NCAA Needs a More Heads-Up Approach to Concussions
By Hallie Zwibel and Alice Heron-Burke
Molly Poletto, a University of Utah goalkeeper destined for stardom, was forced to cut her soccer career short after suffering eight concussions. Molly acknowledged that she did not give herself enough time to heal between injuries, behavior that ultimately resulted in years of speech and vision therapy, withdrawals from college courses, and short-term memory loss.
Molly isn't alone. Every year, thousands of student-athletes who suffer a concussion return to the field before they are fully healed, potentially resulting in serious cognitive disabilities. These disabilities can severely compromise life prospects after graduation.
Unfortunately, existing concussion protocols don't properly protect students. The National Collegiate Athletic Association, the organization that regulates college athletics, specifies the stages a student athlete must go through before returning to the field after a concussion. But the NCAA says little about how a student should return to the classroom.
That needs to change. A student unable to engage in academics isn't ready for competitive athletics. Without a strong "return-to-learn" protocol alongside a "return-to-play" guideline, decision-making responsibility falls to those most reluctant to keep star athletes sidelined -- the students themselves, their coaches, and colleges where athletics is big business. The NCAA must implement a specific, evidence-based strategy that ensures students that have suffered a concussion can return to learn.
Currently, the return-to-play protocol relies on subjective determinations and self-reported symptoms. But athletes operate within a competitive culture that discourages reporting symptoms accurately. Indeed, five in every six suspected college football concussions go unreported. That figure is likely similar in other high-risk sports. In fact, one-fifth of college athletes are unlikely to report concussions symptoms to a coach.
Consequently, many students who look physically fine but are still struggling to regain full cognitive abilities return to play too early.
Even worse is the danger of another concussion suffered before a student-athlete has fully healed from the previous one. The student may experience severe changes in behavior and information processing abilities. Multiple concussions can even cause permanent brain damage.
Therefore, the NCAA should implement a "return to learn" concussion protocol. This should include required medical assessments, such as neurologic exams and tests for vision and memory, to determine if a student-athlete is ready to return to learning. It should also incorporate wellness services that ensure students are mentally prepared to reintegrate into modern university life -- beyond college athletics.
The return-to-learn approach works. Consider one student who suffered a concussion at our school, the New York Institute of Technology. Upon entering our Center for Sports Medicine, physicians assessed the student and assigned him a numerical score based on the severity of his symptoms. They also performed a comprehensive neurological exam, assessed vision and cognitive abilities, and provided physical therapy services for the student.
Medical staff were able to identify the student's weak areas and tailor their treatments accordingly. Moreover, access to counseling and wellness services ensured the student was properly equipped to handle any mental symptoms -- like anxiety or depression -- that could arise after injury. Ultimately, he safely reintegrated back into the classroom -- and to his team.
Such success would have been impossible without a holistic protocol involving experts focused on the student's well-being.
The NCAA must take similar steps to ensure students feel supported in their academic environment. Only then will student-athletes be able to return to university life ready to play and learn.
Hallie Zwibel is director of New York Institute of Technology Center for Sports Medicine, where Alice Heron-Burke is senior director of Counseling and Wellness.
