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Trainers and emergency crews tend to a Belen player who recived a concussion during a football game in Aztec.
Balancing the play-through-pain philosophies that many football coaches and players still embody with current information about the long-term effects of concussions is a tough seesaw to straighten out.

While most coaches agree a concussion is a serious injury, recovering from one is on a case-by-case basis. Most high school students who receive a concussion are asymptomatic within one week, and 27 percent of concussions are resolved within 24 hours. But it takes more than a month to recover from 2 percent of concussions, according to a recent study by researchers at the Sports Concussion Clinic at Children's Hospital in Boston and the Center for Injury Research.

New Mexico and San Juan County schools have taken steps to decrease the risk of second-impact syndrome, which is when a person suffers a concussion before a previous head injury has healed. And area coaches and doctors have their own ideas for future steps that could keep players safer.

Giving athletes a computerized neuropsychological assessment before a season begins is one useful tool for determining how severe a concussion was and if a player is ready to go, said Dr. Jason Lucas, a physician at Orthopedic Associates who works with high school football teams.

Farmington, Piedra Vista, Navajo Prep, Aztec and Shiprock use an advanced computerized neuropsychological assessment program called imPACT testing. It's the same test every NFL player takes before a season begins.

All athletes, from football players to cross country runners, answer a series of questions before the season starts. After they suffer a head injury, they take the same test and the results are compared to the baseline test to see if their memory, recall or cognitive ability have changed.

Orthopedic Associates funds the imPACT software at Piedra Vista, Farmington and Aztec. Kirtland Central and Bloomfield do not have the software because the schools don't have a full-time athletic trainer to oversee the program, Lucas said.

High school athletes assessed with a computerized neuropsychological exam before and after a concussion are less likely to return to the playing field one week after receiving a concussion, according to the concussion study.

"Bloomfield is an area we are trying to grow and develop so that they have an athletic trainer to help provide services to the athletes," Lucas said.

Mike Archibeque, the quarterback for Bloomfield, spent the season scrambling from defenders. In a game against Grants this year he was sidelined and physicians examined his eyes during the first half after several hard hits. He returned to the game in the third quarter only to be knocked unconscious.

He was later released from the hospital with a headache but no diagnosed head injury, his father said. He sat out for a few practices and returned to the field for the next game.

"He took some pretty good shots (in the next game), and it didn't affect him at all," said Mike Archibeque Sr. "But the kid's just tough."

Archibeque has developed a reputation as a fearless competitor the last few years. He received a concussion during warmups at a wrestling meet in Pagosa Springs, Colo., last winter and played through and won the tournament, his father said. But Archibeque's toughness doesn't quash all of his father's fears.

"Having boys and going through all the things we've gone through with broken arms and other injuries, of course I worry about it," Archibeque Sr. said. "If he wants to play, I watch him and ask him before the game how things are and how his head is. But he's never, after all these injuries, never complained of any dizziness, any loss of thought, any problems in his class. I feel the injuries that he's had weren't as serious as they could have been.

"But I really don't know how concussions (affect a person) two years from now," Archibeque Sr. said.

Having a baseline test would have clarified if Archibeque healed quickly or if he put himself at risk by suiting up before completely healing. Archibeque said he nursed a headache and had some trouble focusing the first few days back to school after the concussion but felt fine when he played in the game.

"Everyone was worried about me ... The coaches kept asking me are you OK, are you OK?'" he said. My head "hurt for a couple days after, then it started going back to normal."

New Mexico has one of the strictest laws in the country for monitoring student athletes with head injuries. The law requires any player with a "suspected head injury" sit out until they have no symptoms and then follow a gradual return-to-play protocol that takes seven days to complete and is overseen by an athletic trainer or physician. The law also requires coaches to be educated on the symptoms and dangers of concussions.

Phillip Satenga, the athletic director for Bloomfield, said the school cannot afford to hire an athletic trainer.

"When it comes to safety of students, I'm not going to say that anything is enough. We have done a good job, and do a good job, but there is always room for improvement," said Bloomfield Coach Bruce Hatch. "I'm not on the financial side of things so I'm not going to comment on if we should have one, but you can always do more."

Twelve high schools in New Mexico, including the five local schools, use the imPACT testing software. About 25 percent of high school football players nationwide take some type of computerized neurological test before the season, according the concussion study.

"It allows an evaluation to take place to see if they've come back to that baseline level where they should be," Lucas said. "It's a great step in the right direction."

Rick Ballard, the coach at Shiprock, said other key concussion factors not often discussed are conditioning and competition.

The Shiprock football team faced an epidemic of concussions when playing in class 4-A. The number of head injuries dwindled after dropping down to 3-A and concussions dropped from 27 in 2005 to zero in 2010. A level playing field, a strength training program and properly fitted equipment were the reasons for the decline, Ballard said

The New Mexico Athletic Association uses student enrollment to assign a high school to a class. Ballard suggested determining high school classes based on the number of students who go out for football.

"Being stuck in District 1, 4-A football, there was no way those (Shiprock) coaches could be successful; there was no way they could not have concussions," Ballard said. "Now the kids know it's going to be a level playing field."

Ryan Boetel: rboetel@daily-times.com