High School Football Team Research Articles

Abnormalities in Diffusional Kurtosis Metrics Related to Head Impact Exposure in a Season of High School Varsity Football.

The purpose of this study was to determine whether the effects of cumulative head impacts during a season of high school football produce changes in diffusional kurtosis imaging (DKI) metrics in the absence of clinically diagnosed concussion. Subjects were recruited from a high school football team and were outfitted with the Head Impact Telemetry System (HITS) during all practices and games. Biomechanical head impact exposure metrics were calculated, including: total impacts, summed acceleration, and Risk Weighted Cumulative Exposure (RWE). Twenty-four players completed pre- and post-season magnetic resonance imaging, including DKI; players who experienced clinical concussion were excluded. Fourteen subjects completed pre- and post-season Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). DKI-derived metrics included mean kurtosis (MK), axial kurtosis (K axial), and radial kurtosis (K radial), and white matter modeling (WMM) parameters included axonal water fraction, tortuosity of the extra-axonal space, extra-axonal diffusivity (De axial and radial), and intra-axonal diffusivity (Da). These metrics were used to determine the total number of abnormal voxels, defined as 2 standard deviations above or below the group mean. Linear regression analysis revealed a statistically significant relationship between RWE combined probability (RWECP) and MK. Secondary analysis of other DKI-derived and WMM metrics demonstrated statistically significant linear relationships with RWECP after covariate adjustment. These results were compared with the results of DTI-derived metrics from the same imaging sessions in this exact same cohort. Several of the DKI-derived scalars (Da, MK, K axial, and K radial) explained more variance, compared with RWECP, suggesting that DKI may be more sensitive to subconcussive head impacts. No significant relationships between DKI-derived metrics and ImPACT measures were found. It is important to note that the pathological implications of these metrics are not well understood. In summary, we demonstrate a single season of high school football can produce DKI measurable changes in the absence of clinically diagnosed concussion.

Comparison of Indiana High School Football Injury Rates by Inclusion of the USA Football "Heads Up Football" Player Safety Coach.

Background:In Indiana, high school football coaches are required to complete a coaching education course with material related to concussion awareness, equipment fitting, heat emergency preparedness, and proper technique. Some high schools have also opted to implement a player safety coach (PSC). The PSC, an integral component of USA Football’s Heads Up Football (HUF) program, is a coach whose primary responsibility is to ensure that other coaches are implementing proper tackling and blocking techniques alongside other components of the HUF program.Purpose:To compare injury rates in Indiana high school football teams by their usage of a PSC or online coaching education only.Study Design:Cohort study; Level of evidence, 2.Methods:Athletic trainers (ATs) evaluated and tracked injuries at each practice and game during the 2015 high school football season. Players were drawn from 6 teams in Indiana. The PSC group, which used the PSC component, was comprised of 204 players from 3 teams. The “education only” group (EDU), which utilized coaching education only, was composed of 186 players from 3 teams. Injury rates and injury rate ratios (IRRs) were reported with 95% confidence intervals (CIs).Results:During 25,938 athlete-exposures (AEs), a total of 149 injuries were reported, of which 54 (36.2%) and 95 (63.8%) originated from the PSC and EDU groups, respectively. The practice injury rate was lower in the PSC group than the EDU group (2.99 vs 4.83/1000 AEs; IRR, 0.62; 95% CI, 0.40-0.95). The game injury rate was also lower in the PSC group than the EDU group (11.37 vs 26.37/1000 AEs; IRR, 0.43; 95% CI, 0.25-0.74). When restricted to concussions only, the rate was lower in the PSC group (0.09 vs 0.73/1000 AEs; IRR, 0.12; 95% CI, 0.01-0.94), although only 1 concussion was reported in the PSC group. No differences were found in game concussion rates (0.60 vs 4.39/1000 AEs; IRR, 0.14; 95% CI, 0.02-1.11).Conclusion:Findings support the PSC as an effective method of injury mitigation in high school football. Future research should seek to replicate this study using larger samples from additional states.

Humane Education

Humane Education

Examining Sport Team Identification, Social Connections, and Social Well-being among High School Students

Past research has found that sport team identification is positively correlated with social psychological health (Phua, 2012; Wann & Weaver, 2009) including work testing adolescent fans (Wann, Brasher, Thomas, & Scheuchner, in press). The current study was designed to extend previous investigations by examining the relationship between team identification and the establishment and maintenance of social connections. Data from 177 high school students confirmed expectations as identification with a high school football team was positively correlated with both social well-being and social connections. However, social connections were not found to mediate the relationship between identification and well-being, contrary to the team identification – social psychological health model (Wann, 2006b).

Learning Persistence Through Sports: Three Autoethnographic Sketches

ABSTRACTIn this paper, I use autoethnographic sketches (Rambo, 2007) to examine the way that sports have taught me the value of persistence. Specifically, I explore the way that (a) playing baseball as a young child, (b) serving as the team manager on the high school football team, and (c) working out as an adult have each equipped me to cope with the limitations associated with my physical disability, cerebral palsy, while also allowing me to articulate my relationship to my body on my own terms. I hope that this paper encourages readers to examine the practices that undergird their lives and to explore the origins of the values that motivate their everyday experiences.

Evaluation of the King–Devick test as a concussion screening tool in high school football players

ObjectiveConcussion is the most common type of traumatic brain injury, and results from impact or impulsive forces to the head, neck or face. Due to the variability and subtlety of symptoms, concussions may go unrecognized or be ignored, especially with the pressure placed on athletes to return to competition. The King–Devick (KD) test, an oculomotor test originally designed for reading evaluation, was recently validated as a concussion screening tool in collegiate athletes. A prospective study was performed using high school football players in an attempt to study the KD as a concussion screening tool in this younger population. Methods343 athletes from four local high school football teams were recruited to participate. These athletes were given baseline KD tests prior to competition. Individual demographic information was collected on the subjects. Standard team protocol was employed to determine if a concussion had occurred during competition. Immediately after diagnosis, the KD test was re-administered to the concussed athlete for comparison to baseline. Post-season testing was also performed in non-concussed individuals. ResultsOf the 343 athletes, nine were diagnosed with concussions. In all concussed players, cumulative read times for the KD test were significantly increased (p<0.001). Post-season testing of non-concussed athletes revealed minimal change in read times relative to baseline. Univariate analysis revealed that history of concussion was the only demographic factor predictive of concussion in this cohort. ConclusionThe KD test is an accurate and easily administered sideline screening tool for concussion in adolescent football players.

Abnormal white matter integrity related to head impact exposure in a season of high school varsity football.

The aim of this study was to determine whether the cumulative effects of head impacts from a season of high school football produce magnetic resonance imaging (MRI) measureable changes in the brain in the absence of clinically diagnosed concussion. Players from a local high school football team were instrumented with the Head Impact Telemetry System (HITS™) during all practices and games. All players received pre- and postseason MRI, including diffusion tensor imaging (DTI). Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was also conducted. Total impacts and risk-weighted cumulative exposure (RWE), including linear (RWELinear), rotational (RWERotational), and combined components (RWECP), were computed from the sensor data. Fractional, linear, planar, and spherical anisotropies (FA, CL, CP, and CS, respectively), as well as mean diffusivity (MD), were used to determine total number of abnormal white matter voxels defined as 2 standard deviations above or below the group mean. Delta (post-preseason) ImPACT scores for each individual were computed and compared to the DTI measures using Spearman's rank correlation coefficient. None of the players analyzed experienced clinical concussion (N=24). Regression analysis revealed a statistically significant linear relationship between RWECP and FA. Secondary analyses demonstrated additional statistically significant linear associations between RWE (RWECP and RWELinear) and all DTI measures. There was also a strong correlation between DTI measures and change in Verbal Memory subscore of the ImPACT. We demonstrate that a single season of football can produce brain MRI changes in the absence of clinical concussion. Similar brain MRI changes have been previously associated with mild traumatic brain injury.

Football and Arab-American Muslim Identities in Fordson: Faith, Fasting, Football

Abstract Rashid Ghazi’s Fordson: Faith, Fasting, Football (2011) addresses the Fordson High School football team in Dearborn, Michigan, a team composed of almost entirely of Arab-American Muslims. Ghazi tackles subjects such as being Arab-American in a post-9/11 world, how players practice and play games while fasting during Ramadan, and how a predominantly Muslim school navigates matters of church and state. This essay reads Ghazi’s little-seen documentary as an entry point to discuss the history of Arab Americans in sports.

“Clear Eyes, Full Hearts, Can’t Lose”: Friday Night Lights and Victorian Fictions of Provincial Life

Friday Night Lights, the 2006-2011 television series about a Texas high school football team, owes a debt to readers of Victorian fictions of everyday life and provincial fiction. Habituated to the quotidian, readers of Victorian fictions of provincial life are arguably the best equipped for understanding the critically-acclaimed television series, for in it, like the fiction that precedes it, hardly anything of moment happens. Plot and telos are hardly the point; the series locates its energies in the stuff of everyday life rather than in the logic of suspense. Recent work on the provincial novel helps us understand the politics of FNL in a way that goes beyond its own explicit themes of race, class mobility, and education. That both the Democratic and Republican candidates for the U.S. presidency in 2012 used the fictional team’s mantra—“Clear Eyes, Full Heart, Can’t Lose”—suggests the extent to which the ideas of the show tapped into a politics about nation. Paradoxically, the show’s deliberately provincial scope allowed it symbolically to unify the nation.

Is Bigger Really Better? Obesity Among High School Football Players, Player Position, and Team Success

American football is one of the most common high school sports in the United States. We examine obesity among high school football players, and variations based on positions, team division, and team success. We used 2 data sets from the North Carolina High School Athletic Association (n = 2026) and MaxPreps (n = 6417). We examined body mass index, calculated using coach-reported height and weight, by player position, division, and success based on win-loss percentage. Most players (62%) were skill players, with 35% linemen and 3% punters/kickers. Most skill players (62%) were healthy weight and 4% obese or morbidly obese. In contrast, only 8% of linemen were healthy weight, with 21% morbidly obese. Team success was correlated with size only for skill players. Obesity is a significant problem for high school football players. Pediatricians should consider the context of football playing in assessing long-term health risks for these young men.

Head Impact Exposure Sustained by Football Players on Days of Diagnosed Concussion

This study compares the frequency and severity of head impacts sustained by football players on days with and without diagnosed concussion and to identify the sensitivity and specificity of single-impact severity measures to diagnosed injury. One thousand two hundred eight players from eight collegiate football teams and six high school football teams wore instrumented helmets to measure head impacts during all team sessions, of which 95 players were diagnosed with concussion. Eight players sustained two injuries and one sustained three, providing 105 injury cases. Measures of head kinematics (peak linear and rotational acceleration, Gadd severity index, head injury criteria (HIC15), and change in head velocity (Δv)) and the number of head impacts sustained by individual players were compared between days with and without diagnosed concussion. Receiver operating characteristic curves were generated to evaluate the sensitivity and specificity of each kinematic measure to diagnosed concussion using only those impacts that directly preceded diagnosis. Players sustained a higher frequency of impacts and impacts with more severe kinematic properties on days of diagnosed concussion than on days without diagnosed concussion. Forty-five injury cases were immediately diagnosed after head impact. For these cases, peak linear acceleration and HIC15 were most sensitive to immediately diagnosed concussion (area under the curve = 0.983). Peak rotational acceleration was less sensitive to diagnosed injury than all other kinematic measures (P = 0.01), which are derived from linear acceleration (peak linear, HIC15, Gadd severity index, and Δv). Players sustained more impacts and impacts of higher severity on days of diagnosed concussion than on days without diagnosed concussion. In addition, of historical measures of impact severity, those associated with peak linear acceleration are the best predictors of immediately diagnosed concussion.

Concussion Symptoms and Recovery in Football Players

Source: Lau BC, Kontos AP, Collins MW, et al. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? Am J Sports Med. 2011; 39(11): 2311– 2318; doi: 10.1177/0363546511410655Researchers from the University of Pittsburgh sought to determine which on-field signs and symptoms are predictive of protracted (>21 days) versus rapid (≤7 days) recovery after a sport-related concussion in high school football players. Participants included 176 male high school football players (mean age 16.02±1.22 years) from the state of Pennsylvania who were diagnosed with a sport-related concussion by a trained sports medicine professional (ie, certified athletic trainer, team physician) during the preseason or regular season between 2002 and 2006. On-field signs and symptoms were observed and documented by the trained professional at the time of injury and included confusion, headache, loss of consciousness, post-traumatic amnesia, retrograde amnesia, imbalance, dizziness, visual problems, personality changes, fatigue, sensitivity to light/noise, numbness, and vomiting. Participants completed computerized neurocognitive testing using the Immediate Post-concussion Assessment and Cognitive Test (ImPACT)1 within an average 2.4 days after injury, and were followed until cleared to return to play by one of the study’s team of neuropsychologists using international clinical concussion management guidelines.Sixty-nine participants (40%) were lost to follow-up or did not return to football. Of the 107 evaluable athletes, 62 experienced rapid and 36 experienced protracted recovery. There were no significant differences between protracted and rapid recovery groups with regard to pre-injury history of headache, migraine, ADD/ADHD, learning disability, or more than one previous concussion. Mean recovery time in days for the rapid and protracted groups was 4.31 and 29.61, respectively, after correction for outliers. Nine participants’ recovery time fell between 7 and 21 days. The most common measured sign/symptom at the time of injury was headache (94.9%) and the least common was loss of consciousness (13.3%). Dizziness at the time of injury was associated with a 6.34 odds ratio (95% CI, 1.3–29.9; P=.01) of a protracted recovery from concussion. No other on-field signs and symptoms were associated with an increased risk of protracted recovery.The authors conclude that assessment of on-field dizziness may help identify high school football players at risk for a protracted recovery from concussion, which may allow clinicians to manage and treat concussion more effectively in these at-risk athletes.Dr LaBella has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.This study is important because it is the first to evaluate on-field signs and symptoms at the time of injury as possible predictors of prognosis after a sport-related concussion in adolescent football players. Previous studies focused on signs and symptoms at the time of initial clinical evaluation in an emergency department and up to several months after injury in heterogeneous groups of adults with sport- and non-sport-related concussions, with results demonstrating that persistent dizziness was associated with prolonged recovery.2–4 Since many high school football teams have health care providers on site to evaluate injuries and render care, information about signs and symptoms at the time of injury is valuable.The strengths of the current study include a uniform evaluation of all athletes by a team of neuropsychologists who applied the same specific set of criteria to define recovery and determine return-to-play status. Possible confounders such as pre-injury history of headache, learning disability, and previous concussion were accounted for in the analyses. The study’s limitations include a sample comprised of only male high school football players, so results cannot be extrapolated to older or younger players, females, or other sports. Additionally, 40% of athletes were lost to follow-up. Finally, balance was assessed in the enrolled athletes with Romberg, tandem walking, and heel-to-toe walking tests. Postural/balance tests specific for sport-related concussion, such as the Balance Error Scoring System (BESS), may be more sensitive measures of postural stability in athletes.5Despite these limitations, health care providers who evaluate and manage concussions in this population of athletes, especially those providing sideline care, will find these results clinically useful. Identifying dizziness at the time of the injury may allow health care providers to better inform athletes of what to expect regarding the timeframe for recovery and return to school and sports. Furthermore, previous studies2–4 suggest that prompt implementation of modalities to treat dizziness (eg, vestibular rehabilitation) may expedite recovery.

Incidence of Staphylococcus aureus Nasal Colonization and Soft Tissue Infection Among High School Football Players

Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections have been documented with increasing frequency in both team and individual sports in recent years. It also seems that the level of MRSA skin and soft tissue infections in the general population has increased. One hundred ninety athletes from 6 local high school football teams were recruited for this prospective observational study to document nasal colonization and the potential role this plays in skin and soft tissue infections in football players and, in particular, MRSA infections. Athletes had nasal swabs done before their season started, and they filled out questionnaires regarding potential risk factors for skin and soft tissue infections. Those enrolled in the study were then observed over the course of the season for skin and soft tissue infections. Those infected had data about their infections collected. One hundred ninety of 386 available student athletes enrolled in the study. Forty-four of the subjects had nasal colonization with methicillin-susceptible S. aureus, and none were colonized with MRSA. There were 10 skin and soft tissue infections (8 bacterial and 2 fungal) documented over the course of the season. All were treated as outpatients with oral or topical antibiotics, and none were considered serious. Survey data from the preseason questionnaire showed 21% with skin infection, 11% with methicillin-susceptible S. aureus, and none with MRSA infection during the past year. Three reported a remote history of MRSA infection. We documented an overall skin infection rate of 5.3% among high school football players over a single season. Our results suggest that skin and soft tissue infection may not be widespread among high school athletes in northeast Ohio.

Invasion USA (review)

Reviewed by: Invasion USA Ron Briley Invasion USA (1952). Directed by Alfred E. Green. Distributed by American Pictures. 73 minutes. Americans have long celebrated their opposition to tyranny, dating back to the American Revolution and clarion call of "no taxation without representation." Many citizens take pride in the second amendment to the Constitution, believing that individual possession of firearms will prevent foreign invasion and the imposition of dictatorship in the United States. More sophisticated considerations of how fascism might come to America, such as It Can't Happen Here by Sinclair Lewis, emphasize that American fascism would most likely manifest itself in the guise of right-wing populism. Nevertheless, American popular culture perpetuates the fantasy of foreign invasion and heroic citizen resistance. While such scenarios are often reminiscent of partisan European fighters (many of whom were communists) during the Second World War, there is a tendency to view such resistance as uniquely American. This is another example of American exceptionalism, grounded in a perception that the belief in freedom is a national, and not a human, value. Red Dawn, released in 1984 when President Reagan was reinvigorating the Cold War, describes the adolescent fantasy of a high school football team, the Wolverines, who defeat communist forces from Cuba and the Soviet Union, no match for quarterback Patrick Swayze and his teammates/warriors. Although made on a much lower budget, film director Alfred E. Green's Invasion USA (1952) perhaps best places the idea of American Cold War exceptionalism in historical and global context. Invasion USA projects the scenario of a full-scale Soviet assault upon the United States. Made during the Korean War and heyday of McCarthyism in Washington, Invasion USA depicts an expansionist Soviet empire intent on world domination, abetted by fifth columnists and Americans too soft to make the sacrifices necessary for the preservation of liberty. [End Page 148] The film begins in a New York City bar, where news anchor Vince Potter (Gerald Mohr), factory owner George Sylvester (Robert Brice), Congressman Arthur V. Harroway (Wade Crosby), Arizona rancher Ed Mulfory (Erik Blythe), and attractive socialite Carla Sanford (Peggie Castle) are mesmerized by the enigmatic Mr. Ohman (Dan O'Herlihy), who suggests that the patrons should curb their carping about selfish concerns and recognize that the American way of life is being threatened. Mr. Ohman mysteriously disappears, and the group at the bar is awakened from a trance-like state by a news bulletin reporting that American forces in Alaska are under attack. The source of this assault remains unnamed in the film, but the Cold War historical context, the invasion route through Alaska, the unintended comical Slavic accents, the proclamations from the "People's Army," and the use of MiG-15 fighter planes clearly indicate that the invading enemy comes from the Soviet Union. The story of the invasion is modeled after the news bulletin technique pioneered by Orson Welles in his radio broadcast of The War of the Worlds. The startled bar patrons watch the enemy launch an invasion of the Pacific Northwest supported by the employment of tactical nuclear weapons against American military installations. The President announces that the United States will retaliate with atomic bombs and take the war into the enemy's home territory. Nevertheless, the invasion appears to be gaining momentum, and the denizens of the bar recognize that they need to do their patriotic duty. Each, however, pays the ultimate price for failing to venerate and uphold the American Way. Sylvester returns to his tractor factory in the San Francisco area. While at the bar, he complained about government intervention in the operation of his plant, voicing discontent with suggestions that he direct some of his production lines into national defense. But his return is too late, for the enemy has occupied the factory. A fifth- columnist laborer helped the invading forces gain control over the means of production, casting doubt upon the political loyalty of labor. Sylvester confronts his former employee and is shot in the back by a member of the "People's Army." Meanwhile, Mulfory arrives in Arizona to retrieve his family. As they flee their home, the enemy bombs Hoover Dam, setting off a flood, which consumes...

The Long Gay Line: Gender and Sexual Orientation at The Citadel

[ILLUSTRATION OMITTED] Joe Johnson was born in Palatka, Florida, and grew up fourteen miles outside of town. His father was a logger, and his mother worked various jobs, including school bus driver and cafeteria worker. Johnson was a well-rounded kid: he loved art, excelled in academics, and played on the offensive of his high school football team. Coming from a working-class family, college was only an option if admission came with a generous scholarship. The Citadel's acceptance letter did, and Johnson decided to go. His parents couldn't have been prouder. Hell Week is always hot and humid, and the summer of 1983 was no exception. The weather is just part of the trial by fire that includes racking (yelling), marching, push-ups, shirt-tucks, and haircuts. For Johnson, however, Hell Week wasn't all that hellish. He had already gone through boot camp after joining the National Guard a year earlier, and he was in pretty good physical shape because of football. More importantly, Johnson knew that Hell Week was as much about mental discipline as physical strength. Still, as the Military College of South Carolina, The Citadel prided itself on being tougher than the toughest boot camp, more difficult even than the national service academies. After all, the service academies had been admitting women since the mid-1970s. In the 1980s The Citadel's mission was to fashion whole men, men who would become leaders in the military and in civil society. Most of these men were southern. A few, like Joe Johnson, were gay. Like other American military academies, The Citadel is an institution steeped in tradition. The graduates of academies like The Citadel and West Point join a long gray line of distinguished alumni who have gone on to guide the American military during times of war and govern the country during times of peace. It should come as little surprise that some of these alumni were and are gay. It may be a bit more surprising that gay cadets and alumni believed in and defended the tradition of all-male military schools with the same tenacity, and employing many of the same arguments, as their straight comrades: The Citadel built character, deepened a sense of honor, and strengthened the bonds of brotherhood among men. Just as important, for some cadets (gay and straight), The Citadel offered unassailable proof of manhood in a society that might otherwise doubt or deny it. Exploring the contentious history of The Citadel during the culture wars of the 1980s and '90s reveals much about the roles of gender and sexuality often hidden in plain sight in the South. Even though there has been excellent work on the struggle over gender integration at The Citadel, the role of homosexuality at the institution and the relationship between gender and sexuality remain largely unexplored. When we finally look at these once taboo topics, we find, not surprisingly, that The Citadel was (and is) populated by a varied cast of characters, individuals who shatter stereotypes about singular identities of womanhood, manhood, southernness, and homosexuality. A range of men, some gay, attended The Citadel and fought to keep it all-male. Losing that battle, these men found that the newly integrated institution evolved both in ways that they had feared and in others they could not have foreseen. (1) CITADEL HISTORY Today, The Citadel guards the marshy bank of the Ashley River, one of two rivers that together separate the peninsula of Charleston from the mainland. But when the garrison was first established in the early 1820s, it was more centrally located, just north of downtown, where it was the first of defense against slave insurrections. Founded in 1822 after an aborted rebellion planned by a freedman named Denmark Vesey, the municipal guard of armed white men stood at the ready to thwart future uprisings by the region's enslaved African Americans. By 1842 South Carolina officials saw that more than arms were necessary to defend the state and its people. …

Review

Reviewed by: American Indian Education: Counternarratives in Racism, Struggle, and the Law Ruth Spack (bio) Matthew L. M. Fletcher. American Indian Education: Counternarratives in Racism, Struggle, and the Law. New York: Routledge, 2008. ISBN: 978-0-415-95735-9. 223 pp. American Indian Education: Counternarratives in Racism, Struggle, and the Law is the inaugural volume in Routledge’s series on critical race theory in education. Matthew Fletcher, a law professor, examines the legal underpinnings of contemporary American Indian education by telling stories about a fictional Michigan tribe, “loosely based” on his own community: the Grand Traverse Band of Ottawa and Chippewa Indians (6). Most of the chapters address issues of ethics and fairness and follow specific, often recurring, characters as they negotiate emotionally charged social settings and legal or semilegal proceedings dominated by the non-Indian population. For readers who are well versed in the history of American Indian education (which Fletcher touches on only briefly in his introduction) and who therefore understand the truth of the fictionalized events, the book is a unique and useful addition to the literature. Chapter 1, “Commodifying Indian Students and Sports Mascots: The Lake Matchimanitou Warriors,” introduces an activist named Parker Roberts, who appears before the school board to protest rules that disadvantage an all-Indian high school football team and to call for the elimination of stereotypical names, war cries, plastic tomahawks, and other offenses at the games. Chapter 2, “Burying [End Page 72] Indian Histories in the Curriculum: The American History Teacher,” follows Parker as she attempts to change the school curriculum to include histories of Michigan Indians. Chapter 3, “Criminal Injustice and Demonizing Indian Students: The American Indian Student,” focuses on the treatment of high school Indian students, who are forced to sign “affidavits” and are turned over to the local police for actions that non-Indian students enact with impunity. The participation of a tribal lawyer at the school board hearings significantly affects the outcome. Chapter 4, “Intergenerational Character of Indian Experiences in Education: Niko Roberts on the Ice,” which Fletcher describes as “an interlude” (9), provides the larger sociopolitical and familial context in which American Indian students attain an education. The most dramatically rendered chapter in the book, it links Parker’s personal experiences with her son’s and describes a harrowing accident involving heroism in the face of tragedy. Chapter 5, “Indian Academic Fraud: The Terrible Tribe,” revolves around a secret society supported by the university that Parker’s son, Niko, attends in Ann Arbor. Founded more than one hundred years earlier by “children of wealthy and powerful members of the Great Lakes shipping elite” (96), the society comprises members who conduct themselves according to their version of authentic Native American teachings and traditions. Their practices offend Indian students on campus. Niko’s petition to end the university’s support of the society engenders heated and sometimes thoughtful discussion at the Board of Regents Student Affairs Committee. Chapter 6, “Indian Literary Fraud: Vann Logan’s Novel,” exposes the deceptive posing of a non-Indian as an Indian writer, causing Niko and other students to consider such issues as who has “authority to speak on behalf of or about Indian people” and what constitutes American Indian literature (134). Chapter 7, “Indian Cultural Restoration: Toledo Marks’ Return,” involves a lawsuit that leads Niko, now a lawyer, to represent his grandfather, a traditional pipe carrier, against an accusation that he violated the First Amendment when he spoke to schoolchildren about the pipe ceremony. Chapter 8, “Indian Political Resurgence and Affirmative Action: [End Page 73] The Lake Matchimanitou Indian School,” has a satiric, futuristic bent. It describes how a tribal community establishes a private school designed exclusively for Indigenous people and humorously imagines a future U.S. Supreme Court case challenging the constitutionality of “the Indianization of American education” (175). This chapter serves as a literary expression of Fletcher’s point that “American Indian education continues to be in crisis and perhaps always will be until American Indian people have the necessary resources and take the full responsibility for education their own” (3). One of the most successful features of Fletcher’s book is the range of educational experiences covered, from elementary...

Introduction of Kevin D. Lafferty as the Henry Baldwin Ward Medalist for 2009

Members and fellow officers of the American Society of Parasitologists, it is my pleasure and honor to introduce Dr. Kevin Dale Lafferty, the winner of the 2009 Henry Baldwin Ward Medal. As his major professor, I have tracked Kevin's professional career since its inception. As his collaborator for 20 yr and co-leader of our research group for 17 yr (now as a leadership trinity with Ryan Hechinger), I have witnessed many of the events Kevin will present in his acceptance speech. So my observations here will be like the classic Japanese film Rashomon, directed by Kurosawa, in which the several characters give their somewhat different interpretations of the same incident. In the fog of memory, who knows what really happened? I will finish with much greater certainty, offering a brief overview of his contributions to the field of parasitology. Kevin was born in 1963 in Glendale, California, and raised near Pasadena, a committed southern California surfer dude. His early years are clouded in mystery, but we do know that he had a loving family and he was a wide receiver on his high school football team. He ventured off to university at UCSB as an aquatic biology major. UCSB is the only university in the United States with a surfing break on campus, and this played a big role in his choice of school. I gather that his plan was to do something within an easy drive of a SoCal beach. To a great extent, this still governs his academic geography. I met Kevin in November of 1987. He was a student in the

They’re Not Just Little Adults

Kids are really different from their adult counterparts! It is critical that physicians, coaches, physical therapists, and athletic trainers keep the features of growth and development in mind as athletes progress from childhood to adolescence. Children are not all the same and they don’t necessarily mature in the same way or at the same rate. Just take a freshman high school football team for instance: There may be a few teammates who shave, are well developed, and are ready to compete against juniors and seniors. They are likely close to their adult size, having already experienced their growth spurts. Others will probably be baby-faced—perhaps with peach fuzz on their chins. Their muscle development is still waiting for the blast of testosterone that will hasten their development. The weight and height differences between these groups may be substantial, thus raising the question, should they be competing against one another in a contact sport? Such are the issues of maturation sorting—a mixing bowl of factors complicated by hormones, genetics, nutrition, and environment. The progressive musculoskeletal development that occurs between childhood and adolescence is fascinating but presents challenges for clinicians who care for those attempting to reach their maximum athletic potential. As we consider the consequences on the bone growth centers from the increased hours of training and the miles run, we realize that we do not have all the answers with which to reconcile optimal performance and growth. Many aches and pains that arise are minor concerns and so may reflect what previous generations of clinicians called “growing pains.” Some discomforts, though, should not be ignored and must be attended to properly to avoid more significant problems later. Such dilemmas are addressed by Lindenfeld et al and Purcell et al in this edition. Many sports injuries sustained by children and adolescents clearly demonstrate that there are limitations to what the growing skeleton can tolerate. Knowledge of these limitations should be part of the planning schedule for practice and training, especially in high-risk sports such as gymnastics and wrestling. Of particular concern are some of the conditions that affect the spine of young athletes. Whereas many adults suffer from low back pain (and a number use this condition for secondary gain), children, with rare exception, don’t malinger. Low back pain in children should always be taken seriously. Most cases involve mechanical or structural issues that can be successfully treated, especially if diagnosed early. All the more reason to pay special attention to such complaints in kids. In addition to focusing on treating many of these musculoskeletal conditions, it is worthwhile to emphasize their prevention, as Sekiya et al and Zernicke et al do in this issue of Sports Health. Sekiya et al demonstrates the difficulty of changing the mind-set regarding unsafe weight loss practices in amateur wrestling. Although recent guideline and rule changes have helped, much more can be done to improve the health environment of wrestling. The nutrition work by Zernicke et al is particularly interesting in light of what the typical American teenager ingests in high school cafeterias and fast-food outlets, making one wonder why teenagers don’t sustain hip fractures in their 20s. The publications in this issue pose a challenge to those looking to improve the health of youngsters. By accepting this challenge, we hope to enhance the lives of this and future generations.

Posterior Sternoclavicular Dislocation

A 17-year-old boy playing quarterback for his high school football team was tackled by a lineman who fell onto him, driving his right shoulder into the ground. On presentation to the Emergency Department, he complained of right shoulder pain and difficulty swallowing. His right arm was semi-adducted and he was unable to move it without significant anterior chest discomfort. A chest radiograph was performed (Figure 1), followed by a computed tomography (CT) scan of the chest with intravenous contrast (Figures 2, 3).

Traumatic Dislocation of the Hip in a High School Football Player

Although traumatic dislocation of the hip often occurs as a result of automobile accidents, dislocations have been reported to occur during sports activities. Using the experience in treating a 17-year-old high school football player with a posterior dislocation, complicated by involvement of the sciatic nerve, this case report provides background information on hip dislocations and provides a description of the immediate treatment by the physician, followed by 6 weeks of immobilization, and a detailed account of the 5-month intervention. The patient was injured while making a tackle during a high school football game when another player fell on him from behind. The case report describes his plan of care after immediate hip reduction surgery and 6 weeks on crutches. Generally, the program utilized a progression of non-weight-bearing resistance training and stretching in the initial stages of intervention and progressed to weight-bearing activities (on land and in the pool) as the patient was able to tolerate more stress. In addition, the treatment of the sciatic nerve using electrical stimulation during treadmill walking is described. The patient was seen in an outpatient physical therapy clinic an average of 2 times per week for 5 months. At the end of 5 months, results of the Lower Extremity Functional Scale (LEFS) indicated that recreational and sporting activities were within normal limits, and the patient was able to return to playing on his high school football team the next year.