coach Pelini brought me aside and said ‘I’m going to be honest with you. If you were my son, I’d never let you play football again,’” Lawrence recalled. “To have a coach put that first – put your health and safety first – it was eye opening.”
Not long after that discussion, Lawrence suffered his fourth and final head injury, and left football. He and his family are still very much involved in the game, and Lawrence said he understands mentalities like those of Thomas.
“A high school player in Missouri probably thinks football is his life, and it’s everything to him,” Lawrence said. “It’s great to have passion for what you do, but at some point, you also have to be real with yourself.”
And with the lack of physical proof to tell an athlete it’s time to hang up the cleats, Bixenmann said it often comes down to an athlete making the best decision for him/her self.
“How many concussions is too many? Is it four, is it 10? We don’t know,” Bixenmann said. “You’re dealing with an organ system that is pretty unforgivable. The brain is such a different organ that it’s just scary for people.
“There’s so much unknown there that it may not be worth putting your body on the line.”
For more information on concussions and other sports-related injuries, visit Injureplay.com or download the Interactive Athlete app on the Google Play Store, Windows and Apple Store on mobile devices