Sidelined: Student-athletes balance health with competitive nature of sports

It was a scene many CMU fans watched during the last three seasons without understanding what was really unfolding on the sidelines.

Struggling to remember where his helmet had gone and why he wasn’t in the huddle on the next play, Lavallii would attempt to put his game face on.

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In his mind, the running back had a ball to carry and the Chippewas had a game to win.

But a concussion had rendered Lavallii ineligible to return to the field. It was a frustrating experience each time it happened. It happened multiple times.

“It got to the point where I was starting to get a little worried,” Lavallii said.

After taking brutal hits during high school and three CMU football seasons, he was forced to take a step away from the game he loves.

The senior running back was advised by a neurologist during the offseason to hang up his helmet for the year. His brain could simply not afford the risk of any more trauma.

“It was one of the hardest decisions of my life,” Lavallii said. “I was honest with myself and honest with my coaches. It got to a point where I didn’t think I should be out there, so I said something.”

Lavallii is scheduled for reevaluation in January. It is possible he could return to the field next season.

The absence of the running back from the team this season forced Chippewa fans to confront the brutality of college football and the growing concern for student-athlete health.

Central Michigan Life has requested data detailing how many student-athletes have been diagnosed with a concussion during the past year. The CMU Athletics Department is in the process of aggregating that data. 

Preventing sports-related concussions and the long-term medical effects of playing contact sports is one of the most controversial topics in intercollegiate and professional athletics.

One of the the organizations leading the discussion is the Concussion Legacy Foundation.

Cliff Robbins is the program manager for education and research at CLF and said while the situation is upsetting, stories like Lavallii’s help promote awareness.

“It’s heartbreaking. This is a young man who made an informed decision about what is best for him,” Robbins said. “That’s really hard. Kudos to him for standing up and making it a priority.”

Saylor Lavallii works on the field with Running Back/Recruiting Coordinator Gino Guidugli before the game in Kelly/Shorts Stadium on Oct. 3, 2015. (Photo by Kaiti Chritz | Photo Editor)

What is a Concussion?

There are between 40 and 50 consensus-based definitions of concussion.

Typically, a concussion occurs when the brain collides with the inside of the skull, resulting in damaged tissue on the outer layer of neurons due to blunt-force impact.

Damaged neurons heal over time, but repeated injury can lead to a breakdown in the healing process. The brain becomes more sensitive to damage after injury happens. Consciousness does not have to be lost for brain injury to occur.

Just one severe injury can change a person’s brain chemistry. Concussions present themselves differently in each athlete — ranging from mild to severe — making detection and testing difficult.

After years of debate, medical professionals now say the long-term negative effects of sustained brain trauma while playing sports is likely.

“Injury alone does not directly lead to long-term problems,” said Dr. Kevin Park, a faculty member in the Department of Psychology and Neuroscience. “If it is sustained — doing it over and over again like with football — people might not notice it. But it can compound itself and lead to problems.”

The majority of sports-related concussions occur in the frontal lobe, a critical spot in the brain’s daily function.

The frontal lobe controls cognitive abilities, judgment and sexual behavior. Sustained damage to this area can lead to mental disease, long-term memory loss and other complications.

“(The frontal lobe is) the main center for decision making,” Park said. 

When football players have head-to-head contact, it can lead to biochemical changes in the brain.

“The brain is very plastic, meaning it is resilient. If (an injury) is mild, it can recover. But if the injury is more serious, the brain might rewire itself. The damage will be more permanent,” Park said. 

NCAA Compliance

The NCAA Concussion Policy and Legislation mandates that universities implement the following, according to its website:

—An annual process that ensures student-athletes are educated about the signs and symptoms of concussion.

— A process that ensures a student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be removed from athletics activities and evaluated by a medical staff member with experience in the evaluation and management of concussion.

— A policy that precludes a student-athlete diagnosed with a concussion from returning to athletic activity for at least the remainder of that calendar day.

— Medical clearance for a student-athlete diagnosed with a concussion to return to athletics activity as determined by a physician or the physician’s designee.

According to the 2015-16 CMU Athletic Training Services Concussion Management Plan, the department is compliant in all of these areas.

At the start of each semester, a fact sheet about what a concussion is, how it can be prevented and what a student-athlete should do if they are injured is handed out to each student-athlete.

Every CMU student-athlete is required to provide a detailed medical history, including head and concussion history, prior to any team participation. Returning student-athletes are required to submit a follow-up healthy appraisal before each season, including a concussion history.

New student-athletes are required to take a Baseline Computerized Neurocognitive Test and a Balance Error Scoring System test when they arrive at CMU.

CMU’s Gameday Protocol

All varsity coaches must sign an acknowledgment at the beginning of a semester saying they accept responsibility for supporting their university’s concussion management program.

A recent study published by collaborators of Concussion Legacy Foundation found the biggest predictor in whether an athlete would report a concussion is how the athlete thinks the coach or teammates will react.

“Awareness has changed dramatically recently because of the emphasis that has been put on it,” said Head Football Coach John Bonamego. “We’re way past due on this. It’s sad that it took a (NFL) lawsuit to get us to pay attention to something that is really important.”

The CMU Athletics Department has an annually updated plan that outlines how concussions are handled in-game and on a week-to-week basis.

Team physicians Kevin Anderson and John Mason, CMU’s certified athletic trainers, are responsible for ensuring that a student-athlete suspected of having a concussion is removed from a practice or game and immediately evaluated.

“We start by asking them what day it is, what quarter it is, who we are playing and other simple questions,” Anderson said. “If there is any question about their mental status, we automatically take their helmet to keep the player from going back in the game.”

In the department’s Concussion Management Plan, signed by every student-athlete, it is explicitly stated that any injury assessed as a concussion, regardless of level, will require the player to discontinue participation for the rest of that day.

Anderson makes the final call on whether a player is healthy enough to return to action, not coaches or any other staff member.

“There are some situations with the student-athletes where they think they are OK. (They say) I’ve had this before. No big deal,” said Greg McGillvary, an associate athletic trainer with the football team. “Overall, they realize that this is a serious situation.”

CMU’s Liability

Before competing at CMU, each student-athlete takes a baseline concussion test. If a concussion is sustained a while playing for the university, previous medical history related to brain injury is taken into consideration when diagnosing a gameday injury.

On gameday, when a student-athlete reports symptoms of a head injury or one is observed by a staff member, concussion testing is implemented.

“It doesn’t matter who you are playing or what the score is, the student-athlete’s health is what is most important,” McGillvary said. “It depends on what the student-athlete might have reported or what is observed.”

Before participating in intercollegiate sports, CMU student-athletes must sign an assumption of risk form.

It states the student-athlete understands that voluntary participation in athletics could result in significant and/or permanently disabling medical conditions. Even though all reasonable precautions may be carried out to prevent serious injury, it states risk cannot be totally eliminated.

Senior Associate Athletic Director Brad Wachler said the form is designed to stress to the student-athletes the importance of reporting medical issues and protects CMU from litigation.

“Any university you go to will have that type of form,” Wachler said. “Whether we like to admit it or not, we all know that you go down the line, there has been lawsuits and litigations. Whether its is about concussions or injuries in general, you need to at some point protect yourself and your university.”

According to CMU’s Office of General Counsel, no current or former student-athlete has brought litigation against the university for damages sustained while participating in intercollegiate athletics.

A Culture of Aggression

Athletes are inherently competitive. Coaches and trainers must balance the instincts of players against what is best for a student-athlete's life.

In a concussion fact sheet handed out to athletes, they are told not to initiate contact with their head or helmet, avoid striking an opponent in the head, follow the department’s rules for safety and the rules of the sport, practice good sportsmanship at all times and practice and perfect the skills of their sport to avoid serious injury.

“(Students) are taught from early on that leading with your head is dangerous,” Mason said. “That’s a teaching point. Now is that possible to do? Most of the time, yes. But they get out of position sometimes, they trip and fall, but leading with your head is a teaching point.”

While the fundamentals of football evolve, a culture of toughness still lingers — one national concussion awareness experts are hoping to stymie.

“The problem is that there is no such thing as a tough brain,” Robbins said. “You can play on a sprained ankle. You can play with bruises and bumps. You feel pain with the rest of your body. With a concussion, there is no mechanism with which you can feel pain. Playing through a concussion can only make it worse. It’s a very different injury.”

Rehabilitation

According to CMU’s Graduated Progression of Activity Guidelines Following Concussion, there are six major steps in the recuperation process.

Immediately following the injury, a complete physical and cognitive rest is required. During phase two, light aerobic exercise — such as swimming or walking — is advised. Next, a sport-specific exercise is recommended, with no head contact.

A player must then participate in a no-contact practice before returning to normal practice and eventually play on the field. Before they player can return to action, they must be totally asymptomatic, and have tested within normal levels and must be cleared by the team physician.

The whole process, depending on severity, takes at least three to five days. The CMU Athletics Department spends approximately $1 million on sports medicine each year.

A Message to All Athletes

Coaches, players and administrators agree education on concussions in sports is the most important factor in lessening the risk for potential lifelong consequences.

“I wouldn’t say that having a (singular) concussion relegates you to having long-term problems,” Mason said. “As we learn more about head injuries, that will be important to know. But we don’t know.”

Exposure to the topic and its potential severity is key for CMU’s Athletics Department, just as it is for any other university around the country.

“We take great pride in our educational process here and how diligently we manage concussions,” Wachler said. “You need to report it. Our ability to be able to treat you effectively depends on you reporting symptoms.”

The most recent time Lavallii suited up for a game was on Christmas Eve 2014, during the Chippewas' famous comeback in the Popeyes Bahamas Bowl. He carried the ball four times for eight yards and caught two passes for five yards as the 2014 season came to a close.

Mason senior Saylor Lavallii talks with Junior quarter back Cooper Rush before the game in Kelly/Shorts Stadium on Oct. 3, 2015. (Photo by Kaiti Chritz | Photo Editor)

He looks forward to an encouraging evaluation in January after making the best decision for his long-term health.

This year, Lavallii works from the sidelines as a player-coach. He works closely with backfield guru Gino Guidugli as the CMU running backs prepare for fierce opponents across the Mid-American Conference.

“Unless we build a space where people can feel safe about talking about their concussions, we don’t stand a chance at catching these things,” Robbins said. “When I hear about (the situation at CMU), that’s a great way to handle it. What I hear is an administration and a coach looking out for the athlete’s best interest. That’s a great culture of concussion.”

A football culture, Lavallii said, that has shaped his identity.

“Some people call this a team; I look at it as my family,” he said. “These three-and-a-half years I’ve been here, I’ve met some of my best friends and developed as a human being.”

Lavallii is thankful for the opportunities he has been given in Mount Pleasant. But his gratitude won’t take away the sadness his absence from the field brings this fall.

“I’m forever grateful for CMU football,” he said. “These guys have all shaped me. They’ve given me the opportunity to be able to learn and help out the team in any way I can because I can’t be out there between the lines with my guys.”

“I’m just trying to roll with the punches and learn as much as I can.”