I’m going to assume that most people did not take the time to do the training online that was suggested, so if you’re joining in the middle of this series, or if after reading this post you’d like to take that, the link to the first post is right here. Towards the end of that one you will find how to take this free, fast, online training about head trauma.
So let’s review some of the facts that most coaches of boxing (and boxers) might find a little more surprising that we found in the training:
A concussion causes a chemical change to the brain, which also makes the brain more susceptible to concussions after getting the first one.
Body shots can be just as dangerous and cause concussions just as easily as shots to the head.
Most MRI and CAT scans show the brain to be normal after a concussion. This is because it is NOT a bruise to the brain.
Repeat concussions can just slow recovery or increase chances of long-term problems, but it can also result in brain swelling or permanent brain damage, or even death.
Most concussions happen without the athlete losing consciousness.
Some symptoms might not show up for hours or days (Make sure the athlete is supervised for an hour or two after probable concussion creating hit)
Even activities like studying or a raised body temperature (both physical and cognitive activities) make a concussion worse.
69% of youth athletes played knowing they had a possible concussion and hid the symptoms and did not report them to an adult or coach in order to continue to play.
So lets talk about the things from the video that may have created some hesitations for you. With boxing culture and what we know about how you have to be with boxing (not coddling every single possible hit), some of the things from the training are simply impossible to do. For example, in the second video a soccer coach pulls a little girl who gets knocked to the ground by being bumped by another kid. Okay people, if we pulled every athlete who ever made contact with another athlete we would not have a sport anymore—that’s literally the point of our sport after all. But let’s take the underlining point away from that part of the training: When in doubt, sit them out. And also, that you don’t need a parent’s permission (or the athlete’s) to sit them out.
Another part that might be very difficult for most coaches (I know it is for me) is to require a medical provider to examine the athlete before returning. Again, let’s be real. Most of us don’t have health insurance or cannot afford (even if that’s co-pays) to get our brain examined. Most boxers simply don’t have those resources, and if you’re talking about kids, a lot of kids that are involved in boxing gyms don’t have parents that will necessarily be able to take them in. On the flip side, if you do have parents of those kids that will be able to take them in, they also may yank their kid out of boxing the second that the reality of what they’re allowing them to possibly do to their brain becomes a reality like that. You can’t let that stop you from making sure that your athlete is safe. Who’s the boss in your gym after all? You’re the one that is liable, and it’s your team culture that you’re setting—not theirs.
One reason to put your foot down (no matter how angry or resistant an athlete or parent is) is that your other athletes and parents need to know, without any doubt, that you will honestly take care of them if you suspect that they or their kids take a hit that concerns you. That confidence is built over time by watching how you handle all of your athletes.
It definitely gets tricky when you’re trying to provide the best care for people who just don’t have the resources for every little thing. All I can say as far as advice is that I handle every case individually. If someone has the ability to see a doctor, I always recommend that with a suspected concussion. If they do not, then I’ll often start checking around my resources or the team, and together we can usually find a way to get them taken care of. Sometimes that’s people that we’re friends with outside of the team that have medical experience (it might not always be a full-blown neurological doctor is what I’m getting at), and sometimes that’s helping out financially. At the end of the day though, I use my experience and education to judge how severe I believe the concussion possibly is (or the likelihood of one being present) and go from there. If someone truly doesn’t have the resources, but I do believe they have a mild concussion, then I’m not going to allow them to participate in practice for a while. They are encouraged to be there and to help with their knowledge and continue learning with the team technically or through film, but not to participate physically.
Why? Because even a raised body temp can further the damage in those first few weeks, remember? If I believe they truly have an emergency room level concussion, I take or send them. Period. We take care of the emergency to health first and deal with the rest of payment afterwards.
I also always make sure that I’m not the one making the call past my belief that they have one and if I need to require a doctor’s consent to come back to practice. What do I mean by this? I mean that I’m not the only eyes on any athlete. A parent or spouse is always the one to make the call about their child if I believe they might have signs. First, I always make my decision before talking to the parent or spouse. This means that I know exactly what my hard line for inside of my gym is for that athlete and I don’t hesitate once talking to the parent or athlete themselves. Next, I fully disclose any reason that I might have suspected a concussion in the first place and then I let them make the call on if they want to continue or to seek further medical attention. I never suspect a concussion, write it off, and not inform someone. I need the spouse or parent to have their eyes on the athlete too, and at the end of the day, it’s the athlete’s brain, not mine. So even if I think they’re fine, it is up to them to make the decision if they agree with me or if they want more medical attention to double check. I require the athletes to provide an emergency contact when they sign our waivers. I make sure that they understand that this is who I’m contacting with issues like this as well. I want someone else to know that we suspected a concussion, I think it’s fine, but symptoms show up hours and days later.
This definitely didn’t answer all of your skepticism if you’re like me. After this training the first time I immediately thought to myself, “pshh…yeah, that’s cute. But what about when my athlete has a fight coming up? What about how that changes the culture in the gym? How am I supposed to baby injuries and then turn around and tell them to toughen up in the ring? And what about in the ring? What if I think they get one in the first round of a fight?” I promise you, next week, we’ll talk about those questions as well as what we, as athletes, can be doing outside of boxing to make sure our brains stay as healthy as possible for as long as possible. Our sport doesn’t have to end in nearly the brain damage cases that it does. Let’s change the way it’s seen by bringing some more education into the gym with very easy practices that don’t at all hurt our toughness or training.