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Cohen, Nowinski team up to educate Scarsdale


Chris Nowinski and Scott Cohen


Chris Nowinski and Scott Cohen have a lot in common. Nowinski played football at Harvard, and later went on to become a professional wrestler. Cohen, a junior at Scarsdale High School, grew up playing football. For both, contact sports led to life-changing, undiagnosed concussions, causing major disturbances in their daily lives that took a long time to
recover from. Now, separately and together, they are working hard to make sure that doesn’t happen to others.

Cohen raised a student record $10,000-plus for Nowinski’s Concussion Legacy Foundation, is just the second high school ambassador for CLF and is the founder of his own concussion club for students at the high school.

“I lost my career and my sports from my concussions, so it’s really awesome to see a young person who goes through it want to turn it into something positive,” said Nowinski who, with his life back in order, is studying neuroscience at Boston University while also traveling to educate about the dangers of concussions and the importance of proper post-concussion management.

Cohen plays baseball and swims, but he used to play football and basketball, too. No more contact sports after multiple concussions.

“Far more difficult than not being able to play football was trying to understand what was going on with my brain,” Cohen said. “After missing two months of school I had a lot of catching up to do. Making up two months of schoolwork is never easy, but it’s especially hard when your brain isn’t working properly. With the help of my teachers I was able to catch myself up even though my brain wasn’t fully healed yet. It took me over a year to become fully comfortable in school again. I really felt like something good needed to come out of my situation, so you can only imagine my excitement when I learned about the Concussion Legacy Foundation.”

Thanks to Cohen’s efforts (visit scarsdalenews.com for more), Nowinski brought his story and his message to the high school last month. With the help of adviser Dr. Chris Griffin and athletic director Ray Pappalardi, almost 30 coaches, teachers, nurses and psychologists from the district witnessed what was Nowinski’s second appearance at SHS. He was also part of a concussion seminar in 2012.

“It’s inspiring to see,” Nowinski said of Cohen’s work. “I know how much of a struggle it’s been to go through post-concussion syndrome, and to see a high school student turn it around and actually make it better for his classmates and everyone around him is just heart-warming.”

At the seminar, Cohen’s mom Marci elaborated on the story her son told of missing chunks of school due to his post-concussion syndrome, by giving a parent’s perspective of feeling helpless and uneducated: “He’s so textbook. The piece we didn’t know was that he got his bell rung when he was in middle school and he used to come home and pop Advil and sit on the couch and we wondered what was wrong with him. It was just, ‘Oh, he got his bell rung.’ We didn’t know those were concussions and that is why, if you asked us, we wouldn’t mention concussions. His second one was so bad that the truth is he probably had a whole lot more. You guys are able to tell the parents they’re not supposed to come home and not be able to do anything after a game. Their head isn’t supposed to be killing them.”

Those powerful words and tears hit home for Pappalardi. “They just thought that was what happened when you played football,” Pappalardi said. “I never realized people would think that way. If we continue to educate coaches and reach out to parents about these kinds of subtle things that happen on weekends even in youth sports I think that’s important.”

For Pappalardi, you can’t be overeducated on the topic, but he feels that the New York State protocols in place for taking kids out of action and returning them to play are on par with the growing vault of information out there on the topic.

“I think he was pretty conservative, but I don’t mind that,” Pappalardi said of Nowinski. “You need people on that end of the fence and the New York State protocol is pretty clear on what we need to do and NFHS [National Federation of State High School Associations], too. If a child shows any symptoms they must be removed immediately and cannot return until cleared by a medical professional and for us that’s the school doctor. There’s no wiggle room.”

Most important in Pappalardi’s eyes are getting the initial report and diagnosis of a concussion — which also means making sure students are aware of the damaging consequences of not reporting — and then doing everything necessary to make sure the injury heals.

“You don’t want to let somebody down on the field, but I tell people, ‘You only have one brain,’” Pappalardi said. “We don’t know how well it can be repaired once it’s damaged. I’ve had kids who lose six months of school because of one big contact. We’ve just got to be careful. Once a kid’s had one concussion they are more likely to have a second. That message you can never hear enough times.”

Scarsdale does ImPACT or Immediate Post-Concussion Assessment and Cognitive Testing for athletes using preseason baselines secured with computerized testing and has a sideline test that takes different aspects of a few standardized concussion tests that don’t directly diagnose a concussion, but can give a quick impression as to whether an athlete should be removed from a game or practice.

High school physical education teacher and multisport coach Alex Greenberg noted Scarsdale’s concussion management policy is strong, with the school having the best interest of the kids at heart.

“I thought it was a very good presentation,” Greenberg said. “He brought up some valid points and had some statistics in there that were good to see. As coaches we’re on the forefront every day, so we see a lot of it and we know how prevalent it is. It’s always good to see the stories of people who have been through it and the struggles they go through post-concussion and how they reacclimate to life. It’s important to keep that in mind about a student-athlete. I thought it was beneficial as coaches and teachers to see. It’s a subject we need to keep looking into. You can only take the information you know from the experts and do the best you can with it.”

A concussion story

A concussion in its simplest definition, according to Nowinski, is a “force to the brain that leads to changes in the way the brain functions.” It does not have to be a direct blow to the head, but a force that temporarily changes the shape of the brain within the skull, such as a blow to the body like whiplash. What every concussion does have in common is that you can’t see it.

“Every athlete interprets by pain or loss of function,” Nowinski said. “It either hurts or you can’t throw or run and that doesn’t happen with concussions. We actually have to teach them to interpret what’s really 40 or 50 symptoms that can mostly happen under other circumstances, like a headache. We have to teach them that is something worth mentioning to an adult.”

Some sports are easier to check and recognize than others. For example, with baseball or volleyball or soccer the action is where the ball is. With football that’s not the case and in the constant contact scrum of 22 players it’s harder to see everything that happens.

“A concussion in volleyball is a game-stopping event,” Scarsdale volleyball coach Ann Marie Nee said. “In other sports head contact could happen without the coach seeing it. In volleyball, nothing is supposed to go near your head and when it does during a game, coaches and players would notice.”

Nowinski played football at Harvard and “then like most Harvard graduates” he became a professional wrestler with World Wrestling Entertainment. “It was a very different lifestyle in front of a crowd when I got hurt 12 years ago,” he said.

His first diagnosed concussion — the key word being “diagnosed” — came against the Dudleys. He suffered a blow during a match and didn’t know where he was, who was supposed to win — nothing. He called it “total chaos,” but found a way to finish the match. Backstage the trainer approached him, sensing something was wrong.

“The problem was I had no concept of what had happened to me,” Nowinski said. “I had no way to verbalize it, I didn’t know it was bad for me. I lied and said I was fine, denied the fact that my head was throbbing, denied what happened out there. In one minute I got coherent enough to make the case that I was fine. Back then we didn’t have any concussion protocols and there was no testing… I literally went to the bowels of the Hartford Civic Center and hid for a couple of hours while I tried to straighten my head out.”

For five weeks, Nowinski’s head was a mess. When he got his heart rate up he was nauseous. He was forgetting things in the ring. “That’s not what a Harvard guy is supposed to do,” he said.

Finally he sought help after trashing a hotel room in his sleep, with his girlfriend there in harm’s way. “She woke up to me acting out my dream,” he said. “In this one I was trying to climb the wall and then jumped head first into the wall onto the nightstand and didn’t wake up for another couple of minutes. That’s what it took to scare me straight.”

For Nowinski, it was what he called “15 years of pounding my head every night” that led to five years of headaches, three years of being sedated to go to sleep, loss of job and depression. He considers himself lucky it happened in his 20s when he had been making money and it wasn’t strange for him to disappear from family and check in monthly.

“Imagine going through that as a high school student or younger and imagine if you’re expected to keep up with every kid and compete for spots in college?” Nowinski said. “You can’t. I was lucky, but it’s really hard for the students and it really can derail the entire life you thought they were going to have if they end up in that situation. They can lose their grades and it can change their colleges.”

It wasn’t until he met Boston University’s Dr. Robert Cantu that Nowinski realized all the problems he had over the years were actually from concussions. Once Cantu opened his eyes to what might qualify as a concussion, there were six that Nowinski was readily able to diagnose after the fact between football and wrestling. Though wrestling is scripted, that doesn’t mean it’s not risky and dangerous with the stunts and the heat of the moment. Also, as part of his initiation after making it past a wrestling camp and being hired as a pro, Nowinski had the brains beat out of him, an “actual assault to welcome me to the business.” He has the video of that.

The rise of CTE

One of Nowinski’s biggest victories is in spearheading the study of CTE or chronic traumatic encephalopathy. According to the Boston University CTE Center website, it’s “a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head. CTE has been known to affect boxers since the 1920s. However, recent reports have been published of neuropathologically confirmed CTE in retired professional football players and other athletes who have a history of repetitive brain trauma. This trauma triggers progressive degeneration of the brain tissue, including the buildup of an abnormal protein called tau. These changes in the brain can begin months, years or even decades after the last brain trauma or end of active athletic involvement. The brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression and, eventually, progressive dementia.”

This started in 2008 and Alan Schwarz, a 1986 Scarsdale graduate, started writing about it for The New York Times when the study was in its infancy with just four brains of former NFL players being studied. They were 4 for 4 with CTE. That number is now 87 of 91 NFL, 26 of 34 college and 7 of 24 high school brains that have been donated by families who feared their loved ones should not have suffered the way they did.

“Families shouldn’t be this accurate,” Nowinski said. “These people should have other diseases, but they tend to not. They almost all exclusively have CTE, not any other forms of diseases that would cause this.”

The damage to the brain is something you can’t see with modern technology. Only after death can the brain be sliced to view potential abnormalities.

“If 10 percent of NFL players got brain tumors, we’d probably stop playing the game because that seems really tangible and ugly and a bad idea,” Nowinski said. “But because it’s CTE, because it’s insidious onset and slow development we tolerate it.” He added, “You don’t want to play 20 years of football. I can tell you that right now. If you walk into a clinic and you played 20 years, I don’t care what your symptoms were, when we look at your brain I’m almost certain we’re going to find CTE.”

Nowinski suggests limiting the number of hits to the head any athlete suffers. In addition, he is in favor of delaying the introduction of heading in soccer and tackling in football to high school. U.S. Soccer Federation released guidelines this month eliminating players under 11 from heading the ball.

Dartmouth football started using robotic dummies, or Mobile Virtual Player (MVP), for tackling in practices. The idea is to limit the player-to-player contact to games, and therefore the instances of concussion.

“The only people we hit in the head this much if you think about it are people at the professional level who are making millions, college level who are trading for their education and then 95 percent of them are kids,” Nowinski said. “None of us would do this to ourselves. Whatever you can do to get that number down I think it’s important. It very much correlates with the number of concussions and it very much correlates with the overall risk of something like CTE.”

The images of brains with no CTE, bad CTE and the various levels Nowinski showed struck a nerve with some audience members.

“His images of what brains look like after years of contact sports was particularly memorable and the fact that it is not the one or two big hits that cause the problems, but the compounding of all of the smaller ‘bell-ringers’ that athletes can get,” Nee said. “It wouldn’t deter me from allowing my son to participate in sports, but the lecture did make me more aware of signs of concussions when kids come home. I would possibly delay participation in rougher sports until he has the knowledge to know proper technique to avoid concussions. I liked his idea of delaying tackle football until high school, for example.”

The future is bright for what is still a relatively new area of study as people like Nowinski and Cohen have been making their own noise on the subject.

“I think we can get our arms around the diagnosis and management of concussion the next 10 to 20 years as technology improves,” Nowinski said. “That will continue to get better. The biggest fight and change we need to make is that we shouldn’t be hitting kids in the head on purpose. The two most popular sports for kids, soccer and football, encourage repetitive brain trauma. Knowing what I know today I couldn’t imagine a worse thing to do to a child than hitting them in the head all the time.”

Read more local coverage of your hometown in this week’s issue of The Scarsdale Inquirer. Newsstand copies are available at several locations listed above, or subscribe today for convenient home delivery.


November 18, 2015