Kokomo Tribune; Kokomo, Indiana

November 15, 2013

Fighting concussions

Dr. Daniel Kraft helped write state rules

By Ken de la Bastide Kokomo Tribune
Kokomo Tribune

---- — Right after the hit during a Northwestern High School junior varsity football game, Noah Brahm knew he had suffered a concussion.

Braham was playing defensive end when the hit took place Sept. 30, which brought his season to an end.

“I knew it right away,” he said. “My vision was blurry and I was extremely dizzy.”

For Brahm it was the second football season that was curtailed by a concussion while playing on the defensive team.

“Last year the trainer told me I had suffered a concussion,” he said. “I’m planning on playing next year. I’m not really concerned.”

Noah’s mother, Beth, knew her son had suffered a second concussion.

“He was very dizzy. I noticed him on the sidelines wavering back and forth,” she said. “I could tell he was not acting himself. I could see he was having problems.”

The Northwestern High School trainer Michael Berger recommended that Noah see Dr. Daniel Kraft at Community Howard Regional Hospital.

The hospital staff works with all athletic trainers at Howard County schools in terms of education on concussions and other injuries.

Kraft helped write the legislation passed by the Indiana General Assembly concerning concussions suffered by high school athletes which went into effect in 2012.

He said the legislation is only for high school athletes explaining the reason only for high school is there is no governing body for kids younger than high school.

“We don’t have a state junior high school athletic association, so there wasn’t anybody that could enforce the rules,” Kraft said. “The [Indiana High School Athletic Association] helps enforce the rules.”

There was a law being considered this past summer to implement the rules to cover all clubs and any athletic events that took place at school facilities. Kraft said there were enforcement issues.

“The idea of trying to help our younger athletes is still there, [we] just need to determine how to do it,” Kraft said. “There are [school] districts around Indiana that are extending their impact testing which is one of the parts of the equation to middle school.

“The whole idea of legislating how to take care of concussions is really a tricky issue,” he said. “We want to improve the care for the athlete that has a concussion.”

Kraft said the most important part of the legislation is education. Each year, the athlete and their parents have to receive some education on concussion and how we manage, diagnosis and recognize the symptoms.

The legislation states if an athlete has symptoms of a concussion during a practice or at a game, they have to be taken out of the contest immediately either by the medical staff or referees. They can’t return to action on the same day.

Before returning to practice the athlete have to been seen and evaluated by a medical professional with proper training.

Kraft said in the past five years the number of patients being seen with a concussion has raised by 20 percent among athletes.

“The biggest change over the past 10 years for us is to understand how significant concussions are and how it impacts our kids,” he said. “Ten years ago, when someone got hit and they had concussion like symptoms, we would take their helmet. Hold them out for 15 minutes and at that point if they were clear with no symptoms we would let them go back in.”

The new rules specify when kids have concussion like symptoms they should never go back into a game that day, he said.

“The biggest danger of concussion is having an injury on top of one that has not healed completely,” Kraft stressed. “When that occurs, you’re chances of long term issue’s goes up.”

Kraft said genetics is a part of the research now being done into concussions with the belief we’re going to find that genetics play a role in a kid being more susceptible to concussions.

“Some people believe the old saying that three concussions and you’re out,” he said. “That’s not true. There is no gold standard for how many concussions someone can have. It depends on their age, how often, how close together they were and how long it takes to recover.

“Sometimes we do tell kids they shouldn’t play again,” Kraft said. “Based on Noah having one a year ago and again this year, we probably wouldn’t tell him not to play. Most people would say he is at a little higher risk.”

Kraft said the NFL has really pushed raising awareness of concussions to the high school level and lobbied for the passage of the legislation in Indiana.

“We have to continue to get better,” he said.