Since I only ever played football one year, my chances of suffering a concussion were limited. In fact, I only remember about three occasions in my life where I probably, or likely, suffered what the athletic trainers and doctors would call an honest-to-God concussion.
The first, when I was about five or six years old, was when my family was visiting the family of one of my dad's school buddies. I don't remember what I said or did to him, but my buddy Bill Klinetop whacked me over the head with a Tonka truck, and that was in the days when Tonka trucks were made of heavy duty metal, not glorified plastic.
I wailed like a banshee and there was enough blood to quench Bela Lugosi on a slow night, but I don't remember any other lingering effects.
Then, when I was in fifth grade. my sister, an aspiring cheerleader (and later a very good one) talked me into doing some convoluted gymnastics maneuver with her. She swung me between her legs and I guess I was supposed to flip through or something, but I let go of her hands when I wasn't supposed to and landed face first on the kitchen floor. Let me tell you, when they tell you about seeing stars, they know what they're talking about. Only they were more like electrical sparks.
Again, there was plenty of wailing and blood, but the longest lasting effect was a cut lip which probably should have had stitches but didn't (I'd make a heck of a hockey player, if I could just skate and take the cold).
Then came my one year of football. Seventh grade. I weighed about 80 pounds but because I wasn't quite fast enough to play in the backfield, I was the world's smallest down lineman. I actually had a leather helmet, with a white two-bar facemask. I wish I had a photo.
At one practice, I was covering the hole through which the back was supposed to run the ball. The back was fast, but not particularly big, but ran me over like he was Henry Hynoski with a piano on his back. When they scraped me off the turf, my football career was over.
Later, a track teammate took an errant discus to the head while minding his own business warming up on the track at Bloomsburg High School, and a cross country teammate, while jogging over the course at the Conrad Weiser Invitational, actually ran smack dab into a utility pole. He went down like 140 pounds of bricks and was knocked unconscious and didn't run, but nobody ever thought to test him for a concussion. In fact, back in those days, the rest of us thought it was pretty darned funny.
Times have changed
Now, with the increased concern over possible head injuries in all sports, concussion testing has become a must for athletes. School districts are mandated to give their athletes tests to determine a baseline should they get a concussion during play or practice.
In case of a suspected concussion, the athlete retakes the test to determine his numbers post-injury to those before the injury.
I recently sat down with members of Shamokin Area's soccer teams to take one of the tests that are marketed to schools. Star Physical Therapy, which is under contract to Shamokin Area for athletic training, uses the Pearson Clinical Assessment, an online test by Pearson Concussion Vital Signs Webinar Series.
The test takes about a half hour to complete and consists of six parts, each of which asks the test taker to make split-second decisions or recognitions.
I actually took the test twice, once with the athletes and later, at the office, by myself, using the password information given to me at the school by Miranda Petrovich, Shamokin Area's trainer. I think I did better the second time, knowing a little better what was expected and not being surrounded by computer-literate teenagers (I was the next to last one out of the room). The latter test was the one which Tom and Lori Swaldi, of Star, used as my baseline when I underwent post-concussion testing there.
Lori said Star has used a couple of different baseline tests over the years and settled on the Pearson one for a basic reason.
"Athletes can't fool this test because of all the algorithms used," she said. "If an athlete isn't serious taking the test, it shows up and we make them take it over."
The baseline test
The first part of the baseline test tests visual imagery. You are shown a list of 15 words. Then, a longer list of words flashes on the screen and you have to hit the space bar on the keyboard when you see one of the original 15 words. The interesting thing about this is that you quite naturally try to memorize as many of the 15 words as you can; the first five or six words are a lock, but then you're not so sure about the rest.
Oh yeah, plus they make you remember the original 15 words about two-thirds of the way through the other sections.
The second part of the test is finger tapping. That's just what it sounds like. You tap the space bar with your left and right forefingers as many times as you can in 10 seconds.
Next is 'Symbol Digit Coding,' in which you are shown a horizontal line of images with corresponding numbers, then have to match the images and numbers on a another line. Not too hard, but you're asked to do it several times. When I took the test at the school, I had some cursor trouble during this portion of the test, which put me behind most of the kids around me for the rest of the test, making me feel stupid (old).
Then comes the Stroop Test, which is basically matching letters and colors. For example, the word 'red' is posted on the screen, sometimes in red letters, sometimes not. You're asked to hit the spacebar first, if the word and colors match, then if they don't, etc.
Next up was a portion of the test that gave me problems the first time, possibly because I didn't read the directions carefully enough. This is the Shifting Attention test. The top of the screen shows an image of a certain color, then two corresponding images and/or colors on the bottom. The test taker is supposed to match either the image, or the color, depending on what the screen tells you, using the left and right keyboard arrows. For some reason, my mind went blank and I spent 10 to 20 seconds searching for the arrow keys. Then, when I found them, I still wasn't sure what I was supposed to do until probably between half a dozen and a dozen different screen images were shown.
Next was what I simply call the letter B test. It's really the Continuous Performance Test. For a period of five minutes, random letters flash on the screen. You're supposed to press the space bar only when the letter 'B' flashes. Not too hard, except for some reason, the mind (at least my mind) tries to jump ahead and guess when 'B' is going to show up. In my case, I hit the space bar a number of times for the letter 'P'. I think it's probably a visual illusion -- you see what you think is the upper loop of a B and it's only a single loop of a P.
After that, they throw you the word and image recognition parts of the test again, and then you're done.
The test is designed to give an athlete a baseline score to compare with what he or she does after suffering a concussion.
The fun part
My scores for all parts of the baseline test were valid, meaning they could be used. According to my percentile ranks, at least as I understand them, my verbal and visual memory and my reaction time are nowhere near as good as the average teenager's, but probably not so bad for someone my age,
Now came the fun part. I visited Star and Lori put me through post-concussion testing.
For the first part of this, you are strapped into a harness and stand in a semi-cylindrical box in your stocking feet. Your feet stand on metallic rectangles which, as part of the test, will eventually move. You stare straight ahead at a computer screen while the tester asks you to perform various functions, some with eyes open, some with eyes closed, some while the box is still, some while there is some swaying motion.
Eventually, the tester literally makes the room move. Lori made the metallic rectangles move to test my balance. My first question was whether it was actually moving or some kind of illusion, and Lori said the foot rectangles were actually moving. Cumulatively, the effect is what I imagine experiencing a severe earthquake would be like.
Basically, my scores for this part of the test were well within the range they should be, except for one thing. Lori asked me during the test if I had ever had an inner ear infection.
"I had ear aches all the time when I was a kid," I replied.
"I could tell by your balance," Lori said.
Meaning that my internal balance is a little off center. Specifically, I literally lean to the right when I'm at a standing position. You can't tell by eyesight, but the tests clearly show it.
The next part of the test determines visual acuity and perception. You are shown the letter 'E' similar to one on an eye chart as it flashes onscreen, in different sizes, at different speeds and in different directions (up, down, etc.) while hooked up to an apparatus to measure your brain movements. After you do a round or three, the tester stands behind you, holds your head, turns it back and forth and you do the whole thing over again.
The natural reaction is to fight the person turning your head, so you have to keep your eyes on the prize while concentrating on letting the tester do the turning.
Amazingly, I scored like some kind of Superman on this part of the test (which has little to do with actual vision - I'm very, very nearsighted). The dynamic visual acuity in my left eye scored 247. Average for a high school athlete is about 180. Lori, Tom and Jeff Sluck, Mount Carmel's athletic trainer, who helped Lori administer the test, all said this part of my score jumped out at them. Apparently, my score is in the neighborhood of what Division I and professional athletes score. Even my right eye was above average at 197.
Tom said this made sense, given my profession. People who observe things, especially photographers, likely have this acute ability. It also made sense with my background. I was never a sprinter, but basically had some speed and quickness when I was younger.
The advanced testing athletes can undergo now is worlds away from the old days, when trainers held up a couple of fingers in front of a concussed athlete to determine if he could go back in the game.
Trainers now have statistical evidence which they can use to decide if an athlete should or should not play. Since research has shown that athletes who have suffered one concussion are three to six times more likely to suffer another than an athlete who has never had a concussion, this is invaluable information.
It's up to the athlete and his or her parents to put that information to pertinent use.
And that's a whole 'nother story.