October 7 update:
The impact of this column has been amazing both in terms of how many people it has reached and the message it sends. As a result, Corinne Atchison has been invited to be a featured speaker at the AVCA Convention in December. The column follows, but first here are the details of her appearance in Columbus:
Concussions in Volleyball:
Practice and Training Precautions to Reduce the Risk to Your Players* (GCCC C160 – 162)
Saturday, December 17, 3:15 – 4:15 p.m.
Suggested Audience/Level: All – Intermediate
Featured Speaker: Corinne Atchison, Texas Advantage Volleyball
Have you ever wondered what it is like to have a concussion? During this presentation, Corinne recounts her own personal experience and long road to recovery. She discusses the need for baseline testing and the need to monitor young athletes post-impact. Finally, Corinne suggests best practices to reduce the occurrence and recurrence of concussions through changes in drills and warm-ups and enhanced concussion protocols.
In the past four years, Corinne Atchison has coached three TAV teams to national championships, including the USA Volleyball 13s open this past summer. She is the 2016 AVCA 13s club coach of the year.
But Atchison, 36, who played briefly in college and started coaching at 20, deals daily with symptoms from concussions from being hit by volleyballs.
It’s changed the way she lives every day and it also has changed the way Atchison trains her volleyball teams.
By Corinne Atchison for VolleyballMag.com
As a player in the 90’s, I know I took a few hits to the head. Back then, we just said “my bell got rung” and you would return to the court as soon as you stopped seeing stars.
Concussion awareness and protocol were non-existent.
It wasn’t until the NFL was exposed by a doctor and former players that concussion talks became more serious.
In my case, I sustained my first diagnosed concussion in June 2012. Two years later, I had another more devastating concussion and I am still in recovery. Over my career, I witnessed many athletes go through similar ordeals without really understanding the magnitude of their suffering. Many gave up the sport and their lives were forever changed.
Today, I do not have statistics to share with you on the frequency or severity of concussions in girls volleyball, but I can share my story, my observations, and my suggestions to reduce head injuries in the sport I love.
And I will tell you the way I coach has been greatly affected, especially in practice and warm-ups.
My first diagnosed concussion was in 2012, two days before USAV Nationals in Columbus, Ohio. During a practice, I was walking across the 10-foot line while my players were serving. A short serve struck me in the right temple. There was little pace on the ball, but because of where it hit me, the effect was immediate. All I remember is a flood of tingling, numbness, ringing in the ears, and just not “feeling right.”
I walked over to another coach and said, “if I fall over and go unconscious, it’s because I just got hit in the head and I am not OK.” My eyes were fully dilated and I was slurring words. The trainer conducted several concussion protocol tests. In one test, she provided me with three words to remember, waited 30 minutes, and then asked me what they were. I had zero clue that she had even talked to me.
I was taken to the hospital for a CT scan and cleared. In most cases, CT’s for concussed patients come back normal. The doctors prescribed medications for the nausea and vertigo I felt and I was sent home. That was standard protocol in 2012.
I took the medication, attended Nationals, and felt awful the entire time. Six weeks later, I was back in the gym for a volleyball camp. Some girls were peppering and an errant ball hit me in the head, resulting in the second concussion. My doctors now suspect this was second Impact Syndrome, since I probably had not fully recovered from the first concussion. Immediately after being hit, two coaches noticed my glazed eyes and knew I was not OK. Eventually, the symptoms subsided and I went back to living a normal life.
Two years passed.
By then, concussion talks on ESPN and in the news were commonplace. Impact testing had been implemented in most schools, and people were starting to take more precautions before allowing athletes to return to play.
In the fall of 2014 had become the head coach at Ursuline Academy. We started the school season at the Pearland High School tournament. As I was warming up our team, a ball hit me on the right side of the head. Everything went black, but I maintained consciousness. I walked to the bench with my head in my hands. I was extremely sick to my stomach, my ears were ringing loudly, everything was leaning right, noise and lights were crashing in all around me, I literally couldn’t see straight, and my head felt like it was about to explode.
I told my assistant I had another concussion and asked him to coach. Afterwards, I lied down on the floor of the high school cafeteria. An athlete’s dad came over and wanted to call 911. I recall arguing and saying “No, I will be fine, just let me lie here for a bit.” They did persuade me to see the trainer, and she made a parent take me to an emergency clinic.
At the clinic, I entered the wrong last name (I hadn’t used my maiden name in over 10 years), I couldn’t remember my address, and I didn’t know my birth year.
I can laugh now, but when you are suffering from a concussion, they should not make you fill out your own paperwork. They ran a CT, which came back normal and the doctors agreed with my self-diagnosis of another concussion. They prescribed medications for the headache, nausea, and vertigo and sent me back to my hotel. A parent drove me home to Dallas. On my return, I went to see our trainer and she referred me to a concussion specialist.
He conducted impact testing. He did not have a baseline on me, so we used a normal range for comparison. I failed every test with a score of 5 percent or below. There was major concern about the severity of this concussion. The doctor informed me I was not allowed to work for a week. He prescribed another handful of medications. I was told to return home, stay in a dark room, stay off electronics, and sleep as much as possible.
A week later, my impact-testing scores were still under 5 percent, so I was required to stay home another week. After two weeks, my internal competitive drive compelled me to return to coaching my team. After another follow up with my doctor, he sidelined me for another three weeks.
As I look back on those six weeks, I do not recall anything. My memories were swept away as if they never existed. After the three weeks passed, my team was in the playoffs and I refused to miss those games. I didn’t practice with the team, I just showed up to coach for the matches and felt awful every second of it. Gym noise and lights were unbearable.
By January 2015, I was heavily medicated. I was no longer sleeping. I fainted almost every day and my life revolved around either coaching or lying in bed.
By March, I had lost 25 pounds. I was now seeing a chiropractor, massage therapist, trainer, concussion specialist, and several neurologists. The neurologists confirmed I was still concussed and when they asked how often I got headaches, I responded, “There is not a second of the day where I do not have a headache, where I do not feel slow or fuzzy, where I do not feel like I am going to fall over.”
They decided to start a round of Botox injections, which reduce migraines. This involves a series of 32 individual shots into your forehead, temples, and back of head. We did that twice, with the second series 12 weeks after the first. In between, we did an occipital nerve block injection, which is another set of 16 injections in the base of the skull, neck, and shoulders. After another six weeks, we attempted another series of injections in my sinus cavity. At this point, I was willing to try anything to get some type of relief, even if it was only a 10 percent improvement.
By January 2016, my memory, thought processes, headaches, and vertigo were still affecting me. In fact, some symptoms had worsened.
I switched doctors and ended up at the Ben Hogan Concussion Center in Fort Worth. Upon examination, my new doctor requested additional X-rays and MRIs. He also had me evaluated by physical therapists, occupational therapists, and ophthalmologist.
He said, “Corinne, you are kind of a mess, and there is a lot going on, but if we can do this slowly, I think we can get you back.”
Since then, I have been prescribed with glasses with a blue tint to help handle bright lights and a prism to improve balance. I attend vision therapy, occupational therapy and speech therapy twice a week and vestibular therapy once a week. The vestibular therapy is re-teaching my brain how to lie down and stand up, to balance, and to help my body “sense” itself. I also gave up coaching high school because of the rigors and now only coach club.
Since my first concussion, I have been highly sensitized to the risk of concussions in volleyball. From my observation, many concussions occur during warm-ups or practice. As coaches, we often conduct drills with hitters on opposite sides of the net attacking with a variety of shots. Over time, someone inevitably mis-hits, putting another athlete in harms’s way. Another classic drill is “Serve and Chase.” It’s great when you begin and everyone is serving in the same direction, but after a few serves and misses, you end up with some players chasing while others are serving at the backs of their heads. Coaches should also be aware many concussions occur when we are not in control of the situation, often before practice even starts.
As a direct result of these observations, I have instituted a few simple precautions to minimize the occurrence of head injuries for my teams :
No matter the drill, we always hit in the same direction when putting balls across the net. My servers all serve and my hitters all hit from the same side of the net until we run out of balls. Then, we all shag at the same time. If we don’t have enough balls to go around, we’ll have one serving group and one shagging group. No one is allowed to run under the net and risk having her back to a server or hitter.
Very rarely do I let my athletes “play” before practice without coaching supervision. If they arrive early, they are instructed to go through their prescribed warm-up routine. By the time they are ready to play, coaches are there to supervise.
During tournaments, my team always shags for the opposing team. This eliminates an opposing player’s need to run under the net to shag and reduces her risk of being hit. It also ensures my team is facing our opponent’s servers and hitters during warm ups. Before instituting this precaution, you would have likely seen my team in a huddle by our bench, exposing our backs to our opponent’s servers and hitters and increasing our risk of being hit from behind.
During our hitting warm-ups, our defenders shag for our hitters so they don’t have to run under the net to retrieve their balls. When we add in the setters or defenders, we put them all on same side of net, with the “off” hitting line ready to shag in case the opposing team doesn’t offer.
Lastly, I strongly recommend baseline concussion testing for all of my players. A baseline helps diagnose the severity of a concussion and provides a benchmark to allow safe return to play.
My symptoms are now steadily improving but my ordeal is not over. People often say “I wish the old Corinne would come back” or “How are you still not healed?” I’m still trying to figure out this “new” me. I am just now learning to accept the fact that some of my symptoms may be permanent. Even so, the “new” me had to share my story in order to shed light on the trauma many of our young athletes will face. The “new” me also feels compelled to share my best practices in hope of reducing concussion occurrence and sparing young athletes from an ordeal like mine.
I’ve always wondered why it happened to me and why I had to go through it. But I’m a firm believer in everything happens for a reason and maybe it was because I’m supposed to help advocate and bring awareness.
Even though all concussions may not be preventable, if this helps prevent even one volleyball head injury and for someone to not have to go through what I did, I will have made a significant contribution.
Contact Corinne Atchison at firstname.lastname@example.org