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. Rockets Jerseys China . Halifax beat the Saint John Sea Dogs 7-5 on the strength of two goals apiece from Nikolaj Ehlers, Matt Murphy and Brent Andrews. 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CHICAGO -- Jimmy Butler spun a basketball on his finger. He joked around with Cleveland Cavaliers guard Kyrie Irving during a brief 1-on-1 exchange. He smiled as some of the NBAs biggest stars lobbed some playful barbs in his direction.Back in Chicago on the eve of the Olympics, Butler is fitting in quite nicely with the U.S. national team.There are a lot of great players on this roster, but more than just basketball players, I get to learn a lot more about them off the court, Butler said, who they are as people and their families, and how they act, their personalities. I think thats been my favorite part of this whole journey, just getting to know the guys that I go up against every year.Its good practice for the fall, when Butler returns to a new-look Bulls team that suddenly includes a pair of longtime opponents for the versatile swingman.Derrick Rose is gone, traded to the New York Knicks. All-Star center Pau Gasol landed in San Antonio. But Dwyane Wade and Rajon Rondo decided to join Butler in Chicago, providing championship experience, but also two more players on the wrong side of 30 who like to have the ball in their hands.Im excited. I know they are as well, Butler said before Thursdays Team USA practice at the United Center. Its a new start for a lot of us.Butlers reputation also took a hit in the wake of Chicagos 42-40 finish in April, ending the franchises string of seven consecutive playoff appearances. The two-time All-Star was openly critical of new coach Fred Hoiberg and did not click with Rose last season.Asked about speculation he had a hand in Chicagos offseason activity, Butler brushed the notion away like he would an overzealous defender.That has nothing to do with me. I dont move guys, he said. Its like I always say, people are going to think what they want to think.That doesnt bother me, he continued. I know where I stand. I know who I am.Butlers inclusion on the national team establishes the 6-foot-7 Marquette product as one of the best players in the world, part of a steady rise for the No. 30 selection in thee 2011 draft.dddddddddddd On the 12-player roster for Team USA, only Draymond Green and DeAndre Jordan are lower draft picks.Butler, 26, averaged 20.9 points, 5.3 rebounds and 4.8 assists last season. He has increased his averages for scoring and assists in each of the last four years.I knew he was a workhorse, but that man really never stops working, Golden State guard Klay Thompson said, and I give Jimmy a lot of credit because he came into this league and obviously he didnt have the hype he (would) if he was like a top-five pick, but hes worked himself into an All-Star and one of the best wings in the game.Before this Olympic run, U.S. coach Mike Krzyzewski had only seen Butler on TV.The very first thing is just how strong and what a great athlete he is, Krzyzewski said. Then what a good guy he is, and then what an outstanding competitor. You felt he was going to check every box, but you put two checks in each of these boxes. Hes terrific, and hes a really good guy.Krzyzewski said Butler and Paul George are the most versatile players on the team, capable of guarding any position. Butler had four points and three rebounds while playing 14 1/2 minutes in the United States 107-57 exhibition victory over China on Tuesday night.Next up is a matchup with Venezuela on Friday night at Butlers home with the Bulls, and then a trip to Houston for one more game against Nigeria before departing for Brazil. When it comes to the Olympics, Butler said he just wants to win.Its a very familiar response for U.S. assistant Tom Thibodeau, who coached Butler with the Bulls before he was fired in May 2015.To see how much hes grown from his first year in the league to what hes become, its a testament to how hard hes worked, his intelligence, his drive, Thibodeau said. Each year hes gotten better, and I think his makeup will allow him to continue to improve each year.---Jay Cohen can be reached at http://www.twitter.com/jcohenap ' ' '