Playing it safe: R.I. youth coaches, parents making headway on concussions

Posted: September 29, 2014 | Author: admin | Filed under: Concussions, Youth Sports | Tags: Concussions, player safety, Safety Tag, Youth Sports | Leave a comment »

By PETER ELSWORTH

There has been a dramatic increase in awareness about concussions in youth athletics in recent years, driven in part by high-profile incidents among both professional and student athletes.

“[Concussion] is in the news all the time now,” said Neha Raukar, director of the Center for Sports Medicine at Rhode Island’s University Emergency Medicine Foundation. She cited this summer’s provisional settlement between the National Football League and former players who suffer long-term effects of the traumatic brain injuries.

That concern is being felt in youth sports as well.

“There’s more awareness,” Raukar said, crediting better training among coaches in recognizing the injury and learning to take the appropriate actions.

Raukar, a professor at the Warren Alpert School of Medicine at Brown University, helped write the Institute of Medicine’s 2013 report “Sports-Related Concussions in Youth: Improving the Science, Changing the Culture.” It cited football, ice hockey, lacrosse, wrestling and soccer as having the highest rates of concussions among male high school and collegiate athletes. Soccer, lacrosse, basketball and ice hockey were the leaders among female athletes.

According to Deborah Sharpe, executive director of the Rhode Island Brain Injury Association, among younger athletes, “With girls, [concussions are] more soccer related, with boys, more football related.”

“People were aware of it in general, [but] there’s more awareness today,” she said.

That’s due, in part, to training for coaches before youth athletes even take the field. Trying to determine whether an athlete has suffered a concussion can be difficult, especially on the sidelines of a game. Coaches are taught to recognize the warning signs, based on a player’s behavior and response to questions.

For the 2014 season, all coaches in the American Youth Football and Cheer league, which covers athletes ages 5-18, were required to complete the CDC’s Heads Up Online Training Course. The free training points out the warning signs of a concussion and details the process for returning to the sport after such an injury. Only a medical professional can diagnose a concussion, but the training gives coaches — and parents — a place to start.

Bryan Stetson, the president of the Cranston CLCF Football and Cheerleading organization, said a lot of new parents ask him about concussion. He said he has been coaching football since 2003 and, “Unfortunately, it happens. It’s a contact sport.”

But he said the aim was not only to try to prevent concussions, but to increase awareness of symptoms — among parents as well as coaches.

Players no longer “get up and shake it off,” he said. If a kid is dazed or on the ground and a doctor diagnoses concussion — every high school football game has to have medical personnel on the sidelines — “the kid is out of the game.”

Stetson said the player would probably not return for two or three weeks, and only with a doctor’s clearance. Even then, he said, training would ramp up. “You’re not going to throw him back into a game,” he said, adding that the coach makes sure the player can exercise without suffering a headache or other symptoms.

The guidelines extend to other sports, as well.

Regulations for the Jamestown Soccer Association say, “If the player is experiencing any pain, dizziness, or nausea, they should be removed from the field and not be considered for re-entry into the game.” The coaches are then required to contact the parents, who will decide whether to take the child to a doctor.

Paul van Leynseele, a soccer coach for a recreational team of 10- to 12-year-olds in Jamestown, said he was required to complete concussion training.

Awareness and willingness to act are two different things, he said.

“You can be aware of the issue, but what are you going to do about it?” he said. “You have to be prepared to lose a player, even a star. [You have to be] willing to take him or her out.”

Raukar said she has attended football games as a medical adviser and has been taken to task by parents for taking a child out of a game.

“I’ve been yelled at, [told] the kid needs to play,” she said, adding that while she may not be sure the player has been concussed, if there is a chance he or she will be hit again, she is unwilling to take the risk. “When in doubt, take them out.”

While soccer is not generally considered a contact sport, van Leynseele said, it does involve heading the ball, which is becoming increasingly controversial with young athletes, particularly girls.

“The literature is so divided whether heading causes head injuries,” said Raukar. At the same time, she said she was concerned about girls because they sustain concussions at lower forces. “Their biomechanical threshold is lower,” she said. “And when girls suffer concussions, it takes them longer to recover,” she added.

And people who have suffered one concussion are more prone to getting another, Sharpe said.

Chris Cowan, an assistant coach of the Jamestown Middle School soccer team, said the town’s soccer association emphasized the importance of recognizing head injuries. And he said the referees were trained not just to focus on the kids heading the ball but also on collisions and falls, which can also cause concussions.

Legislation has also focused attention on the issue. In 2009, Washington became the first state to enact a comprehensive youth sports concussion safety law, named in honor of Zackery Lystedt, a middle schooler who fell into a coma and was permanently disabled after being allowed back into a game minutes after suffering a concussion.

All states have since enacted some version of the law. In 2010, Rhode Island passed its own law, which advocates “immediate removal of [youth athletes] if concussion is suspected” and “return to play only after medical clearance.”

However, Raukar said the law only applied to public high schools, not middle, elementary or private schools and municipal sports programs, such as town soccer leagues.

And, in June, state lawmakers approved a measure that requires school nurses to take an online course in recognizing concussions.

According to the Rhode Island Department of Health, fewer than 10 concussions were reported in 2009; in 2013, that number shot to more than 300.

While there was an increase in Rhode Island after passage of the bill, the numbers have leveled off, according to George Finn, chairman of the Sports Medicine Advisory Committee for the Rhode Island Interscholastic League.

“The action taken now is a lot different than 10 years ago,” said Finn, who is also director of athletics at Barrington High School. “If you provide education, parents will understand.”

Said Raukar: “A lot more moms are educated, and they’re putting their feet down.”

For more information on brain injuries, go to biausa.org/ri/ or bit.ly/1uMPeur. For more on the Heads Up course, go to 1.usa.gov/1vlPykC.

What parents need to know

Learn to spot the concussion danger signs. According to the CDC’s Heads Up course, you should call 911 or take an athlete to the emergency room right away if he or she exhibits one or more of these conditions after a jolt to the head or body:

- One pupil is larger than the other.

- Drowsiness, or can’t be awakened.

- A headache that gets worse.

- Weakness, numbness or decreased coordination.

- Repeated vomiting or nausea.

- Slurred speech.

- Convulsions or seizures.

- Cannot recognize people or places.

- Increasing confusion, agitation or restlessness.

- Exhibits unusual behavior.

- Loses consciousness, even briefly.

Other symptoms can include:

- Sensitivity to light or noise.

- Concentration or memory problems.

- Double or blurry vision.

- Complaints of “just not feeling right.”

Source: Elsworth, Peter. “Playing It Safe: R.I. Youth Coaches, Parents Making Headway on Concussions.” Providence Journal. N.p., 29 Sept. 2014. Web. 29 Sept. 2014.

---