MADISON, Wis. Wisconsin defensive tackle Ethan Hemer stood on the practice field two years ago overcome with an intense feeling of sadness that he could not explain. All he knew was it began after his head hit the turf during a football drill.
It wasn't until later that Hemer realized he'd suffered a concussion.
"It's really hard to explain," Hemer said. "I had no reason to be sad, but I was just sad out on the practice field. I got really emotional. It was bizarre. And then I knew this wasn't right, so that's when I talked to the trainers."
Hemer's story is one shared by scores of college football players across the country. But only his willingness to report his symptoms allowed the training staff to properly assess the severity in a timely fashion.
The importance of responding to the body's signals in times of distress is a message Wisconsin's head trainer, Mike Moll, imparts on players at the start of each season. Concussions in football have become a hot-button issue as more information reveals itself about the effects of serious blows to the head. Continuing to play through the pain, Moll said, benefits no one.
"I think athletes are more willing to talk about concussions now because they've been more popular in the media," Moll said. "Athletes might be more aware and be less willing and for good reason to play with symptoms. I think previously they were probably under-reported. But it wasn't because we wanted them to be under-reported. It's just that athletes weren't reporting them as frequently."
The website impacttest.com notes: "In the United States, the annual incidence of sports-related concussion is estimated at 300,000. Estimates regarding the likelihood of an athlete in a contact sport experiencing a concussion may be as high as 19 percent per season."
According to a study from the Department of Neurological Surgery at the University of Pittsburgh, 34 percent of college football players have suffered at least one concussion and 20 percent have endured multiple concussions.
Handling concussions at Wisconsin
Moll assesses concussion severity with a symptom report, which asks a player to rate headaches, nausea, balance problems, irritability and visual problems, among other symptoms. The scale ranges from 0 (not experiencing this symptom) to 6 (severe). Other tests allow Moll to determine simple motor patterns with a player's arms by following directions. Cognitive tests include having a player count down from 100 by seven or repeat a three number sequence.
Players then undergo a series of computerized neurological tests to measure brain function. The exam, known as a baseline test, assesses memory, reaction times and cognitive processing speed.
At the beginning of each season, every Wisconsin football player on the roster undergoes the baseline test in case he suffers a concussion during the year. Moll can then compare the tests after a concussion.
In order to clear a football player for full-contact drills, that player must wait until all symptoms resolve. Afterward, Moll said the player would be allowed to return to aerobic activity, which includes 20 to 30 minutes of stationary biking, as well as his regular weight lifting program. The next day, a player progresses to a running workout at practices. Then, he will wear a green non-contact jersey the following day. If a player handles those well, he is cleared for full-contact play.
"It's going to be at least three days before they return to normal activity," Moll said. "If somebody was to sustain a concussion during a game, the earliest they would probably return is Wednesday."
Moll noted that the occurrence of concussions for Wisconsin's football team was split about evenly between practices and games. But there are hundreds of practices and only 12 to 14 games each season.
Concussions have hit Wisconsin's football program hard during the past year. Two players defensive tackle Jordan Kohout and linebacker Cody Byers were forced to quit playing football after sustaining concussions while with the Badgers. Kohout suffered two small strokes as a result of migraines associated with football.
This past Saturday, wide receiver Jared Abbrederis left a game with a chest injury and a slight concussion. His status for this week's game is uncertain.
"I think we definitely need to be cautious with a player's head," Kohout said. "If a guy is feeling wrong, you shouldn't continue to play. The coaches and the players both need to be on the same page. There's definitely some coaches that are going to be like, Quit being a wuss.' And there's some players that are like, I can tough it out.' I get the being tough thing. Everybody has aches and pains every once in a while.
"But Coach (Bret) Bielema definitely stresses the health of the brain. He's pretty big on not returning to play until you're ready. Thankfully, here at Wisconsin, the training staff is great."
New rules in place
Concussions in football are inevitable. But at the college level, rules changes have been implemented this season to cut down on the number of possible blows to the head, including stringent enforcement of helmet safety. At Wisconsin, the concepts have been met with mixed feelings.
Bielema is on the rules committee that helped change the helmet rule. He said he suffered his first concussion during a game as a high school freshman. Back then, he played tuba in the school band, but after the game, he never made it to the field because he passed out on the walk there.
The incident taught him about the seriousness and delayed symptoms of concussions and helped shape his opinion on player safety.
Among the new rules in place regarding helmet safety are:
If a player loses his helmet, it is treated like an injury and he must sit out the next play, unless the helmet comes off because of a penalty.
If a player other than the ball carrier loses his helmet, he can no longer be involved in the play.
If a ball carrier loses his helmet, the play will be whistled dead immediately.
"I know a lot of coaches had different opinions and felt maybe it was little bit drastic," Bielema said. "But when you're talking about the health and well being of an 18- to 22-year-old young man who's got his whole life in front of him, there's nothing that's more important."
The rules could also lead to unusual scenarios. For example, a 10-second runoff takes place if a helmet comes off with less than a minute remaining in the game. If a team has a timeout, it can use it to avoid the runoff, but without the benefit of a timeout, it could cost that team the game.
"If a guy's helmet falls off with three seconds to go, catching the ball on the goal line, the game's over," Badgers linebacker Chris Borland said. "I don't know if that's a good adjustment. But I think it's good that they're looking out for guys playing the game."
In an effort to expedite the process of getting back on the field, Wisconsin players said they each had a "helmet partner" in case a helmet comes off during play. That way, if the helmet is damaged during play, the player can run to the sideline and exchange helmets with a teammate.
According to the NCAA, helmets came off an average of twice per game last season.
The NCAA also implemented new kickoff rules this season. Kickoffs now take place from the 35-yard-line instead of the 30 to produce more touchbacks. The kickoff team is limited to a five-yard running start, and touchbacks occur at the 25 instead of the 20.
"Some of the rules, I think, I don't really know what you can really do with it," Badgers center Travis Frederick said. "You really want to keep everybody safe, and you really want to go out and make this game as safe as possible, but again it's a contact sport. We all sign up for it. We all know that's a risk of this game."
Despite mixed feelings, Wisconsin players recognize that the need for safety is paramount. The helmet rule change in particular might be viewed as a nuisance, but if it saves someone like Hemer from suffering another concussion, he admits it's worth it.
"When I first heard it, I was really skeptical," Hemer said. "I didn't really understand why. And there were a lot of instances where I was thinking this could actually hinder a defensive lineman. But when we had the referees come in to give a presentation before the season, guys asked a lot of really good questions.
"The refs were very thorough and explained everything to us, and now that I've had the rules explained to me, I understand that it came out of necessity and health concerns. For that reason, I guess I don't really have a problem with them."
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