The doctor is in ... the New York football semifinals

Caledonia-Mumford coach who testified in front of Congress on concussions is two wins from a state football title.

Wednesday, November 17, 2010 By: John Schiano | MaxPreps.com

CALEDONIA, N.Y. It's not part of the official job description, but you don't get hired as the varsity football coach at Caledonia-Mumford (N.Y.) without being a tough kind of guy.

The high school is the most notable building in this semi-rural town a short ride outside Rochester where the locals love their football games on Friday nights.

And they expect victories. Lots of them.

Going 9-1 with the loss coming in the Section V championship game to put an end to the season elicits questions along the lines of "Where'd we go so wrong this fall?"

It's good then that Mike Monacelli replaced the legendary Bill McAlee (117-14-3 in 15 seasons) in 1988 and scarcely skipped a beat, going 185-49, despite a 2-6 rookie season, entering this weekend's New York State Public High School Athletic Association semifinals.

The hairline is receding a bit and the beard turned salt-and-pepper too many seasons ago, but Monacelli remains an imposing figure around town. His reputation as well as respect for his work, however, have spread far beyond the Livingston and Monroe counties border for reasons that go well beyond football.

At a time when management of concussions and head-injury cases has become one of the hottest topics in professional and amateur sports, Monacelli is a guy that very important people turn to for guidance.

 

"People say, 'Hey, we've got more concussions than ever,'" Monacelli said. "I say that's good in a way because that means we're getting more kids diagnosed correctly. I had three during the season, up to three or four weeks. You don't mess with that. These kids have lives after football."

James Schmutz, executive director of the American Sports Education Program, calls the coach a model to follow, and Monacelli was summoned in May to testify in Washington, D.C., before the House Education and Labor Committee studying sports-related concussions among high school students.

Even for a take-charge guy like Monacelli, the visit to Rayburn House Office Building on Capitol Hill was more than a little intimidating, though he jokes the experience was made easier by being one of the fortunate few people to sit in a witness chair there without having first been indicted.

There was a lot more to it than what goes into scripting out the three weeks of summer practice leading up to one of Cal-Mum's annual preseason scrimmages.

"The paperwork was easy," Monacelli said. "I was more worried about the question and answer part. They had a vested interest, and when they asked a question they knew what the answer was and now they wanted to hear the coach's answer. They either played or their kids played, so they knew the topic. It was impressive and scary. I knew I was on the line to back up my paperwork with the right answers."

Monacelli aced the exam as impressively as his Red Raiders winners of 14 Section V trophies and four state championships have sailed through the postseason to earn a berth against Walton of Section IV on Friday in the NYSPHSAA Class D semifinals in Rochester.

He spoke authoritatively on how coaches and school administrators have become increasingly enlightened and cautious in recent years with respect to concussions. After testimony ended on that spring day, high ranking committee members came down to the well of the hearing room to thank Monacelli and discuss some points at greater length.

"Their aides said they never do that," Monacelli said. "They usually bang the gavel and they're out the door."

Hit-and-run treatment of concussions is no longer the norm. The subject took another step up in visibility this month when the 22,500-member American Academy of Neurology called on schools to bench athletes suspected of suffering concussions until they are checked by physicians trained in diagnosing such injuries. The AAN also recommended that certified athletic trainers staff all sports events, including practices.

The Centers for Disease Control and Prevention reported there are 3 million sports-related concussions a year in the United States, making the category second only to auto accidents as a cause of traumatic brain injury in the 15-to-24 age group. Concussions are most frequent in high school football, though experts say such injuries can be particularly harmful to girls and to younger athletes.

Under current regulations, New York scholastic athletes showing signs of concussion can return to play only after clearance by district medical personnel, though that is sometimes a rubber-stamp approval of the recommendation of the player's personal physician. There is currently no provision for mandatory input by a neurologist or other brain-injury specialist.

Still, erring on the side of caution has begun to prevail. Avon two-way standout Rich Welch pulled himself out of the sectional semifinals and then was not cleared to return for the title game against Cal-Mum. What was expected to be a much closer game turned into a 54-14 romp for Cal-Mum.

And Baldwinsville lost two-way starter Tyler Rouse, one of the top sophomores in the state, to a concussion in the sectional semifinals. He missed all of a close victory over Syracuse CBA in the Section III final before being OK'd to resume action last weekend in the state Class AA quarterfinals against Corning.

Still, self-policing may not be enough.

In Washington, Congress is considering national guidelines that would set standards for when to allow young athletes back onto the field following a concussion.

In New York, Assemblyman Ken Zebrowski announced last week that he will introduce legislation requiring high school athletes in contact sports to undergo neurocognitive assessment testing that can help track the progress of recovery after a concussion. Coaches in contact sports would also have to undergo training that includes identifying a head injury and post-injury protocol.

"This legislation is about ensuring we have the tools necessary to protect our kids from long term health consequences," Zebrowski said.

Monacelli, who is also the athletic director in his school district, became an early supporter of arguably the most prominent concussion assessment program available and got enthusiastic support from his superiors. At Cal-Mum, all sixth-, eighth- and 10th-grade students have been given baseline examinations through ImPACT, developed at the University of Pittsburgh Medical Center, since 2006 so that medical experts can compare pre- and post-concussion medical data while evaluating the student's recovery.

"If that child does get hurt, we can take that paper to the pediatrician or the primary care physician and they have a better way to diagnose," Monacelli said. "Maybe there is nothing wrong here. But maybe there is."

Having one more resource to rely upon makes Monacelli more confident that the well-being of the student-athletes is always the No. 1 consideration.

"For me personally as a coach, it has taken the guesswork out of determining when a player is ready to return to action after a concussion," he said. "In the past, the return to play was based more on feel than facts 'How many fingers am I holding up here (or) what's your girlfriend's name?'"

John Schiano, who has written about high school sports in western and central New York for more than 25 years, covers New York for MaxPreps. He may be reached at johnschianosports@gmail.com.