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There was a time, in the not too distant past, when getting your “Bell Rung” was seen as a badge of honor.

After taking a hard hit to the head, woozy athletes were regularly told to “shake it off” or “walk it off.”

Chris Nowinski hopes those days are gone forever.

He’s doing everything he can to make sure of it.

Nowinski, in conjunction with Dignity Health Central Coast and its network of local hospitals — Marian Medical Center, French Hospital Medical Center and Arroyo Grande Community Hospital — led a symposium Saturday at Arroyo Grande High School about the dangers of Concussive Brain Injuries, more commonly referred to as concussions.

“We’ve known about these injuries for decades. There just wasn’t a name for it back then,” said Nowinski, a Chicago native who played football while attending Harvard University before going on to a career in World Wrestling Entertainment (WWE). “Doctors didn’t know how to treat them or they gave the wrong treatment. During games, teams would put concussed players right back in the game and that actually made things worse,” Nowinski said.

One concussive brain injury is too many and yet thousands of players have sustained far more during the course of their youth, high school, college and pro careers.

“We did a survey of 730 Division I college football players. We asked them how many had concussions and many of them didn’t know if they’d ever had one,” said Nowinski. “The number one reason players don’t want to leave a game is because they don’t want to let down their teammates.”

Football concussions get the most press coverage but they can happen in any sport.

“I played soccer when I was in college. In one game, I had a head-to-head crash with another girl while going for a header. I went down and was bleeding,” said Emily Murrer, the symposium’s opening speaker. “I went back into the game. There was no follow up, no protocol. I just continued playing. I didn’t want to let my teammates or coaches down. I didn’t realize I had a concussion until the next morning when I woke up and wondered ‘where did I get this gash in my head?’ I had no memory of the injury or the game. Luckily, nothing serious happened long term.”

But long term damage from concussive brain injuries can be serious.

Nowinski also has first-hand knowledge of the problem.

“I got into this because I banged my head too much and didn’t do anything about it,” said Nowinski. “In the WWE, I was a bad guy.  As you know, pro wrestling is not supposed to be a real fight but accidents happen. In the Royal Rumble in 2003, I got kicked in the head in mid-match. It was an accident. I didn’t want to stop wrestling so I lied about it for five weeks but at the five week mark, I couldn’t sleep and I started sleep walking and I decided that I had to figure out what was going on.”

Nowinski’s serious concussion affects lasted for a year and he still has problems today.

“Fortunately, I met Dr. Robert Cantu. He was the eighth doctor I went to about the problem and he was the first one who recognized that I had been concussed,” said Nowinski. “I should have been (WWE) champion but the concussion changed the trajectory of my life.”

It sent him back to college, this time Boston University, where he earned a PhD in Behavioral Neuroscience.

In 2006, Nowinski published the book Head Games: Football’s Concussion Crisis, an effort to bring the recognition, treatment and prevention of brain injuries out of the dark ages.

In 2008, Nowinski and Dr. Cantu went on to co-found the Concussion Legacy Foundation, a non-profit organization dedicated to solving the sports concussion crisis.

“The problem can at least be partially solved through education,” said Nowinski. “I do a lot of community education. I talk to a lot of people to give them tools to help keeps themselves and their kids safe.”

Nowinski says not enough is being done about the problem. He is trying to get doctors and hospitals, schools, teachers, coaches, administrators, parents and kids to understand the importance of concussion education.

“We’ve partnered with Dignity to really educate the community about the dangers of concussions,” said Nowinski. “Dignity now has a pilot program in six schools (Arroyo Grande, Mission Prep, Santa Maria, Orcutt Academy, Pioneer Valley and St. Joseph High Schools) where they do baseline testing before each season begins. It will help doctors get an objective look at athletes’ brains if they are injured.”

Dr. Willard Chung was Dignity’s host for Saturday’s symposium. Chung is the program director for Dignity’s Family Medicine Residency Program.

“We began the day with a program for local physicians before this second symposium for the general public,” said Chung. “The program with the six schools that we began in August, works with athletic trainers, doctors and the schools to help get athletes back to playing again — safely.

“Early identification is extremely important to help us find early signs and symptoms, especially in young athletes. You can have dramatically more adverse effects in children than in young adults especially with repeated concussive injuries.”

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“There are signs and there are symptoms. Signs are what you see on the outside — being woozy, unsteady, slurring speech, mood changes and depression,” said Nowinski. “Symptoms you can’t see, things like headaches, nausea, trouble with light or noise — just not feeling right.”

Prevention is a key element of the program.

The question — how do you prevent concussive injuries in the first place?

“You look at football,” said Chung. “Wearing a helmet is not preventing injuries. It’s the impact the brain receives inside the helmet that creates the problem.”

“If you’ve ever seen a youth football game, you see kids as young as eight-years-old making and receiving hard hits to the head,” said Nowinski. “In baseball, they have pitch counts to make sure young pitchers don’t throw out their arms. But in football, they don’t have hit counts. The brain can’t take too many hard hits for too long. In California, you now have Safer Soccer where no headers are allowed before age 11. Now we’re focused on football. One change will help – don’t let kids play tackle football until high school.”

Nowinski and Dr. Cantu were among the first to see the link between concussions and chronic traumatic encephalopathy (CTE), the brain disease thought to be brought on by repeated hits to the head.

“Boston University has the longest standing and leading CTE center in the world. In 2006, Dr. Cantu identified their first two cases of CTE and nobody was talking about it,” said Nowinski.

Nowinski later showed his audience an interview from 2006 with an NFL representative who flat out said CTE didn’t exist and brain injuries weren’t a problem.

At present, CTE can only be identified by studying the brain after a person has died.

Of the brains of former NFL players, 99 percent – 110 out of 111 – suffered from CTE. The Foundation also studied brains from college and high school players and discovered 91 percent of deceased college and 21 percent of deceased high school players had CTE.

 “You can’t teach everything you know in an hour. I want people to walk away from here today with respect and understanding of concussive brain injuries and CTE,” said Nowinski. ““We don’t want you to be hit in the head but if you are hit in the head — do something.”

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