NOTE: My story in Friday’s paper is on Connor McCartin, a former special teams standout for Virginia who will not be cleared to play football ever again because of the concussions he has suffered over his career. This blog post dovetails with some of the reporting I did for that story. ...
Jon Copper shared the mind-set of a majority of athletes: The pain hurts, but it’s not that bad. I can play through it. Don’t show them your hurt. Don’t let them take you off the field. Keep going. I’ve got to play.
And so, during the seventh game of the 2008 season – his final one as a Virginia linebacker – Copper spun to tackle a North Carolina running back on a second-down play early in the fourth quarter. The running back’s knee collided with the side of Copper’s helmet. Copper instantly and momentarily lost all motor ability. He doesn’t remember much of the next 15 to 20 minutes.
But he remembers getting up, a tad disoriented, and marching right back to the Virginia huddle. He’d suffered his second concussion in three weeks, not that that mattered to him at the time.
When the third-down play started, Copper moved at half-speed because that’s all his body could muster. After the drive ended, team trainers came over to examine Copper on the sideline.
“They asked me if I was okay, and I said I was, even though I knew I was a little woozy from the hit,” Copper said in a telephone interview. “They did some diagnostic stuff on me, which I passed okay. Without me telling them I had a concussion, I went back into the game.”
Copper played the remainder of the fourth quarter and overtime of what became a 16-13 win in Charlottesville. He finished with a game-high 16 tackles. Copper looks back on that day with regret.
“That was the worst one because after that game for the next 15 to 20 minutes, memory-wise, I was in and out,” Copper said. “I don’t remember everything that happened the rest of the fourth quarter, don’t remember everything that happened in overtime. But it was no oversight at all on the trainers. They did everything they could have and should have to make sure I was okay.
“I was just not forthright in saying I just took a pretty bad hit and taking myself out. I was passing all the diagnostic tests okay. . . . It was an extremely poor decision on my part” to return to play in the game.
This is the battle that doctors such as John MacKnight – Virginia’s co-medical director of sports medicine – and trainers such as Kelli Pugh – who is the primary care provider for the Cavaliers football team – battle on a too-frequent basis. They can only treat problems they know exist, and not all concussions are visibly apparent. Sometimes it’s up to the athletes to report head injuries. Sometimes the athletes choose not to.
Thanks in large part to a greater push to educate student-athletes on the symptoms and dangers of concussions, MacKnight said more players are reporting head injuries, which enables quicker treatment.
“One of the key issues in management from our standpoint is that we well appreciate that concussions are under-recognized, despite our best efforts,” MacKnight said. “I think in the past you would have individuals that either didn’t know they had a concussion and so they didn’t bring it to our attention, or simply knew what the implication of the concussion was in respect to their ability to play and so they didn’t tell us.
“I think they’re becoming more comfortable with the sense that it’s important to report. We’re seeing more concussions at earlier stages now than we did before.”
Since the beginning of training camp, Virginia’s football medical staff has diagnosed 12 concussions, according to MacKnight. The staff diagnosed 13 concussions all of last season.
MacKnight said it’s not that the frequency of concussions is increasing. Rather, it’s that more concussions are being reported. And that, he said, is a good thing.
In most cases, players are treated for the concussion, given a few days off and then allowed to return to practice. During training camp, Coach Mike London at various points mentioned true freshman linebacker Daquan Romero and redshirt sophomore defensive tackle Justin Renfrow as dealing with “concussion issues.” Both eventually returned to the field and have played in all three games thus far this season.
Junior defensive end Connor McCartin, a prominent special teams cog, was not as fortunate. During a kickoff in the first week of training camp, McCartin suffered his second concussion in 10 months. He did not recover in the standard amount of time, and after three weeks of rehab, Virginia’s medical staff informed him it would not clear him to play for the Cavaliers ever again. For multiple reasons, the short- and long-term risk to McCartin’s health was too great.
“Parents come in and talk to me about, ‘Hey, how many more of these events can my kid have before we have to worry that he’s not going to be himself again after he is done playing football?’ ” MacKnight said. “And I have to look them in the eye and honestly say, ‘The next one may be the one.’ Or if they’re in my office because they’ve had a concussive event then, I have to say honestly, ‘This one may be the one. Only time is going to tell.’
“Is it likely that that’s how it would be on the first event? No. But when you get a mounting number, when you get four, five, six, seven, eight concussions, certainly you have to respect the notion that that event or the next one that they just never really recover from, and then obviously we’re sorry that we let them back into participate and were injured as a result.”
There are football players who hit because collisions are part of the game. They tolerate the contact and move on.
And then there are football players who look forward to the next play because it will give them another opportunity to crash into someone and make an impact that will linger. It’s not about malice. It’s about feeding an insatiable desire for a sensation only blunt physicality can provide. McCartin was one of these football players, and he certainly was not in the minority.
But verb choice is important in this story. On Sept. 2, McCartin became the sixth Virginia student-athlete MacKnight disqualified from participation in his or her sport because of concussion concerns in 13 years on the job. MacKnight does not enjoy that part of his job at all. Through his interaction with the team and the players he treats for various injuries, he comes to know them and how much they care about the sport they play.
He knows McCartin is “an aggressive, head-hunting kind of a guy,” MacKnight said. And so when he hears McCartin has said he suffered a couple of concussions in high school, MacKnight is skeptical.
“I guarantee you [McCartin’s] total number of concussions is probably is at least twice what he tells you that it is,” MacKnight said. “Not because he’s a bad guy, but probably because he ignored them so many times in high school he probably doesn’t have a set number to admit to and certainly didn’t seek care for them and never had them diagnosed.”
McCartin suffered his first collegiate concussion Oct. 16, 2010, during a Virginia home game against North Carolina. On a kickoff return, McCartin fulfilled his primary duty.
“I just went and hit some guy,” McCartin said, “and I was just kind of out of it.”
The lights at Scott Stadium and the noise from the crowd amplified the pain in his head. He left the game, informed the medical staff and did not return. Afterward, he took a condensed version of the Concussion Resolution Index online test. Virginia’s medical staff uses compares the results of that test with the results of the cognitive baseline exam each football player takes before the season begins.
Days later, once all the concussion symptoms subsided, McCartin took the CRI test again. Pictures appeared on the computer screen. He had to hit the space bar once if he’d seen the picture before, twice if it was the third time he’d seen the image. Then there were pictures that appeared once with numbers and a second time without. McCartin had to report which numbers went with which pictures.
Once his score met the marks he’d set on his baseline test, McCartin was allowed to participate in non-contact activities for a day to make sure no symptoms returned. By the time he was cleared to return to practice, McCartin had sat out the following week’s game against Eastern Michigan.
McCartin said he experienced no enduring effects of the concussion. He played in the remaining five games of the 2010 season.
Everything was fine until he went flying down the field during a training camp session last month. He collided with a teammate and suffered his second concussion.
This time the headache lingered and McCartin’s cognitive scores took much longer to return to his baseline test levels. Eventually he was sent to the neurology department at the university’s hospital, where he underwent further diagnostic testing.
On Friday, Sept. 2, McCartin was called in for a meeting with Virginia’s medical staff. Based on some of the things the doctors had been telling him in previous visits, McCartin said he had an idea of what was coming.
But that did little to soften the blow when MacKnight, Pugh, Virginia head athletic trainer Ethan Saliba and two doctors from the university hospital’s neurology department informed him it was no longer safe for him to play football.
Copper never had such a meeting. After he suffered his first concussion – on the last defensive play of a game at Duke on Sept. 27, 2008 – Copper’s symptoms went away by midweek and he was cleared to play again, which he did the following Saturday against Maryland.
He suffered his second concussion during the North Carolina game on Oct. 18, 2008.
“You can’t cheat the diagnostic tests,” Copper said. “But when they looked me in the face and said, ‘John, are you doing okay?’ I told them that I was when in reality I wasn’t. As players, we want to be out there. You don’t want to come out of the game. It’s part of the makeup.
“What changed from my first year to my fifth year is that the coaches and the trainers did a much better job of explaining to players like myself the significance of making a decision like I did. From what I understand now, having researched it quite a bit myself after the fact, the worst concussions and brain injuries come when you do what I did, which was I got dinged up and I stayed in the game for half a quarter plus overtime. That’s when you’re most susceptible.”
Again, his symptoms went away by midweek. Again, he was cleared to play the following Saturday at Georgia Tech. He led the team with seven tackles. He also suffered his third concussion of the season on Virginia’s last defensive play of the game.
“We were winning,” Copper said. “They were running their option offense so they were running a lot and didn’t pass very well, but since they were behind they were in a passing formation. I was coming around to contain the quarterback. The quarterback ends up throwing the ball, and I got cut-blocked. And I just fell and the side of my head hit the turf.”
For an instant, he lost all motor ability again. But he was able to walk off the field and within two minutes, he said, he was back to full strength. He took a few days off, completed a battery of tests, and by mid-week, with no lingering symptoms, he was cleared to play the following Saturday.
He tied for the team-high in tackles with eight in a 24-17 overtime loss against Miami.
For about a year after his senior season ended, Copper suffered from brief memory lapses. Nothing major, he said. In fact, he’s not even sure it was related to the concussions. He thinks his brain just might have been a little less sharp since he no longer was in school.
Today, Copper works as a nutritional coach at a chiropractic office in Roanoke. He does a little personal training on the side, as well. He said he does not suffer from any lingering effects of the concussions, none that he notices, anyway. And he still makes it to as many of Virginia’s home games as he can.
He said concussion awareness among college players still is not where it needs to be, but it has come a long way from where it was during his first few seasons at Virginia. He imagines such awareness only will continue to improve, and that encourages him.
“The kids that are playing now, now is when concussions and neck injuries are starting to come out, so they grew up with it,” Copper said. “When I was growing up, we didn’t know much about concussions at all. We just played. Guys that are in college now, their education about concussions started earlier.
“I don’t think it’s where it needs to be, but not through the fault of the NCAA or coaches or trainers. We had folks coming in every year talking to us about concussions. But as a player, it took me having a few and then doing my own research to go, ‘Whoa, I didn’t handle that the best.’ It’s not where it needs to be, but I think every party involved is doing the right things to get it to where it does need to be.”
Prior to the moment he laid on the team’s practice field that early August day, dizzy and disoriented, his head throbbing, McCartin had never thought twice about the imminent threat his sport posed. McCartin had lived for moments just like the one that ended his playing career. It was another kickoff, another opportunity to gather just enough momentum to put a good lick on somebody.
MacKnight said concussions more frequently occur in training camp than during the season because the number of players on the field – and thus, the number of collisions – is higher.
McCartin took the CRI test once and then again, but his score did not come close to approaching those of the baseline cognitive exams he’d taken before training camp began. That was just one of the concerns MacKnight and the Virginia medical staff had about McCartin’s recovery from the concussion.
MacKnight said there were two primary reasons and two secondary reasons why he opted not to clear McCartin to resume playing. The first primary reason was the prolonged recovery time that had been necessary for McCartin to lose all his concussion symptoms. The second was that McCartin’s CRI scores were not returning to standard levels even three weeks after he’d suffered the concussion.
“So not only is he symptomatic, his brain is telling us, ‘Hey, I’m not anywhere near resolving this, and I have some element of cognitive decline that has not gone away,’” MacKnight said. “Now, our presumption is that it will go away, but I think when you look at his pattern and you say, here’s a guy who’s now symptomatic way longer than he’s ever been and he’s also showing us subjectively that his brain isn’t healthy at this point, this is a guy that really shouldn’t be putting on a helmet an whacking people anymore.”
Also, MacKnight said, McCartin has attention deficit disorder – “Kids with attention deficit always have more trouble with concussive injuries,” MacKnight said. “That’s a well-described link.” – and he’d had a history of suffering concussive blows dating back to high school.
So in the training room at McCue Center, the athletic department’s nerve center, MacKnight and a handful of other school medical officials informed McCartin he no longer could play football at Virginia.
“I was devastated,” McCartin said.
What are you supposed to think when you’re 19 years old and have just been told you can no longer participate in the sport you’ve loved since you were six and desperate to follow in your big brother’s footsteps?
McCartin didn’t know what to think, and so after his meeting with MacKnight and the other doctors on Sept. 2, he drove in silent shock over Scott Stadium, where the Cavaliers were participating in their day-before-game walk-through.
When he arrived, he met with his older brother, Kyle, a redshirt junior quarterback, and then with London and special teams coordinator Anthony Poindexter. The coaches told him his playing status would have no effect on his standing with the team. He would remain on scholarship, and they would find a way to keep him involved.
The following day, during the season opener against William & Mary, McCartin wore a headset on the sideline as he communicated with Poindexter, wrote down play calls and made sure the special teams units were ready to go.
“That kind of helped me not focus so much on the playing aspect because I had something to do,” McCartin said.
He has been a fixture at Virginia’s practices ever since. McCartin organizes the special teams scout squad and helps Poindexter break down film afterward. He did not attend Virginia’s game at Indiana on Sept. 10, but he was in the coaches’ box for the Cavaliers’ game the following week at North Carolina. He wore a headset and communicated with Poindexter, who roamed the sideline.
The plan, McCartin said, is for him to continue to fill his new role in practices and games for the rest of this season, as well as during his senior year in 2012.
It’s been about three weeks since he received the news. He understands why and how the doctors came to the conclusion that they did, and he knows he’s better off, for the sake of his short- and long-term health, not playing football anymore. But has he come to accept that he’ll never suit up again in pads and a helmet, never be able to charge downfield and knock the snot out of someone at full speed?
“I’m getting there,” McCartin said. “It’ll come one day.”
Until then, he’ll hold onto the fond memories he has of the days when he could line up for a kickoff and enjoy the ensuing chaos.
During the last game in which McCartin played – Nov. 27, 2010 at Virginia Tech – a Hokies player took a swing at him after the opening kickoff of the second half. McCartin retaliated. This was how he liked to play. Always chippy.
Both players drew personal foul penalties.
And for the life of him, McCartin said with a sly grin, he cannot not recall exactly what he did to earn his.