A few weeks into the summer season, she was playing another close game. It was almost half-time when she lined up as left outside midfielder.

As her leg reached for the soccer ball, she fell. At the same time, an opposing player’s foot swung toward her head.

The next thing Savannah Witt remembers is sitting on the ground and watching everyone move slowly on the sidelines. She tried to shake it off and play the rest of the game, but had to sit out the second half.

Witt, now a redshirt sophomore for the Montana Grizzlies soccer team, was hand-picked to play for the Colorado Rapids women’s reserve team the summer after graduating from Billings West High School in 2012. She moved to Denver, Colo., for the summer to play and fine-tune her skills before the fall season.

But instead of honing her skills, Witt found herself spending the next four days in her bedroom with the lights off recovering from her fourth concussion. The team’s trainers told her she probably wouldn’t bounce back that summer, so she left Denver and tried to heal in time to play for the Grizzlies.  

Concussions continue to be a sore spot for both professional and collegiate sports, but during the last 10 years, athletes have begun voicing the effects on and off the field. This new awareness sparked an interest in an injury doctors knew little about, and became a catalyst for research.

But the sport is stuck in a paradox of trying to avoid injury while maintaining traditions.

Witt is one player who recovered well enough to get back on the field, but not without difficulty.

THE REALITY

Witt returned to the field before the Grizzlies started fall practice in 2012. During the Shodair Soccer Classic, an annual showcase of Montana’s top prep players, Witt fell again and bumped her head. She knew it was another concussion.

When Witt came to Missoula in August, she thought she would be able play her freshman year.  But she didn’t pass either of the computerized physical or cognitive baseline tests, which measure reaction time, processing speed and visual and verbal memory. All Montana athletes are required to pass the test before they practice.  

She ended up redshirting her freshman year.

Witt sat on the sidelines while other freshman practiced. Head coach Mark Plakorus never made a formal announcement to the team about her condition, and never required her to come to the weekly weight training sessions. He told her school should come before soccer.

But it was hard to concentrate on school when she struggled to memorize facts and couldn’t skim-read books for class. She would feel sick if she stared at a screen too long during lectures.

Her other symptoms included dizziness and sensitivity to light. She couldn’t go to football games because the noise gave her headaches. One of the worst side effects was waking up dizzy and nauseous.

"It was hard just to constantly not be able to get out of your own head," Witt said. "So compared to another injury where it's like, yeah, your leg hurts or your back hurts, it's like in your head where you're trying to think and comprehend and process things. It's hard to really get away from it, the only way is to really sleep."

A concussion is a type of traumatic brain injury resulting from a blow to the head or body, and may cause the brain to bounce against the skull. The effects on the brain happen at a cellular level, which is why damage can’t be detected on a brain scan. Athletic trainers can determine if the athlete has a concussion through tests and watching for signs of common symptoms.

“I've talked to other people who have had concussions and it's a hard feeling to really put words to," Witt said."It just kind of makes you feel like you're outside your body looking in, so it seems like everything else around you in the world is moving a lot faster than you can process it."

Witt isn’t the first Griz player to get a concussion and won’t be the last.

Dave Dickenson, the quarterback who led the Griz to the 1995 NCAA I-AA football championship, was forced to end his career due to multiple concussions. This fall, quarterback Jordan Johnson missed the second game of the season after he suffered a concussion during the team’s opening game against the University of Wyoming.

The NCAA reached a settlement agreement this summer over a lawsuit involving several concussion-related class actions. According to its website, the organization will provide current and former student-athletes $70 million for concussion testing and diagnosis.

A group of soccer players and parents also filed a lawsuit this summer against FIFA, soccer’s international governing body, for negligence and insufficient treatment of concussions. The plaintiffs are asking for rules changes in the game instead of money.

In February, the NCAA published results from a 2010 self-reported concussion survey of 20,000 athletes from more than 600 NCAA schools. Women soccer players reported the second highest total number of concussions and were fifth in reporting at least one concussion.

Players have different tolerances for concussions. One concussion can end one player’s career, while players like Witt can make a comeback.

THE PAST

After Witt didn't pass her initial tests her freshman year, head women's soccer coach Mark Plakorus said telling her she couldn't play was one of the hardest things he's ever done.

"It's completely devastating to them," he said. "A lot of it is they are so passionate and they love it so much. It's hard to put into words how difficult it is to have that type of conversation with a young lady, ‘cause the biggest thing they want to know is 'Why is this happening?' And you don't have an answer."

Plakorus knows what it’s like to be fuzzy in the head. When he grew up playing sports, getting hit in the head was commonly called “getting your bell rung.” There weren’t baseline tests or knowledge about the repercussions of head injuries.

After college, Plakorus was playing on a soccer team for the Air Force when he got his sixth concussion. The last memory he has from the game in Billings is being down 0-1 in the first half.

During the second half, an opposing defender ran into him and he fell on the field. As he scrambled to get the ball, another opposing defender slammed his head into the ground.

The next thing Plakorus remembers is waking up in the hospital, strapped to a backboard with a breathing mask pumping oxygen. He doesn’t remember having his faced pushed into the ground, having a seizure, or riding in an ambulance to the hospital. Plakorus only knows what happened after watching a video of the game.

A few years later, Plakorus got his eighth and final concussion when he was coaching women's soccer at the University of Iowa. It was the spring of his first year and the seniors asked him to play on their co-ed team. During a game, the ball hit Plakorus in the chin and he collapsed on the field. The doctor told him if he got knocked unconscious one more time, he might not wake up.

Plakorus never gave up hope that Witt would play again. They talked about her options and how to cope if soccer was snatched away from her, but always held onto the chance of her recovery.

***

The science behind it--

College sports have come a long way since the time Plakorus played, when a serious head injury was merely considered a “bell ringer.”

In 2010, the NCAA held its first concussion summit. The summit recommended the NCAA consider requiring member schools to adopt a concussion management plan. At the end of April, the NCAA adopted the recommended policy. However, the NCAA doesn’t check if the plans are being enforced.  

The Grizzlies have a seven-step recovery plan that includes no activity, light aerobic exercise and sport-specific exercises before eventually returning to practice. An athlete must pass each step before returning to play.

Before any UM athlete starts practice, they’re required to have a physical and take a cognitive baseline computer test. If a concussion is suspected, they must retake the test. The trainers can then compare the results and use the information if a player has a concussion.

The NCAA has also changed some rules in sports. Last year, it passed a rule that football players who targeted and hit defenseless players above the shoulders would face a 15-yard penalty and ejection.

Caroline Faure is the director of the Center of Sports Concussions in the sports science and physical education program at Idaho State University. She said the greater awareness of sport injuries comes from a combination of media coverage, state-by-state legislation to protect youth players and educational programs for parents and athletes.

"We're not as afraid to use that name ‘concussion’ anymore, whereas maybe five or 10 years ago, that diagnosis carried a very negative connotation," Faure said. “Now we’re recognizing that the injury is just part of the game.”

In the past, Faure said physicians were hesitant to diagnose concussions because the definition of concussions varied. Doctors didn’t agree on whether being knocked unconscious indicated a concussion, and used a subjective grading scale ranging from mild to severe.

Faure said she doesn't think players are getting more concussions today, but more are being reported. The Sports Concussion Center looks at data collected from ISU and 19 surrounding high schools. She said they track the numbers to have a good idea of what is happening and see what they can change in the industry to reduce concussions.

In light of several recent lawsuits, concussions have become part of the social conscience. One concussion can make a difference in living a mentally healthy life, or in some cases, dying from the injury.

Chronic Traumatic Encephalopathy, a degenerative disease of the brain, is the result of repeated brain trauma. Some of the worst symptoms include paranoia, depression and aggression, according to the Sports Legacy Institute.  The disease can only be diagnosed post-mortem. In a study published in the scientific journal "Brain," 80 percent of people with repeated head injuries showed signs of CTE.

Faure said that, as an athletic trainer, players of all levels will argue with her if she advises them not to play after they’ve had a concussion. Athletes want to play and parents want to see their kids in the game, but sometimes they don’t understand the consequences.

"Injuries are being hidden and covered," Faure said. "There is a culture of ‘suck it up and play’ mentality that exists in sports, and we've got to do more to change the culture of the game and the culture of acceptance for this injury.”

The Sports Concussion Center is doing research on helmet maintenance and its correlation with concussions. It's also studying the value of education programs on concussion frequency and reporting.

Faure said one of the best ways to change the perception of concussions is at the grassroots level. In youth sports, Faure would like to see greater acceptance from coaches for the injury and increased athlete awareness. But it will be years before some of these changes happen, because it’s difficult to change older players who are set in their ways.

ROAD TO RECOVERY

Witt wasn’t feeling better after sitting out the fall 2012 season. So she visited her doctor, who recommended Witt see Dr. Robert Velin and try neurofeedback that spring.

For Witt, the 45-minute neurofeedback sessions felt like four or five hours of intense studying.

Neurofeedback is like physical therapy for the brain. Patients are hooked up to electrodes and work on increasing the efficiency of their brain. They use specifically designed video games to do things like make a puzzle piece appear on the screen or move objects through a maze.

Primarily, neurofeedback is used in patients with attention deficit hyperactive disorder, Velin said. Many concussion patients have problems with concentration, so neurofeedback can help train their brains to restore previous function.

While neurotherapy helped heal her brain, coaching helped Witt cope emotionally.

Griz soccer assistant Sophie Clough knows what it’s like to be forced to the sidelines. Her soccer career ended after a serious injury, so she started coaching and has been with the Griz for four years.

In spring 2013 Clough coached the under-13 girls club soccer team for FC Missoula and asked Witt to help with coaching. Witt covered the weekend games Clough couldn’t make. She enjoyed her first experience coaching, and it opened up the possibility of a career.

"Just being able to stay in the game and the relationship you build with the kids and things, I think it helped Savannah not in a soccer sense, but more just personally," Clough said.

Between coaching and the neurotherapy, Witt started to notice progress in everyday life. She began getting fewer headaches, homework became easier and the dizziness started to disappear. In the back of her mind, she still held onto the chance of getting back on the field.

"Hope is a pretty powerful thing," Plakorus said. "She felt herself getting better, and I think that was huge for her and her confidence. She felt like she was improving and she started to get excited again."

By mid-summer 2013, Witt's doctors cleared her to start running. Plakorus told her they would see how she felt in the fall and go from there. A few weeks before the season began, Witt sat down with her parents and Plakorus to talk about her options. Even though she was cleared to practice, the risk of a more serious injury weighed on her decision.

She decided to wait and give her brain more time to heal.

"It was hard and somewhat frustrating to know that I could kind of be playing," Witt said. "But at the same time, it was exciting to know that I could play the next year. Even though that seemed like a ways away."

A NEW YEAR

Witt finally joined her teammates on the pitch this spring after two seasons  sitting out. Her first game was against Carroll College at the end of spring. Her parents came to watch, and her mother Jill said when Witt walked off the field, her face was glowing.

At practice Tuesday, several injured players sat on the sidelines. Some of them had pulled ligaments, others had pulled muscles. But junior Mackenzie Akins said all these injured players look to Witt as an example.

“It’s pretty inspiring to look to Savannah and see that she’s playing after two years, and it gives them hope,” Akins said.

At the end of August, Witt played in her first collegiate match when the Griz faced the Air Force Academy. She played 49 minutes and had one shot. Eleven games into the season, Witt has played in all the games for 470 playing minutes total. She has 11 shots with four on goal and one assist.

Witt said most of her concussion symptoms have disappeared. Now, she’s just happy that she's back to her normal self. She can sit in class without feeling sick, go to football games when she isn’t traveling and doesn’t worry about headaches.

When Witt returned to the game, she changed her style to protect herself. She was taught to never go half-hearted into a tackle. During games she wears what looks like a headband, but is actually padded headgear that covers her forehead and the sides of her head.

Witt believes she can still make an impact on the game without headers, and adjusted her style of play so she doesn't have to. If it comes down to heading a ball or never playing soccer, it's an easy choice to make.

This fall, Witt’s position is left outside forward. Plakorus said players in this position don’t usually head balls, and Witt is working on hitting balls with her chest. Plakorus said this hasn’t impacted the team at all because Witt brings other assets to the field, like her competitiveness and valuable soccer knowledge.  

On the pitch, Witt finds an escape from the outside world on bad days. All her worries and concerns disappear. Even though Witt has been hurt by the sport she loves, she doesn't play in fear. 

"If I get hit in the head and that's it, then that's God's plan, but I just want to play until I can't play anymore," Witt said. "If I play scared, that's not the type of person I am or the style I play."


alexandria.valdez@umontana.edu 

@avaldez


Brett Berntsen is a Scorpio, and hates long walks on the beach.