One in five high school students who play contact sports suffer a concussion each year, according to the University of Pittsburgh Medical Center. To facilitate recovery of concussed students, Swarthmore has a Concussion Team in place to support injured students. However, concussion symptoms still pose significant challenges for students, as they affect academic performance, physical well being, social interactions, and mental health.
According to a 2014 NCAA report, 13.1 percent of female NCAA athletes and 19.4 percent of male NCAA athletes self-reported as having incurred one or more concussions during their collegiate career.
Courtney Caolo ’21, a member of the Women’s Lacrosse team, is one of those students. This May, a player on a competing team body-slammed her from the side during a lacrosse game, causing her to fall over. She continued playing and did not notice any symptoms until two hours later, when she tried to drive herself home and felt shooting pains down her neck.
“It wasn’t that bad of a fall, but I had gotten a concussion the same way the previous year, so I think that’s what caused it to be that bad again,” Caolo said. “It was the same kind of whiplash.”
Since the beginning of the fall semester, 20 students have reported having concussions. According to Holland, three of them were diagnosed with concussions at the Health and Wellness Center. During the 2016-2017 academic year, 42 reported there with concussion symptoms. According to Sakumura, ten have been cleared and ten continue to work with her and the college’s Concussion Team, which also includes the sports medicine department for student-athletes and director of student of health and wellness Alice Holland for other students. According to Holland, health care providers administer post-concussive symptom scales and physical assessments to students who come in with a concussion to determine how to care for them over time.
“If emergent care is not warranted, special attention is given to stage of healing, social activity, academic activity and athletic activity,” Holland said in an email. “Students are educated on pain management, nutrition, and stress reduction to aid in their recovery.”
Caolo has not yet been cleared. She communicated primarily with Michelle Ray, current interim Title IX director, before the responsibility shifted to Sakomura.
“When a student has a concussion, I reach out to professors and then the student,” Sakomura said. “Once I communicate with the student, the student comes in and then we have a one-on-one conversation about what kind of classes they’re in, what kind of jobs they have, and … how best to navigate the situation because they have this injury.”
According to Caolo, she communicated with Sakomura often throughout her first few weeks of school as she adjusted to the demands of her course load: Biology 001, Chem 010, Art History and Economics.
“The first few weeks when we were still trying to figure everything out, it was really stressful, but I sat down with each of my professors and they all told me, ‘The best thing for you is not to be stressed out about work and just to focus on getting better,’” Caolo said.
However, concussion symptoms can change quickly, requiring flexible recovery plans and accommodations.
“There was one Friday where I had a bio quiz and a chem test,” Caolo said. “I was okay the beginning of that week and then the rest of that week, I just really wasn’t feeling well, to the point where I really wasn’t walking around much, so by probably midweek I was getting really worried, like, ‘I’m not going to have enough time to study for this,’ or even, ‘I’m not sure if I can take both tests in one day.’”
With help from Sakomura, she was able to take one of her tests later. But without yet having official paperwork from student disability services, her professors could not give her extra time during tests until a week later.
“If professors don’t have anything that’s official, it’s hard for them to just make accommodations, because they just really can’t,” Caolo said. “I know that even when I was meeting with dean Sakomura, she was worried about disability services taking a while to get the paperwork done, so that might have been a concern in the past for some people, but I didn’t really have an issue with it.”
According to assistant director of student disability services Jenna Rose, extended testing time, quiet testing environments, and extended deadlines for class assignments are accommodations that SDS commonly authorizes for concussed students.
For many Swarthmore students with concussions, their main concerns are about not falling behind in class and keeping up their grades.
“Luckily my professors are really understanding and I was able to get some tests moved and some papers extended,” Caolo said. “But there [were] a good two weeks when it was really rough trying to schedule all my work in and making sure that I wasn’t pushing myself over the edge.”
In addition, everyday campus activities like getting meals add to the difficulty of having a concussion.
“It’s not easy, especially because there’s no time when you can really rest,” Caolo said. “It’s not like high school, where you can just take the week off of school. You just kind of always have to be going to stuff and always walking around and always going to get food so it’s kind of difficult, moving around when you don’t even feel like sitting up, but it’s been manageable so far.”
Sakomura emphasized that concussed students, however heavy their course loads, need to prioritize rest.
“It’s very tricky because stress can contribute to the concussion not healing in time and students also want to do really well academically in class, so there’s always this struggle,” Sakomura said. “We always try to help the student not to worry so much because that can contribute to the symptoms. It’s really hard not to stress, of course, but really, rest needs to come first.”
Lydia Koku ’18, who was injured in February 2017 and experienced concussion symptoms until May, described the stress that their concussion caused them.
“Having a concussion intensified my spring semester but simultaneously forced me to prioritize my well-being first,” Koku said in an email. “I withdrew from one of my required Honors seminars because I could not keep up with the demands of the course and yet continued to struggle with my three remaining courses. These academic stressors were accompanied by persistent anxieties about whether I would be able to graduate on time and with Honors.”
Some of the lesser-known symptoms of concussions, which fall outside of the domain of dean Sakomura and the Worth Health Center, are emotional issues such as nervousness, mood changes, irritability, and sadness, according to the CDC. According to ‘Scientific American,’ an established science journal, head injuries increase the risk of mental illness. Concussions often intensify mental health issues present before the injury and sometimes cause new issues to arise. For Koku, the pain and long recovery time she experienced led to increased depression.
“This weakened internal locus of control intensified my depression over the course of the injury and afterwards,” they said. “Due to my experience, I now understand the heightened importance of self-care and attempt to infuse patience into my daily life.”
Both Holland and Rose mentioned Counseling and Psychological Services as the resource for students with mental health issues. CAPS provides free, voluntary, and confidential psychological counseling to students, among other services. For Koku, this has been helpful.
“I love CAPS and go every week,” they said.
On top of these concerns, the physical symptoms of concussions, especially constant fatigue and sensitivity to light and loud noises, can inhibit social interactions. Caolo described her experience recovering from a concussion during the first few weeks of freshman year.
“Especially in the beginning of the year I was like, ‘I really don’t feel like myself, so it’s going to be really weird trying to make friends when I don’t even feel like me,’” Caolo said. “You’re not as outgoing or as bubbly and can’t really stay your normal self just because you’re very tired all the time and [your] head is hurting all the time … I really can’t go to anything that’s very loud, which is an issue because that’s most social events.”
Despite these challenges, Caolo was able to attend all of her class sessions the first half of the semester, and with her accommodations, she was able to improve her grades from the first round of tests. She feels that her professors and the faculty with which she communicated helped her significantly.
“It’s actually been a lot easier,” Caolo said. “When I went to go take the next round of tests, it was definitely better with the accommodations.”
Koku also feels that the Swarthmore Concussion Team effectively assured their recovery.
“I could not have asked for a better support system,” they said. “Deans and faculty alike advocated for my continuation at Swarthmore and helped me plan to complete my coursework on time. Professors were accommodating with extensions if I advocated for myself.”
Sakomura feels that the interdepartmental Concussion Team contributes significantly to the efficacy of concussion treatments.
“I’d really like to celebrate the fact that the team around concussions is one example of different divisions at the college working together, and I think that’s really rare, and it’s really lovely,” she said.
Though concussions create additional hurdles and challenges for college students, faculty and staff collaborating and handling concussions with flexibility and understanding can alleviate lasting effects on academic performance and personal health.