by Publisher | Nov 14, 2012 | Print Coverage, Updates
Football players undergo baseline testing and evaluation before resuming play
November 14, 2012
By Christy Cabrera Chirinos, Sun Sentinel
Cooper City football player Tyler Sabine took a brutal hit in a game early this season. The sophomore was throwing up just before halftime. His coaches knew it was time to pull the linebacker from the game.
Two days later, Sabine was diagnosed with a concussion.
That diagnosis kicked into place new guidelines passed by the Florida Legislature eight months ago, establishing strict procedures to allow concussed athletes, such as Sabine, back on the field.
As the
high school
and youth football seasons wrap up this month, many say the new law on concussion management is working.
Sabine was sidelined for more than two weeks before doctors cleared him to begin the gradual four-step return-to-play protocol now mandated by the Florida High School Athletic Association.
“Our trainers were amazing once they realized there was an issue,” said April Bourassa, Sabine’smother. “It was scary. It’s a brain injury, and it’s not like you have another one of those. But they’ve really made it to where now, you’re more informed and I love that. Everyone was very thorough. I felt like my son was being taken care of and informed.”
High school coaches and parents are being more hands-on about concussion awareness. Injured athletes are being evaluated by physicians, and sitting out as long as needed. Once medical clearance is given for them to return, athletic trainers are helping those athletes follow state guidelines that gradually manage a safe return to play.
“This is something that had to be dealt with,” said Archbishop McCarthy coach Byron Walker, who has seen one of his players, running back Nick Bost, sidelined with a concussion this season. “It takes it out of the hands of people who have an interest and puts it in the hands of professionals. It’s just going to be safe for the kids in the end.”
Bost, who was injured during spring practice, only recently returned to action after dealing with post-concussion syndrome months after his concussion.
“I knew it had to be done,” Bost said. “It may have been a mild concussion, but I wanted to be cautious and because I was still having symptoms, I held myself out. And my coaches were cool about it. They understood.”
Returning to action
The new law requires that if an athletic trainer or coach suspects an athlete has suffered a concussion, the athlete must be removed from play. And once an athlete has been diagnosed with a concussion, he or she cannot return to play until medically cleared by a physician.
Once that clearance is given, state policy dictates an athletic trainer supervises a four-step return-to-play protocol in which athletes see their activity level increase daily. If at any point in the process, an athlete exhibits concussion symptoms such as dizziness or sensitivity to light, they must wait at least 24 hours before attempting that level of activity again.
Youth football leagues across South Florida also are working to keep the youngest football players safe. Ross Sinel, president of the American Youth Football League, which includes teams from Broward, Palm Beach and Miami-Dade counties, said educating coaches and parents has been a major part of the league’s concussion management efforts.
And like high school athletes, no concussed AYFL athlete can return to play without a physician’s clearance.
“We had a clinic for our coaches with the doctors from the University of Miami, we have a policy where all coaches and parents have to sign off on concussion documents, and the AYFL has kept a database of all the concussed kids,” Sinel said.
In addition to the new state law which went into effect July 1, Broward County Schools have mandated baseline concussion testing for all high school athletes.
In Palm Beach County, more than 600 football players have participated in voluntary baseline testing.
All of that has helped lead to increased education and awareness of an often-misunderstood injury that if not treated properly, could have lasting effects on young brains.
“I think it’s all helping people do their jobs more effectively,” said Stephen Russo, the director of Sports Psychology at the Nova Southeastern University Sports Medicine Clinic. “The athletic trainers are overseeing the return-to-play protocol, the doctor is doing the medical approval, I’m doing what I’m trained to do and the coaches, at the end of the day, are doing what they’re trained to do. Everyone has their assigned roles in helping the athletes.”
Russo is working with the Broward County Athletic Association to carry out its baseline testing program. He estimates that this year, more than 50 athletes already have come to Nova’s Sports Medicine Clinic for post-concussion evaluation. In the entirety of the 2011-2012 school year, the clinic saw 101 cases.
At Cleveland Clinic in West Palm Beach where Dr. Evan Peck is helping Palm Beach County schools carry out its voluntary testing, there’s been an increase in patients, too.
by Publisher | Aug 7, 2012 | Featured, News Coverage, Print Coverage, Updates
Sunday, August 05, 2012
by Hal Habib
David Goldstein, shown speaking in Tallahassee, has fought to make it illegal for virtually any high school or youth league in Florida to allow a child to return to practice or play if he’s suspected of suffering a traumatic brain injury without first receiving written medical clearance. (Photo courtesy Countywide Concussion Care)
NOTE: This is the second in a two-part series.
Part 1: After son’s tragedy, S. Fla. mother strives to reduce football concussions in youths
The story of David Goldstein begins like many — make that too many — young athletes.
One concussion was followed by another, then a third. If they were scary, the way he handled them, in retrospect, was more frightening. He played two full soccer matches immediately following the second concussion because it was State Cup weekend in Wellington. He didn’t come out of the match following his third concussion because it was a high school district title match. He figured his team needed him.
Disconcerting as that is with what we know about concussions today, David Goldstein, 17, would be the first to say none of that makes his story unique. Kids suffer concussions every day, he points out.
No, what happened next does make Goldstein’s story unique.
First, he got better under the guidance of two University of Miami physicians who have become leading experts on such injuries.
Then, he got going. Convinced by doctors Gillian Hotz and Kester Nedd that baseline testing is an important tool in protecting athletes, he worked to make the test available at his school, Miami-Ransom Everglades. Next, recognizing that public schools in Miami-Dade County aren’t afforded the benefits that private schools enjoy, Goldstein decided to raise $20,000 to introduce the cognitive test to all public schools in Dade.
Still not enough.
Zeroing in on state laws, he fought to make it illegal for virtually any high school or youth league in Florida to allow a child to return to practice or play if he’s suspected of suffering a traumatic brain injury without first receiving written medical clearance. It also requires informed consent to play.
He’s also determined to make baseline testing standard throughout Florida even if it means working county by county, a push that likely helped inspire Palm Beach County schools this year to follow Dade and Broward’s lead.
To say Goldstein’s efforts went just as planned isn’t quite accurate. The bill he championed initially was defeated in the state legislature but his persistence was rewarded when Gov. Rick Scott signed it into law in April. David monitored passage of the bill via computer at school, success etched so clearly across his face that students he didn’t even know were high-fiving, hugging and applauding him. The vote was unanimous.
Oh, and he did not raise $20,000. He raised close to double that.
“My doctors’ motivation to help other people through their research kind of made me realize that I have an opportunity,” Goldstein says. “That I can be the face of local efforts and try to expand them because I’ve gone through it. I was willing to put my face out there. I was willing to go out and raise the money that no one else had time to raise.”
Marc Buoniconti, president of The Miami Project to Cure Paralysis, describes Goldstein as remarkable and selfless.
“David has just been a great ally in this initiative,” Buoniconti says. He works with Goldstein through The Miami Project’s KiDZ Neuroscience Center, which researches traumatic brain injuries because they’re closely associated to spinal cord injuries. “He’s so well-spoken and his story is so dramatic and so spot-on, that it just goes to show you a kid like David, a young kid, is just a great role model.”
Goldstein, whose family lives in Buoniconti’s former Coral Gables home, left an impression on Sen. Anitere Flores, R-Miami, who sponsored Goldstein’s bill. David sought to shed light on a dark, often confounding condition. He didn’t want other kids to experience the partial diagnoses, of being told to never play sports again, of needing to nap in the school nurse’s office because of headaches, fatigue and nausea — what he endured before meeting Hotz and Nedd.
“He recognizes that he is incredibly blessed with family support, and rather than sit back and say ‘good for me,’ he’s gone into communities locally and across the state advocating for what he knows will save lives,” Flores said via e-mail. “I can go on and on because David is that special. I’ll just end by saying that the world needs to keep an eye on David Goldstein because his talent and commitment is far from being exhausted!”
It hasn’t been without a price. Goldstein, a senior who is expected to be Ransom’s captain, is easily distinguishable on the field.
“I actually wear a rugby helmet when I play soccer now, which may not be the greatest fashion statement in the world, but it allows me to play the sport that I love,” he says.
Opposing fans, who have no idea what’s behind the helmet, make him a target.
“Some of the abuse I’ve heard would not be approved by the FCC — not even close,” he says. “I’ve heard some of the meanest things that I’ve ever heard in my life directed at me just for wearing a helmet. … Parents yelling ‘special ed’ at me. And you’ve just got to have the mental and emotional fortitude to realize that those people just don’t matter in your life.”
Cheryl Goldstein, his mother, admits it can be tough to hear.
“You look at this world and you look at how cruel people can be and I’m glad that David is tough enough, at least on the outside, to take it,” she says. “But it impacts him on the inside, as he’s human. I just hope that there’s a lesson in tolerance.”
Like Cheryl, David has testified before the state legislature.
“He felt comfortable to talk about it publicly, which is not something that a lot of children would be willing to do, because obviously he’s talking about problems that he had in his head,” says his father, Adam.
Flores says David not only caught on to the political process quickly, “he dominated it.” She adds, “He wouldn’t take no for an answer. He would fight half truths and misstatements from the other side with facts and figures in a methodical way.”
Adam Goldstein is president and CEO of Royal Caribbean International, but even though a cruise was the grand prize in a drawing that raised the initial $8,000 at Ransom-Everglades, Adam and Cheryl had David go through standard channels to obtain that donation.
“I admit that we are fortunate to know people who have the means to make contributions and who certainly are charitable in other areas of life, but he needed to sit down with every person who contributed to him and explain in person — without us there — what he was doing, why he was doing it and to ask them for money,” Adam says.
David: “It’s definitely a welcome-to-the-real world experience. Usually when I’m talking to adults, in a sense, I’m asking them for help on my homework. I’m not asking them for as much money as they’re willing to give me.”
Nervous? Not really. His cause “almost gave the people I was asking for money no choice” but to help, he says. “When you have passion about anything, it’s an invaluable tool.”
Goldstein, an A student in honors classes, hopes to attend Princeton, his father’s alma mater, and perhaps someday coach. He says until he meets with those who have backed him, he’s unsure of his next steps in the concussion fight … yet in the next breath, he rattles off that he must make sure Dade’s baseline program is self-sufficient for when he leaves for college. He’s got to continue educating coaches, parents and athletes. He has youth organizations to get onboard. Work on his site, countywideconcussioncare.com. Et cetera.
“Kids are getting concussions today,” he says. “They’ll be getting concussions tomorrow. They’ve gotten concussions yesterday. In Florida. All over the country. All over the world. And they don’t know who to turn to.
“They’re going back into the game too early. Second-impact syndrome is happening. People are researching more about CTE — these tragedies keep occurring in NFL players. There’s still more work to be done.
“I’m very happy with what I’ve been able to do but I’m not done and don’t intend to be for a while.”
Says Buoniconti: “I would watch that kid in the future.”
by Publisher | Mar 27, 2012 | News Coverage, Print Coverage
Our lives changed when David suffered his third concussion. It was the district final in soccer against our rival high school and my freshman had just gone into the biggest game of his life. After he had head to head contact, he kept playing the rest of the game and attended club practice the next day. After the practice he collapsed and we all realized something was wrong. David had a concussion and proceeded to have post concussion symptoms for more than three months. After educating ourselves on the dangers of second impact syndrome and the dangers of going back to activity too soon, David decided to speak out and help educate his community on traumatic brain injuries. He started at his school, then he spoke to all the PE teachers, trainers and athletic directors in Miami-Dade County. He even raised the funds so that all of the public high school students could have baseline and post concussion testing for the next four years.
But David did not stop at there. David traveled to the state capitol four times to speak to Representatives and Senators to explain why their support was needed and why we needed to pass legislation. “My experience of passing youth concussion legislation was interesting, frustrating, and rewarding. My Dad tells me that I have received a civics lesson like no other. I learned an incredible amount about the political process, the incredible amount of work it takes to pass a bill, the importance of networking and establishing connections, and the devotion to the cause that is required to drive legislation into a law. I endured a lot of stress, worry, and disappointment over the last year and a half, whether it be from fretting over the bill’s four day stall in the Senate Budget Committee this year or the failure to pass the bill a year ago,” explains David.
“In the end, a sweet victory with unanimous votes on the House and Senate Floors was achieved. The legislation’s passing means that youth athletes will be out of the game and under expert care when they are injured, so that they can get back to the game safely. I supported this legislation so that kids do not have to suffer the way that I did from my concussions.” said David. It was great to be on the same team as the NFL who also worked hard to see that this legislation was supported and passed. It was extremely important to have strong bill sponsors, Sen. Anitere Flores and Rep. Ronald Renuart, who worked hard to ensure that special interest groups did not derail the bill while preserving a good return to play scenario and that the bill was on the agenda for the needed committee hearings and eventually voted on before the end of the legislative session. We are elated that Governor Rick Scott will sign this bill in the next couple of weeks.
By: Cheryl and David Goldstein
by Publisher | Mar 8, 2012 | News Coverage, Print Coverage, Uncategorized
TALLAHASSEE, Fla. — The Florida Legislature today unanimously passed a bill that will help prevent head injuries among student athletes in Florida. Sponsored by Senator Anitere Flores, R-Miami, the bill passed unanimously from the Senate and will now be sent to Governor Rick Scott for the opportunity to be signed into law. Educating youth athletes, coaches and parents about the warning signs for concussions, Senate Bill 256 aims to protect injured athletes from getting back into the game too soon.
“I heard personally from concerned constituents about the lack of awareness regarding head injuries and the proper precautions,” said Flores. “All too often, athletes get back in the game without fully considering their injuries and the potential for long-term cognitive deficits. I am very proud of the strides that were made today to help protect Florida’s student athletes and am thankful for the broad support from both sides of the aisle.”
Traumatic brain injuries occur when a player receives a major blow to the head that causes the brain to slam against the skull, resulting in soft tissue injury and cell death. Often, there is a second injury as the brain rebounds against the opposite side of the skull. These injuries can occur in a variety of sports’ games, tryouts and practices, including football, volleyball, baseball, lacrosse and cheerleading. According to the Center for Injury Research and Policy, of the approximately 140,000 high school athletes who suffer concussions each year in the United States, more than 40 percent return to play before properly recovering. Such head injuries can have profound effects on children with developing brains. In extreme cases, injuries can even lead to death.
Currently, at least 30 other states have adopted legislation similar to Flores’ bill, which is supported by the National Football League and the National Collegiate Athletic Association. SB 256 will educate parents, student athletes and coaches on the risk and identification of brain injuries. It also authorizes the Florida High School Athletic Association and coaches’ associations to create rules for removing student athletes when brain injuries occur, and it establishes a policy to return players back to play after their recovery with the authorization of a doctor.
Seventeen-year-old Miami-Dade County resident David Goldstein and his parents, Adam and Cheryl Goldstein, were among the advocates who came to Tallahassee this session to advocate in support of the bill. David suffered a serious head injury in 2010 when he collided with another soccer player during the district finals for his school team. He knew immediately that something was not right, but he stayed in the game. In the days that followed, David exhibited flu-like symptoms followed by weeks without improvement. The Goldstein family went through months of medical consultations before identifying the proper treatment. Today, David is wise to the potential risks, wears protective headgear and knows how to identify the warning signs of traumatic brain injuries. He has also become an advocate for athlete education and concussion testing at local public schools in his area.
“David’s example resonates because this scary situation could happen to any player and any parent of a student athlete,” added Flores. “Without being educated about the potential risks, parents are simply unaware of the symptoms their child might be experiencing. SB 256 will help individuals assess these situations and provide the proper care.”
