Tebow's road to recovery
Published: Thursday, October 8, 2009 at 9:52 a.m.
Last Modified: Thursday, October 8, 2009 at 9:52 a.m.
When you are a Heisman-winning quarterback who has suffered a concussion, it takes a team to determine whether you are ready to play again.
That's where the Gators' Tim Tebow finds himself just days before the game against Louisiana State University in Baton Rouge.
Will he take a single snap in Saturday night's game?
Doctors who are assessing his progress on a day-to-day basis aren't yet ready to make that call.
Dr. Bayard Miller, a neurologist in the University of Florida College of Medicine, is one of a group of physicians working with Tebow.
The Florida quarterback took a hard hit from a Kentucky player in a Sept. 28 game and spent the night in the hospital after being diagnosed with a concussion.
Miller was not able to discuss specifics of the Tebow case Wednesday, but he did emphasize how much medical science still has to learn about the immediate and long-term effects of such an injury to the brain.
"For somebody with a concussion, they will be up walking around and may look normal, so the tendency is to dismiss the symptoms of a deeper injury," Miller said.
More than 3.5 million sports-related concussions occur each year in the United States, according to the U.S. Centers for Disease Control and Prevention. The number continues to rise.
A New York Times report found that from 1997 to 2007, head injuries resulted in the deaths of at least 50 football players on the high school level or younger. Another study has found former NFL players are far more likely than the general population to suffer from dementia.
Dr. Micky Collins is one of the developers of computer software called ImPACT (or Immediate Post-concussion Assessment and Cognitive Testing). The program, used at the University of Florida, gives athletes a baseline test at the beginning of the season that serves as a basis for comparison following a head injury.
Collins, assistant director of the sports medicine concussion program at the University of Pittsburgh Medical Center, is one of the team of physicians assessing Tim Tebow's mental and physical status.
Miller, associate chairman for clinical affairs in the department of neurology at UF, and Dr. R. Patrick Jacob, a neurosurgeon in UF's College of Medicine, are also part of the team working with Tebow.
When the Gator quarterback was first injured in the Kentucky game, cameras caught Dr. Peter Indelicato, team physician and orthopedic specialist, leaning over Tebow on the field.
But it is team physician Jay Clugston who probably will have the final say as to whether Tebow will take the field Saturday night in Baton Rouge, Miller indicated.
When a player suffers a head injury, the neurologist explained, the most susceptible parts of the brain to injury are memory, information processing and coordination of vision and balance. The brain is trying to compensate for the bruising it has suffered.
To test how quickly the brain's functions are returning to form, the medical team would give Tebow or any other injured player a series of tests.
Tebow would be given a series of words to remember, asked to repeat them back, then he'd be asked to recall the words after he'd been doing something else for a while.
He would be asked about events such as what happened in a game and what else has been going on since, to be sure he was fully aware.
"We'd ask them to follow an object with their eyes, then fix their vision on a target while moving their head," Miller explained. "Normally, if you're looking at a fixed point and move your head, that thing doesn't appear to move. But it is a sense that is easily disrupted."
After some rapid motor movements, Tebow's balance and coordination would be checked out.
"If you've ever had vertigo, you know the room can seem to be spinning and you can't walk from here to the bathroom without falling down," Miller said. It can be much the same after a concussion.
"We've learned that it is really important to put the brain to rest, so when an athlete has a head injury, we don't let them go to class, read, or watch film, even though they are bored to death," Miller said.
"We allow them to return to daily activities, exercise on a bike, but if at any point the symptoms come back, we stop."
After passing a series of such tests and reporting no further symptoms, Tebow was cleared to return to practice without contact on Wednesday.
Miller said that despite such technological advances as the CT scan and MRI, when assessing an injury to the brain, some old-fashioned methods still work best.
"In neurology, many of the tests we do are at the cutting edge, but that's all useless without doing what we did in the 1800s, asking questions to determine if there is some malfunction in the nervous system," he said. "By talking to the patient and examining them, we can get a pretty good idea what's going on."
Team Tebow has spent much of the past two weeks doing just that with the Gator quarterback.
And although his progress has been positive, Miller points out that someone who has had one concussion is more likely to have another. The risk goes down over time.
For a player such as Tebow, two concussions within the span of two weeks could end his season.
Clugston will make his recommendation as team physician. And Miller says he's confident coach Urban Meyer will make the right call for his quarterback.
"Coach Meyer may be paid to win football games, but he looks at each of his players as his children. He'll ask himself, 'If this was my son, would I want him to play today?'
"That's a call you can only make on a day-to-day basis," Miller said.
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