Bringing concussions into focus

Masking injuries to get back in the game can be a life-changing decision

Staff Writers

Marlboro’s Niki Popyer certainly understands the consequences of concussions. By the count of her neurologist she’s had 17, and she still suffers from post-concussion symptoms, such as headaches and attention deficit.

Now a student at Monmouth University, West Long Branch, Popyer has become a spokeswoman of sorts on the impact of concussions. She has testified before Congress about the need to set national guidelines for the treatment of concussions. She has spoken publicly on the issue and communicates with athletes who have suffered them.

“I’ve talked to many young people,” Popyer said. “People have sent me letters. I help them cope with it. I want to get my story out.”

Popyer knows what is going through the mind of an athlete because she’s been there. She knows the urgency that drives an athlete to be in the arena. For some, leaving a game or sitting one out is blasphemy, a sign of weakness. Those thinking of playing at the next level don’t want to sit out two weeks or more, fearing it might hurt their college prospects. So, they lie. The pressure clouds their judgment.

 Metuchen High School’s Sean Haugh wears a protective headband that soccer players use today to help prevent concussions.  ERIC SUCAR staff Metuchen High School’s Sean Haugh wears a protective headband that soccer players use today to help prevent concussions. ERIC SUCAR staff That’s what led Popyer to minimize her injuries.

“Any athlete that is really into the game, they all want to play,” said Chris Grande, athletic trainer for the Long Branch Public Schools. “They don’t want to sit out, whatever the injury is. The kids try to hide it.”

What would Popyer do differently now?

“I would have stayed away longer than I did,” she said. “I just wanted to keep playing basketball. I was young.”

Popyer’s first concussion, she recalled, was when she was playing basketball in seventh grade. After a hard foul, she fell to the floor and hit her head. She ended up in the emergency room. Two days later she was back on the court.

“No one really understood [concussions] fully or understood how long to stay out,” she recalled. “In a few years, everything changed.”

She would continue to get concussions over the next few years, including one that had her back in the emergency room after she again hit her head on the floor during a basketball game and could not see.

Her symptoms, including unconsciousness, disorientation and headaches, kept getting worse. But she still didn’t give in until her final concussion — which came during her sophomore year when she hit her head on a swinging door — ended her basketball career.

It took some time for Popyer to even attend a basketball game again afterward.

“I was mad at basketball,” she noted. But in the end, she concluded that “it wasn’t basketball’s fault.”

As a result of the concussions, Popyer couldn’t ride the school bus or drive a car because the vibrations would cause a headache. She couldn’t do any exercise.

“I had to be careful with everything,” she said. T he visibility of the issue has brought more stringent regulations. In the Long Branch school district, Grande said, any athlete diagnosed with a concussion is immediately removed from the game or practice. “It is life and death,” he said. “If a concussion goes undiagnosed, especially at the high school level, you risk a second concussion and second-impact syndrome, which is life-threatening,” he said, referring to a condition in which the brain swells rapidly.

“If it is any type of concussion, they will be out for at least 11 days before they return to contact,” he added. “I’ve had kids who have exhibited symptoms for 10 days after their concussion.”

According to the New Jersey Interscholastic Athletic Association, possible symptoms of concussions include headaches, nausea, balance problems, changes in vision, sensitivity to light, sound or noise, sluggishness, memory loss, depression or anxiety, irritation and sleep disturbance.

All athletes who are suspected of having a concussion are given a test that examines long- and shortterm memory, balance and vision, Grande said. The initial concussion test is important, because it is possible for an athlete to have a lucid interval, or a brief period of clarity, which can mask the injury.

“It takes a few minutes, because we want to make sure we do a thorough evaluation and make sure we don’t miss anything,” Grande said. “You want to make sure you don’t miss that lucid interval where there is a concussion but it is kind of clear for a little bit.”

The Centers for Disease Control and Prevention estimates that 300,000 concussions are sustained each year in the U.S. during sportsrelated activities. More than 62,000 of those happen to athletes in high school contact sports.

By state law, once an athlete is diagnosed with a concussion, he or she must exhibit seven straight days without any symptoms, and then follow a four-day graduated returnto play exercise protocol before they can return to the field. In Long Branch, this return-to-play period includes riding a stationary bike, jogging, sprinting and non-contact sports drills.

“So we start them off slowly by just riding a bike and getting their heart rate up,” Grande said. “We monitor them to see if any symptoms recur, and if they do, we shut them down.” C oncussions are seen in every sport, even volleyball and golf, though they are more prevalent in lacrosse and soccer. Still, due in part to the visibility of the issue in the NFL, football gets most of the attention with concussions.

These injuries are watched at all levels of football, from professional teams to flag football. In youth football programs, such as Long Branch American Youth Football (AYF), each coach and board member takes an online concussion course prior to the season.

“All of our coaches take a mandatory concussion course online,” said Lucky Wiggins, president of the program. “That course specifies what type of signs to look for.

“We are definitely strict,” she added, “and we have to follow our guidelines.”

The AYF program begins with flag football for 5- and 6-year-olds and has different classifications up to 12 years old. Wiggins noted that by the time players are 8 or 9, they can hit hard enough to cause a concussion.

It is the job of the coaches to keep the game safe for all players, Wiggins said. “As an adult, as a coach and a leader, we have to follow our own instincts and our own rules,” she said. “If a doctor thinks that child should not go out there, we do have to follow our orders, and that child should not go out there. Safety is the No. 1 important thing.”

The rising number of concussion diagnoses, Grande said, does not necessarily mean that more are being sustained. This is more a product of awareness.

“I don’t think more concussions are happening. I think more concussions are being diagnosed,” he said. “If you look at the numbers, they have really skyrocketed over the last few years, and it is really more because of the education about concussions.

“In the old days I got my bell rung, but now that is called a concussion,” he added. “We would play through that 10, 15, 20 years ago. Now you sit out with a concussion.” P opyer still can’t listen to loud music or go to movies that are two hours long, and she gets headaches if she stares at a computer for too long.

The attention deficit that accompanied her concussions has made work in the classroom challenging. Taking tests is difficult. While she is protected by Section 504 of the federal Rehabilitation Act of 1973, which gives her extra time to take exams, among other things, she said some teachers and professors are not as cooperative as they should be.

The symptoms have decreased gradually, Popyer said.

“I used to get horrible headaches,” she said, noting that they are still there, but less severe.

The 2011 Marlboro High School graduate just recently received her driver’s license, and she is able to do limited exercise. Golf has become her new hobby.

Popyer’s advice to young athletes is to be honest about their condition. Part of the reason she suffered as many concussions as she did, she said, was that she didn’t tell anyone about the seriousness of her condition. She also wasn’t honest with herself.

She tells the young athletes who contact her that discretion is the better part of valor.

“Better to sit out a season than have your whole life changed,” she said.

Looking back, Popyer said, she considers herself lucky.