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STAY IN THE GAME Ultimate Sport Physical a step beyond usual exam ALEXIA SEVERSON LAS CRUCES SUN-NEWS LAS CRUCES - Jennie Coyle, 45, of Las Cruces knew that by being involved in school sports, her four sons all basketball players were at risk for injury. Before each sports season began, Coyle was required to attend a parent meeting to watch a video on the signs and symptoms of a concussion, a type of traumatic brain injury. But she never thought it would happen until her 14-year-old son Noah, a basketball player at Mesilla Valley Christian School, hit his head during a game in late February. My son was jumping up to catch the ball and the other player didn t see him and ran straight into my son and his head hit the floor, Coyle said. He was just lying on the ground, out cold, and his eyes were open. When Noah was able to stand up and walk to the bench, Coyle said she could tell there was something wrong with him because his eyes were red and he said his hands had gone numb. It was later confirmed that he had a concussion and Noah took 10 days to recover before he was allowed to return to play with his teammates. We definitely still want him to play and we love the sport, Coyle said. But especially since he has had one concussion, I m a little more cautious. Pre-participation exam While injuries in sports are unavoidable, certain preventive measures, such as the athletic pre-participation physical exam, can help avoid sports-related injury and death by identifying medical and orthopedic problems that may place the athlete at risk for injury or illness. The PPE also helps schools meet risk prevention and liability requirements. The New Mexico Activities Association, a nonprofit organization that regulates interscholastic programs for junior and senior high schools in New Mexico, and Las Cruces Public Schools requires that students who participate in interscholastic athletics complete the PPE, said LCPS Athletic Director Ernest Viramontes. The PPE includes a record of prior injuries, prior surgeries, any heart conditions and the medical history of the athlete, as well as vision screening, vital signs, orthopedic exam and physician clearance. Our No. 1priority in our district is always the safety of the student athlete, Viramontes said. The whole process starts with making sure all the student athletes get a sports physical and when injuries do occur, it s good to have the proper person addressing the injury and the stu dent doesn t come back to play until they ve been cleared by the head athletic trainer or the doctor, depending on the injury. However, because the typical PPE usually only lasts about 10 minutes, David Gallegos, southern representative for the NMAA Sports Medicine Advisory Committee and deputy CEO of Southwest Sport and Spine Center, aims to provide a more in-depth physical and higher level of health care for young athletes through the Ultimate Sport Physical, an annual event that has grown over the years. This will be the 10th year Southwest Sport and Spine Center, an outpatient physical therapy clinic, will host the Ultimate Sport Physical, which will take place from 8 a.m. to 1 p.m. Saturday, April 30, at Arrowhead Park Early NMSU News Clips (1 of 5) University Communications

College High School, 3600 Arrowhead Drive. The event provides middle school and high school student athletes with the required PPE and includes concussion screening, cardiac screening, breathing assessment and orthotics, as well as onsite physicians and athletic trainers who can address any found problems or risk factors. Other organizations and resources relevant to health will also be available to help educate students on things such as staying hydrated, proper nutrition and other teen health concerns. We need a physical to address a lot more, because (the 15- to 24-year-old age group) is the only age group that has an increasing mortality rate their behaviors are risky so we said, let s address that, let s do the physical because we have to do that, and if that s the only time kids ever see the doctor, then let s make that time extremely valuable, Gallegos said. The Ultimate Sport Physical can accommodate up to 250 kids, with each receiving about 90 minutes of time, with the amount of staff the community volunteers, Gallegos said. Memorial (Medical Center) does primary care, MountainView (Regional Medical Center) does cardiology and orthopedics, Southwest Sport and Spine does the physical therapy, the local high school athletic trainers do the athletic training, UTEP (University of Texas at El Paso) does the concussion lab and NMSU (New Mexico State University) does screening for injury prevention, he said. Gallegos said having physicians and athletic trainers on-site during the event ensures that students get any medical problems they may have evaluated immediately, at little cost. If we find something, we need all the people that (the student) would normally go to, to handle it right then, because it would be of no value for me to say yeah, you have a heart problem, go see a cardiologist they charge you $200 dollars, you re never going to go. But when it s all included, it s all part of the ($20) fee, then you leave (the event) with all your answers taken care of. The Ultimate Sport Physical will also address the three most common causes of death in athletics, which are head, heart and heat conditions, Gallegos said. We haven t had anybody die in this state in the last three or four years in sports, Gallegos said. The last person who died, it was due to a heart condition and previous to that, it was a brain injury. But in the country, heat kills kids, cardiac issues kill kids and the one what s become really big in the last two or three years are concussions. So those three things, in terms of serious injury prevention, have to be managed tight. Concussions The Ultimate Sport Physical aims to prevent head injuries by providing concussion baseline testing and teaching parents what is normal and what may be asign or symptom of a concussion, Gallegos said. Students who attend the event can also get concussion counseling, said Dr. Dolores Gomez, a faculty member at the Family Medicine Residence Program at MMC and one of the physicians participating in the Ultimate Sport Physical. A kid who has had history of traumatic brain injury from a concussion can get counseling at the event, because they are going to be able to understand what that means from the previous injury, and what can happen if they get another concussion when they get back on the field, Gomez said.... We know concussions not only cause problems at the time of injury, but have future ramifications, and that is where the concern is. NMSU News Clips (2 of 5) University Communications

While a single concussion should not cause permanent damage, a second concussion soon after the first one, even if not severe, can be deadly or permanently disabling, according to the American Association of Neurological Surgeons. The number of concussions can vary (each year), but you ll find concussions in every sport from basketball to football to soccer to cheer to volleyball, said Tracie Stone, head athletic trainer at Mayfield High School. According to the Centers for Disease Control and Prevention, high school football accounts for 47 percent of all reported sports concussions, and 33 percent of all sports concussions happen during practice, Gomez said. Since August, Gallegos said he has seen one middle school student, seven high school students and one college athlete come to Southwest Sport and Spine Center with a concussion. According to state law signed March 4 by Gov. Susana Martinez, school athletes who get a concussion are not allowed to participate in sports or other athletic activities for a minimum of 10 days, or until they are completely asymptomatic. According to CDC, common signs and symptoms of a concussion include:» Headache» Confusion» Difficulty remembering or paying attention» Balance problems or dizziness» Feeling sluggish, hazy, foggy or groggy» Feeling irritable, more emotional, or down» Nausea or vomiting» Bothered by light or noise» Double or blurry vision» Slowed reaction time» Sleep problems» Loss of consciousness Last year, we did 250 concussion exams (during the Ultimate Sport Physical) and found three kids that were currently in a concussion, Gallegos said. They had had it in the last few weeks, they had not recovered yet. So those kids, had they not come (to the event), could have in theory gone on to play again and gotten a second concussion. Heart and heat Dr. Scotty Smith, a cardiologist at MountainView, said he provides cardiology support at the event and screens for possible heart conditions by examining the athlete and looking at an EKG, or electrocardiogram, which records the heart s electrical activity and can detect things like heart attacks, arrhythmias, heart failure and other disorders that affect heart function. It s very rare, but when people do have certain congenital heart diseases that have not been diagnosed before, then they are at risk of having problems, Smith said. It s a very rare circumstance, but when it does happen, the results are very awful consequences. NMSU News Clips (3 of 5) University Communications

About two-thirds of the time, sudden cardiac death in young people is due to a heart abnormality, according to Mayo Clinic. To prevent heat illness or heat stroke, Gallegos said students who attend the Ultimate Sport Physical will be given information on proper nutrition and staying hydrated. All LCPS coaches and head athletic trainers have to go through training with the school district on concussions and heat index training, Viramontes said. Viramontes said while the basic sports physical is required, anytime students can get extra preventive health care, the better. (The Ultimate Sport Physical) brings forth a team effort in terms of the care of the athlete, which I think is extremely important, Gomez said. These are young adolescents who are usually very healthy, so it s rare to find something, but if you re going to find something, you can definitely prevent something that could happen catastrophically. To register for the Ultimate Sport Physical, visit swsportandspine.com. For information about the event, contact David Gallegos at 575-521-4188 or david@ swsportandspine.com. The $20 fee will be donated back to any organization or school of the student s choice. Space is limited. Alexia Severson may be reached at 575-541-5462, aseverson@lcsun-news.com or @AlexiaMSeverson on Twitter. Injury prevention: Dr. Minerva Ramirez conducts a cardiopulmonary exam on 16-year-old Las Cruces High School student Brandon Baeza at the Arrowhead Park Medical Academy on March 2. JETT LOE/SUN-NEWS NMSU News Clips (4 of 5) University Communications

JETT LOE/SUN-NEWS Centennial High School student Katrina Keding conducts an orthopedic exam on Las Cruces High School student Brandon Baeza at the Arrowhead Park Medical Academy on March 2. NMSU News Clips (5 of 5) University Communications