A national push to get schools to train sports coaches about concussions has one Butte mother on a local awareness campaign.
While football is typically the go-to sport for concussion discussions, Christine Barry worries about other sports than tend to be lower profile but have risk of injury: soccer, volleyball, cheerleading, cross country, club hockey — even golf.
"It's not just football," said Barry. "It's just those multiple, repeated impacts in many sports."
Barry, a sports mom and mental health counselor at Margaret Leary Elementary in Butte, keeps up on the latest research, mostly through the Concussion Legacy Foundation, which advances the study, treatment and prevention of the effects of brain trauma in athletes and other at-risk groups.
Growing evidence surrounding the effect of sports-related concussions at all levels indicates high school, middle school and youth sports organizers are more sensitive than ever to preventing concussions.
Barry is concerned about regular playground injuries, too, that could result in head trauma.
Perhaps in light of the 2015 feature film "Concussion," starring Will Smith, pockets of parents are taking legal action that may affect how youth sports organizers approach concussion prevention.
The New York Times reported in September that a class-action lawsuit had been filed against Pop Warner, the nation's largest youth football league. The suit claims the organization knowingly put players in danger by ignoring the risks of head trauma.
The suit, said the newspaper, is the biggest sign yet that youth football programs are the next front in the legal battle over concussions.
Unlike other cases that have centered only on football leagues, the complaint also accuses USA Football, the youth football arm of the NFL and the group that creates football helmet safety standards, of "failing to protect young players from the dangers of brain trauma and the long-term consequences of repeated head hits, and ignoring medical research that underscores the dangers of playing football."
Every year, Barry conducts concussion awareness workshops for parents and volunteer coaches with the Copper City Kings of the Butte Amateur Hockey Association.
For example, she teaches how players can move into the boards safely plus core training drills to strengthen the head and neck — all to lessen the dangers of impact.
WHAT ARE SCHOOLS DOING?
Barry wonders why there are virtually no athletic trainers for club and youth sports. But East Middle School has one trainer who works games on Tuesdays and Thursdays. She covers football, volleyball, cross country, basketball and wrestling, said Principal Larry Driscoll.
Butte High employs two trainers who work the sidelines at football and soccer games in the autumn. The district contracts its services through St. James Healthcare.
Butte High Bulldogs football coach Arie Grey said while he does not reveal player injuries to the general public — for competitive and player confidentiality reasons — he relies heavily on his sideline trainer to monitor players.
"Half the battle is to prevent concussions, use correct technique, and not hit every single day," said Grey. "We are so lucky to have our trainers so we do things the right way and help our kids."
Locally, the school district follows Montana High School Association policy, and at least two sports clubs are on board.
MHSA has no jurisdiction over middle schools in Montana. But East Middle School ascribes to Butte High's policy, in keeping with the MHSA and National Federation of High Schools Federation policies.
Coaches must watch a NFHS 40-minute prevention/recognition video and rules clinic and take a test prior to the first practice in order to earn certification.
Following MHSA policy, the Bulldogs practices are shorter and allow fewer minutes per week of what Grey calls "live, hard-hitting contact" against another player. The team practices four times a week for up to two hours each time.
In lieu of live contact, players hit on a tackle ring instead of a human as a way to learn safer head placement.
Such policies, in place for six years, align with USA Football, said MHSA assistant director and Butte native Brian Michelotti. Montana teams cannot hold more than 90 minutes' worth of contact per week.
Players are now taught to lead a tackle "heads up" instead of heads down, a much more dangerous angle.
"We also are one of very few schools to hire ambulance coverage for all football, soccer and we also cover the Mining City Duals Wrestling (tournament)," said Butte High Athletic Director Chuck Merrifield. "We also have a sideline doctor for all varsity football."
As for soccer, where headers can result in player collisions mid-air while going for the ball, the MHSA is trying to reduce contact injuries.
"We're looking for ways at reducing heading of the ball," added Michelotti.
MORE PREVALENT TRAINING
Montana schools must require coaches in all positions to take at least a 30-minute online video course that includes a checklist to recognize symptoms in an athlete, said Michelotti.
Parents, too, must read and sign the checklist form before their child can play.
All East Middle School students — not only athletes — are tested, said Principal Larry Driscoll.
"We'll have the entire student body take a baseline test as a preventive measure," said Driscoll.
At least 626 East students are taking the online test this fall.
The district bought a specialized computer testing program for $1,200 and covers the cost per student.
Some teachers test students in physical education classes as part of a brain injury unit; others test during extracurricular sports practices.
Students also study the dangers of concussions in their health classes where they complete the test.
Little Guy Football, in existence for 21 years in Butte, follows USA Heads Up Football procedures. It requires volunteer coaches to complete concussion recognition and response training and to teach heads-up tackling and heads-up blocking techniques.
"You hit with the front of your shoulder, keep your head up, and rip the shoulders skyward so you're avoiding making first contact with the helmet and the crown of the helmet," said Little Guy Football President Matt Stepan, whose son plays.
Little Guy Football is full-contact for fourth-, fifth- and sixth-grade girls and boys. In the earlier grades — first through third — kids play non-contact flag football only in a Butte Family YMCA league.
Stepan said his organization does not have trainers roam the sidelines, but he added, "We work closely with ambulance and first responders, who are often at the site."
Those first responders tend to be parents of players attending the game anyway.
Little Guy Football has adapted in other ways: Players adjust gradually to wearing a helmet early in the season, proper techniques are taught before they are allowed to tackle and block, and helmets are inspected regularly. Coaches learn via the USA Heads Up Football program how to recognize concussion symptoms and follow protocol in reporting to a doctor or other medical professional.
"We're stressing to our coaches that they limit contact in practice to 20 to 30 minutes per practice, with more emphasis on non-contact drills," added Stepan.
Like Grey and his staff, the youth coaches appear to err on the side of caution and keep an injured player on the sidelines following a checklist test — sometimes in spite of a player or parent's desire to keep the athlete in the game.
"Any time we can educate our players, coaches, and concerned moms and dads, it can only help," Stepan said. "You'll never fully eliminate the risks involved, but there's a lot you can do with proper training."
Much of the awareness rests with the kids. High school players learn to self-report whenever they feel unusual after a hit or witness a peer acting dizzy, confused, throwing up, or showing other symptoms.
Grey said at the moment no Bulldog players are sidelined due to possible concussions or doctor-diagnosed head injury.
"Our kids are great because they are very good at taking care of each other," said Grey. "Safety is the number-one goal."
THE WIDER PICTURE
As youngsters, teens, college athletes, and even professionals defer to a more concussion-aware atmosphere, the film "Concussion" deals with the discovery of Chronic Traumatic Encephalopathy (CTE) by a Boston pathologist as he studied the early death of Pittsburgh Steelers players who sustained several concussions during their careers.
Dr. Bennet Omalu (played by Will Smith in the movie) discovered that CTE is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic and asymptomatic hits to the head.
At first, there was an NFL backlash, but last July, the league announced it will penalize teams with fines of hundreds of thousands of dollars and possibly the loss of draft picks if they fail to take players out of games after sustaining a concussion.
HELMET SENSORS, DATA
The nationwide movement and the demand for data seems to be filtering down — a good sign, Barry said.
"We want to get schools to track the concussions that are appearing at school-sponsored sports and at school," said Barry, "so they have a better account of the numbers and so they can better support the kids at school."
Data, she said, is key — much like her younger son's desire to have helmet sensors installed so sideline volunteer trackers can monitor a player's condition on a cell phone app.
"The technology is there; it just hasn't been implemented yet," said Barry, whose middle-school-age son Carson continues honing a science study he developed on helmet sensors a few years ago.
"So much data is coming off that sensor — the number of hits, the impact, concussion range," she said. "The coach who's doing plays and running kids in and out — it's hard for (them) to monitor that."
She would like to see school nurses and playground monitors report the signs of a concussion, too, wherever kids are playing on ice, or dodgeball in the gym, for example. But school nurses are already stretched thin in the district.
Bottom line: Barry wants to ensure that other parents don't suffer the tragedy she did. Her son, Cullen Barry, 17, shot himself in May 2011. He was a stand-out hockey player who suffered several concussions that, in hindsight, she correlates with his suicide.
Cullen's grades suffered, light and reading hurt his eyes, and he was emotional and agitated, but adults around him told him to "buck up." Studies show there's no quick fix after suffering concussions.
Now colleges, high schools, middle schools, and youth sports are more aware of preventing head injuries.
When younger son Carson's team tested the helmet sensors, Barry said it was a bit of a relief.
"As a parent, it took some of the stress off of me — and if Carson's running into the post or the boards or another player, it was reassuring to see the reading from the impact sensor."
She equates the potential acceptance of helmet sensors to convincing the public to wear seat belts when they first came out.
"When seat belts were introduced, no one wanted to use them, and we still have to remind people to use them."
Plus the sensor technology costs money.
"But the possibility of preventing a death or preventing someone from getting CTE, despite the cost, would definitely be a mindset change," added Barry.