PHOENIX -- Despite all the rehabilitation, the headaches would not go away. The imbalance, while better, was still there. His speech improved, but vision and hearing issues persisted.Months after the blow that caused his concussion, Rudy Ayala still had significant symptoms.Though he loved playing football, the lingering problems, along with watching a friend suffer a similar injury, led Ayala to make a difficult decision: He walked away from football.I just realized the damage that can happen to your brain with a big blow like that and I didnt want it to happen again, Ayala said.The NFL and NCAA have taken steps toward preventing, identifying and treating concussions in recent years. The practices used on those levels have trickled down to high schools, where coaches are getting better concussion-recognition training, limitations have been put on head to head impacts and treatment protocols have been established.At the same time, concussions are still a substantial issue in high schools, in part because there are so many more players at that level than in the college and professional ranks combined.The National Federation of High School Associations has guidelines for concussions, including management of athletes who exhibit symptoms and an online concussion course developed with help from the Centers for Disease Control.But the reach only goes so far; there are just too many schools, too many players and too many variations from state to state and school district to school district to make sure concussions are being treated in a uniform manner.The fact that were talking about treatment of concussions is an advancement, said Dr. Javier Cardenas, a neurologist at the Barrow Neurological Institutes Concussion and Brain Injury Center. That said, theres clearly more left to be done.Inconsistencies in the availability of athletic trainers can make it difficult.Having coaches and parents with concussion awareness is a big step, but athletic trainers have a deeper, more clinical understanding of what to look for and what needs to be done after a head injury.Most big school districts can afford to have athletic trainers at every school. Smaller districts may have a trainer who serves multiple schools or none at all.Nationally, about 55 percent of schools have a full-time athletic trainer, according to the National Athletic Trainers Association. Arizona has one of the highest rates at 60 percent and California, in part because of licensing issues, is around 20 percent.If theres one thing that a school can do to improve the safety, it is to have an athletic trainer, Cardenas said. But thats not always possible.Games have a higher rate of concussions due to the increased intensity and larger impacts, with 1.86 per 1,000 athlete exposures, according to a Journal of the American Medical Association Pediatrics study. From an overall standpoint, more concussions occur in practice, a logical progression since there are far more practices than games.Ayala suffered his concussion while practicing the day before a game in August 2014.A defensive lineman on Tempe High Schools junior varsity team, he was injured while tackling a teammate during warmups and the coaches sent for the schools athletic trainer. When Ayala collapsed while trying to stand up, the trainer called paramedics and rushed him to the hospital.I saw him, he wasnt looking right, said Ayalas mother, Teresa. He was just acting weird and I said somethings not right with him. It was very scary.At the hospital, doctors ran a battery of tests and scans to make sure nothing catastrophic had occurred with the impact. The presentation of the concussion was typical, so doctors sent Ayala home.His odyssey was just beginning.Ayala suffered intense headaches, had problems with his hearing and vision, particularly in bright light. He also had trouble with his speech, issues with sleeping and struggled with his balance, often needing to catch himself on a wall after stumbling.Ayala was told not to use his cellphone, computer or to watch TV for more than three months. Accommodations were made for him at school, like closing the blinds in the classroom to block out light, moving him to the front of the classroom so he could keep focused on the lessons.Progress moved at a sloth-like pace, the symptoms lingering months after the initial impact.I felt like, `Am I going to get better? he said. I was really scared.The previous protocol for concussion treatment was rest and more rest. In recent years, doctors have taken a more proactive, multi-disciplinary approach.From a physical standpoint, doctors can prescribe headache medicines and help patients work on their balance. They offer speech therapy and will work with patients on regaining their hand-eye coordination.Doctors now also work on behavioral therapies, helping patients get past the irritability, anxiety and depression that can often come with a concussion. There are cognitive therapies as well, assisting patients with their short-term memory, focus and tasks like calculations or finding the right words when their minds struggle.Our recommendation is you can be active in your recovery aside from that initial period of two to four days, Cardenas said. We want them to get back to being active, healthy and normal, but still avoid injury.Ayalas case was atypical.Most teenagers will recover from a concussion in 14 to 21 days. Ayala continued to have symptoms nearly two years after his injury.Teresa said it took about a year of working with Cardenas before she saw my son come back. Even then, it wasnt until recently that Rudy was cleared to return to sports. He still occasionally suffers headaches.I would hate for anyone to have to go through anything like that, said Ayala, now a senior at Tempe. I know I wouldnt.Ayala is currently a member of Tempes cheer squad for football games and plans to go out for the baseball team next spring.His football career is over. Air Max 90 Nere Scontate . 1, meaning problems for the doping controls at both major international sports events next year. 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Price, heading to the 2014 Olympics for Canada, was named the First Star after posting wins in three starts with a 1.00 goals-against average and a .971 save percentage. Northamptonshire 319 for 7 (Rossington 87, Duckett 86) beat Worcestershire 296 (Kohler-Cadmore 119, Fell 54, Gleeson 4-47) by 23 runsScorecard Ben Duckett continued his prolific form as Northamptonshire reignited their Royal London Cup campaign with a 23-run victory against Worcestershire at New Road. An eye-catching knock of 86 from 75 balls took the 21-year-olds nine-day tally to 631 from seven innings for his county and England Lions but it was a close-run thing as Tom Kohler-Cadmores first List A century kept the home side in contention for their 320 target.It was not until the 45th over that left-arm spinner Graeme White landed the knockout blows in three balls. The dangerous Ross Whitley was caught on the long-on boundary for 22 and Kohler-Cadmore was effectively yorked for 119 after hitting 11 fours and a six from 126 balls.Duckett, fresh from his undefeated scores of 163 and 220 on international duty, returned to county action on Tuesday by making 46 in a defeat by Warwickshire at Edgbaston and then moved 35 miles down the road to lead Northants to an imposing 319 for 7.On a damp morning, skipper Alex Wakeley may have feared the worst on losing the toss for the seventh time in seven matches in the 50-over competition, but Duckett and Adam Rossington, who played equally well for 87, corrected an early wobble. Their partnership of 99 in 16 overs gave the innings shape and substance before the big hitters, Steven Crook (52 not out) and Rory Kleinveldt smashed 76 in nine overs.The late charge, which ended in the last over whenn Kleinveldt holed out to deep square leg after hitting two sixes and four fours, meant that for Worcestershire to win they would have to surpass their chasing record in List A cricket.ddddddddddddThey made a bold attempt. After a bright 43 by Daryl Mitchell, Kohler-Cadmore and Tom Fell broke the back of the target in a relatively trouble-free partnership of 125 in 18 overs. Northants were in need of inspiration when Richard Gleeson broke through by bowling Fell for 54, a well-crafted, unflustered innings with only four boundaries from 50 deliveries.Wickets then began to fall. White, who finished with 3 for 59, held a straightforward return catch from Alexei Kervezee and Brett DOlveira played on to Kleinveldt. Whiteley rattled the pavilion roof with one of his two sixes but momentum was lost with Whites double intervention and the challenge petered out with the last three wickets in five balls giving Gleeson 5 for 47, his best in professional cricket.The match began 10 minutes late because of rain and Northants lost a wicket in the Joe Leachs first over when Josh Cobb angled a catch to DOliveira at point. Rob Keogh and Wakely later went in quick succession and Worcestershire miss an opportunity when Jack Shantry was unable to hold a low, one-handed chance from Duckett. The batsman was then on 33 and the cost quickly multiplied until he finished with one six and 12 fours when mistiming a pull off Leach. ' ' '