Posted: January 31, 2015 Filed under: Concussions, Player Safety, Youth Sports | Tags: Concussions, player safety, Safety Tag, Youth Sports
As many as 3.8 million concussions are reported every year.
Most people think of male athletes when they think of concussions – but new research is showing young women may be more likely to suffer this injury.
Claire Stieg has a passion for horses. She’s been riding since she was a little girl.
But at age 14, Stieg’s favorite sport turned dangerous. While playing polo, she was thrown from her horse.
“I hit the ground so hard that I blacked out and had a seizure,” she said.
Stieg suffered a concussion, and she isn’t alone. Recent research shows female athletes get just as many – if not more – concussions as males.
“Typically, concussions occur around some event when you receive a blow to the head,” said Philip Stieg, MD, chief of neurosurgery at New York Presbyterian/Weill Cornell Medical Center.
One study found high school girls who play soccer are 68 percent more likely to have a concussion than boys.
In sports played by both genders, girls are reporting nearly twice as many concussions – and studies have shown girls take longer to recover from concussion symptoms.
“They can have headaches; they can have sleep disorders, appetite disorders and cognitive disorders,” Dr. Stieg said.
Doctors are still trying to figure out why more females are being affected.
A reason may be that girls neck muscles are less developed making them more susceptible to head shaking and secondary concussion.
“Women are more likely to report they’ve had concussive injuries than men,” Dr. Stieg said.
Stieg suffered headaches and was extremely tired after her concussion. But after two weeks of rest, she felt better – and is now playing college polo!
“I wasn’t afraid to get back on the horse. I really wanted to get back on and ride,” Stieg said.
Dr. Stieg says most concussions resolve themselves within seven days but if you are still having symptoms like headaches or trouble sleeping, you should see a doctor immediately.
Source: “Concussions Affecting More Female Athletes than Male, Research Says.”ABC7 Chicago. N.p., 31 Jan. 2015. Web. 31 Jan. 2015.
Posted: January 30, 2015 Filed under: Concussions, Football, Player Safety, Youth Sports | Tags: Concussions, football, player safety, Safety Tag, Youth Sports
By DANTE CHINNI
Opinion polls and football-participation data show huge splits in the country about who want their children to play, as well as big differences by state in how many kids take the field under the Friday night lights. In large part, these differences follow familiar geographic and political splits, with conservative parts of the country tending to embrace football playing, and more liberal parts souring on it.
For instance, the latest Wall Street Journal/NBC News poll found that urbanites, those in the Northeast and West and Democrats were among the most likely to say they would encourage their children to play a sport besides football due to concerns about concussions. Conversely, those who live in rural areas, the south and self-identified Republicans were the least likely to say they would discourage their children from playing football.
The gaps between some of those groups are remarkable. The split between Democrats and Republicans is 17 points, between those who live in urban and rural locations it’s 12 points.
And when you look at where high school students play football, you can see how some of those different attitudes translate to the field. We took the number of high school students who play football in every state, according to the National Federation of State High School Associations, and compared it with
the 15- to 19-year-old population in every state.
By that measure, eight of the top 10 states for football participation voted for RepublicanMitt Romney in 2012 (Mississippi, Texas, Nebraska, Wyoming, Alabama, Kansas, Montana and North Dakota). Only two, Iowa and Wisconsin, voted for Barack Obama.
On the other end, nine of the 10 lowest participation jurisdictions voted for Mr. Obama in 2012 (New York, Vermont, Pennsylvania, D.C., Florida, Maryland, Nevada, California and New Hampshire). Out of the bottom 10, only Alaska voted for Mr. Romney.
There are obviously factors beyond politics influencing these numbers. In the top-20 states for high-school football participation, there were five states that voted for Mr. Obama in 2012 – Iowa and Wisconsin, along with Minnesota, Michigan and Ohio. They are all Midwestern states with big state universities that play in the Big 10 athletic conference.
Still, the correlation between politics and play is still striking. And states’ views of football may continue to diverge, based on recent trends.
Many of the states with low participation rates have seen declines in the number of students playing football in the last few years, as concussions have become a bigger issue in the public discourse. New York’s numbers went from about 38,300 in 2007 to about 35,500 in 2013. California’s went from 108,100 to about 103,400 in that time. Maryland’s went from about 15,500 to about 14,300.
Meanwhile, some of those with higher levels of participation didn’t see a drop off and even saw more kids take to the gridiron. Texas went from 161,500 in 2007 to 165,500 in 2013. Alabama went from 22,000 in 2007 to 22,800 in 2013. Mississippi held steady at 22,300.
Source: Chinni, Dante. “Where Americans Play Football — And Where They Don’t.”Washington Wire RSS. N.p., 30 Jan. 2015. Web. 30 Jan. 2015.
Posted: January 30, 2015 Filed under: Concussions, Player Safety, Youth Sports | Tags: Concussions, player safety, Player Safety File, Safety Tag, youth football, Youth Sports
By REID EPSTEIN
Ahead of Sunday’s Super Bowl, more than a third of Americans believe the danger from concussions makes football too hazardous for their kids to play.
The latest Wall Street Journal/NBC News poll found that 37% of Americans would encourage their children not to play football, about in line with the 40% who said the same thing in a similar survey before last year’s Super Bowl.
The National Football League has wrestled with questions about player safety in recent years and has changed rules to reduce the number of head-on-head collisions during games. Some research has shown a link between concussions and a degenerative brain disease.
In 2013 the NFL and retired players reached a $765 million settlement to cover claims that the league concealed long-term health dangers to playing football, though a federal judge later found the total was not sufficient.
Democrats more than Republicans say they would encourage their children to play a sport other than football due to concerns about concussions. Some 47% of Democrats said they would oppose the choice of football, compared to 30% of Republicans.
But the starkest difference comes when the responses are broken down by education.
Half of those surveyed who have post-graduate degrees said they would encourage their children to play a sport other than football, down from 57% in January 2014. Among people who didn’t graduate from college, 31% said they would be opposed to their kids donning helmets and pads.
The poll was conducted from Jan. 14-17 and has a margin of error of plus or minus 3.46 percentage points.
Source: Epstein, Reid J. “Poll: 37% of Americans Would Discourage Kids From Playing Football.” Washington Wire RSS. N.p., 30 Jan. 2015. Web. 30 Jan. 2015.
Posted: January 29, 2015 Filed under: Emergency Action Plan, Football, Player Safety | Tags: emergency action plan, player safety, Safety Tag, Youth Sports
By TOM FARREY
Former NFL players who played tackle football as young children were more likely to have thinking and memory problems as adults, a Boston University study published Wednesday in a medical journal found.
Researchers tested 42 retired players between the ages of 40 and 69 and found that those who started playing football prior to age 12 performed “significantly worse” on three measures: estimated verbal IQ; executive function, which includes reasoning and planning; and memory impairment. The study is published in Neurology, the medical journal of the American Academy of Neurology.
Getty ImagesResearchers tested 42 retired players between the ages of 40 and 69 and found that those who started playing football prior to age 12 performed “significantly worse” on three cognitive measures.
“They were worse on all the tests we looked at,” said Dr. Robert Stern, lead author and a professor of neurology and neurosurgery. “They had problems learning and remembering lists of words. They had problems with being flexible in their decision-making and problem-solving.”
The authors concluded that incurring repeated head impacts in football between the ages of 10 and 12, a critical and sensitive window for brain development, may increase the risk of later-life cognitive impairment. During those early years, the brain is rapidly building connections between neurons.
“We have findings from former NFL players, so it can’t be generalizable to the rest of the football-playing public,” Stern said. “But it does suggest something that I think makes logical sense. The logic is you shouldn’t hurt your brain over and over and over again as a child.”
The top medical official for Pop Warner, the nation’s largest and oldest youth football organization, dismissed the study as “flawed.” Dr. Julian Bailes, chairman of its medical advisory committee and co-director of the Northshore Neurological Institute in Evanston, Illinois, told “Outside the Lines” that the sample is too small to draw any conclusions from, and that the results of NFL players cannot be compared to that of athletes who never made it to that level.
“There’s absolutely no information on the number of concussions that the [study subjects] had in high school or college, or the severity of the concussions,” he said. “I think what probably happened is lots of them get no concussions in youth, but three in high school, five in college and 10 in the NFL. They’re trying to say it’s the age of first exposure that is the problem, when it’s more likely cumulative exposure.” Stern said the study was designed to control for that factor. The subjects were split up in a manner so that each group played a similar number of years in tackle football, with a similar number of concussions. The players who started the game later lasted slightly longer in the NFL, 8.67 years compared with 7.02 years.
He also called for additional studies with larger sample sizes.
A spokesman from the NFL could not be reached for immediate comment.
The study, funded by the National Institutes of Health, comes as participation in youth football has been declining: From 2008 to 2013, the number of children ages 6 to 12 participating regularly in football fell 29 percent, to 1.3 million, according to the Sports & Fitness Industry Association, which commissions an annual household survey of sport participation rates. Baseball, basketball, soccer and other sports also experienced declines in that age group, though football’s drop was much steeper than most.
A few institutions are also responding to health and safety concerns: The New York City Council on Friday held a public hearing over a proposal to require doctors to be present at all youth games, and trainers or doctors at all full-contact practices. And the LA84 Foundation, which funds youth sports in California, in December 2013 added criteria to its grant application stating that it would no longer provide support to community sport organizations that offered tackle football before age 9.
Dr. Robert Cantu, a neurosurgeon and colleague of Stern’s at Boston University who did not work on the study, said that young brains are more vulnerable to hits because they lack the coating on the nerve fibers, called myelin, that provides strength and helps transmit information. In 2011, Cantu began advising families with children to avoid tackle football and stick with flag football if possible through age 14.
“Youngsters, especially between the ages of 10 and 12, are developing connectivity networks, especially between the temporal lobe where we house our memory and emotions, and the frontal lobes where our executive functions are, our insider judgment,” he said. “If there is an injury, these pathways are going to be altered, and it can have a significant effect on what the personality of the individual is going to be. He may not have been programmed genetically to wind up with problems with depression or cognitive issues, but that can be the net result.”
Stern and his co-authors cite studies showing that children ages 9 to 12 can incur an average of 240, and up to 585, head impacts per season. Bailes places that number at closer to 65, though he sets the threshold for a head hit at 30Gs, which he called a “significant” hit. His number also assumes the child is playing on a team that abides by Pop Warner rules passed in 2012 limiting full-contact drills to one-third of practice time and no head contact at all except during games.
An independent, Virginia Tech study placed the number at 158 head impacts, if a program abides Pop Warner’s rules.
“If it’s 60 to 100 low-level hits a year, I think that’s pretty safe,” Bailes said. “Kids are going to be banging their heads falling out of trees and off bikes, anyway. So I don’t see any real epidemic here.”
Bailes said the youth football experience of the players today differs from that of the NFL veterans who Boston University studied, players who came up during the 1960s through ’80s.
“They played and practiced under arcane protocols of recognizing and recording concussions, and under different coaching styles than we see today,” he said. “This is a study of the way it used to be. This is really a study of old-timers.”
Gerard Gioia, chief of the division of pediatric neuropsychology at Children’s National Medical Center in Washington, D.C., said the study underscores the need for a longitudinal study of youth athletes that captures events and changes over time. To date, NIH and other funding of brain injury research in sports has largely gone toward looking at adult athletes.
“The design of the study does not allow one to make any firm conclusions about the relationship between these variables,” said Gioia, a member of the medical advisory committee for USA Football, which is supported by the NFL. “Nevertheless, these results do suggest that we need further study of any such possible relationship.”
Stern said the study is “one piece of information” but valuable, given the lack of research on football-related head trauma in the pediatric population. It also is consistent with research demonstrating that children and adolescents are more susceptible to poor outcomes from concussions, and that reduced intelligence has been reported following concussions.
“More research has to be done,” he said. “The dilemma is whether we wait for more and more and more research before changing something, or do we try to alter decision-making based on a combination of logic and early research findings?”
Cantu, who is a senior medical adviser to the NFL, said that the new study’s findings buttress his recommendation about playing flag football instead of youth tackle football.
“To allow your child to be subjecting themselves to repetitive head injury at a very early age when they could be doing the sport a different way and minimizing their chances [of brain injury], to me, is just insane,” he said. “It’s wrong. We should not be allowing this to happen.
“Tom Brady didn’t play football until high school. He picked up the game pretty quickly.”
Source: Farrey, Tom. “Study Cites Youth Football For issues.” ESPN. ESPN Internet Ventures, 29 Jan. 2015. Web. 29 Jan. 2015.
Posted: January 29, 2015 Filed under: Concussions, Football, Player Safety, Youth Sports | Tags: Concussions, encephalopathy, NFL, player safety, Player Safety File, Safety Tag, TBI
By TRAVIS WALDRON
A study of former NFL players released Wednesday found that those who began playing football at younger ages showed more impaired long-term brain development than those who began later.
That could be a key finding for NFL players. But when it comes to young athletes and youth football, the biggest takeaway from the study appears to be that it is another reminder that more research is needed to assess the long-term impacts of playing football for youth athletes, the majority of whom never reach the NFL.
The study from the Boston University School of Medicine, published in the research journal Neurology and first reported by BuzzFeed, examined 42 former NFL players between the ages of 40 and 69 and found that those who began playing football before age 12 “demonstrated significantly greater impairment” than the players who did not start playing until after that age. The players who began before age 12, chosen as the age for the study because the years between ages 10 and 12 are considered an important stage of brain development, performed worse on three measures that were tested: verbal IQ, executive planning (reasoning), and memory recall.
The results suggest that suffering repeated head injuries “during critical periods of brain maturation could alter” the brain’s development and lead to “later-life cognitive impairments,” the study says.
The study, however, is limited in scope. Because it tested only former NFL players, its results cannot necessarily be applied to players who quit football before reaching the sport’s top level, and it is also uncertain whether the age of exposure to brain injuries is more important than the cumulative hits to the head players who eventually made it to the NFL suffered. The number of concussions participants suffered in their career, meanwhile, is estimated, and an accurate estimation is difficult for this age range, especially when attempting to account for those suffered at youth and high school levels.
Because of those limitations, the study says that it “does not allow for the determination of causality between early-life exposure” to repeated head trauma and “later-life impairments,” and its results cannot be applied generally to the football-playing public. Instead, it is relevant primarily to NFL players.
The limitations led another prominent concussion researcher to dismiss the study in comments to ESPN, while Dr. Robert Stern, who led the study for Boston U., told ESPN that despite the limitations the study “does suggest something that I think makes logical sense. The logic is you shouldn’t hurt your brain over and over and over again as a child.” Still, Stern, who did not immediately respond to interview requests, told the New York Times that the study isn’t definitive enough to be used to implement new rules changes at the youth level, and its abstract says merely that the study “may have implications for safety recommendations for youth sports.”
In that sense, while the study establishes a possible link between playing football at earlier ages and later cognitive problems in some NFL players, what it indicates for the broader football-playing public is how much more research is needed into how playing the sport — and suffering repeated head trauma — at young ages affects long-term cognitive abilities for those who stop long before they reach the game’s professional level.
The study itself says as much — it notes, “Future longitudinal studies beginning prior to the start of football participation in youth and using more comprehensive measures of intelligence are needed in order to determine the relationship between [repeated head injuries] in youth and intelligence.” — and in the interview with ESPN, Stern said that “more research needs to be done.” That has also been a key findingof other studies and compilations of studies into the impact of youth concussions, and President Obama has previously called for more research into the subject at a White House summit on youth concussions in sports.
That sort of research may be coming: the NFL, which reached a $765 million settlement with former players who alleged it covered up the effects of concussions, has agreed to fund research into the subject through partnerships with the National Institutes of Health (which funded this study), and other programs have been established to paint a clearer picture of how many concussions young athletes suffer and how that impacts their brains long-term.
This study may be a start, even if its limitations prevent it from being applied directly to younger athletes. But this is an important time for football. States and youth sports leagues are rushing to change rules and implement policies in an attempt to better recognize, treat, and manage concussions in young athletes. And with youth football participation rates dropping and concerns rising among parents about whether their children are safe playing the sport, the NFL is preaching safety directly to those parents to try to ease their fears. Amid all of that, it seems that for now the most important lesson of the Boston study is that we still need much more direct research to gain a clear picture of how hits to the head in football and other sports truly impact young athletes, and what we need to change to protect them and their futures.
Source: Waldron, Travis. “NFL Players Who Start Football Before Age 12 Have ‘Significantly Greater Impairment’ Of Brains.” ThinkProgress RSS. N.p., 29 Jan. 2015. Web. 29 Jan. 2015.
Posted: January 29, 2015 Filed under: Emergency Action Plan | Tags: emergency action plan, Player Safety File, safety plan, Safety Tag, school
Republican Senator Larry Tidemann is sponsoring the bill, which requires all schools to have a plan for any violent incidents that could happen such as a shooting.
The proposal also requires schools to conduct annual lockdown drills.
The 35 schools in the Sioux Falls School District already have a safety plan.
The district’s risk manager says they support the proposal and any changes made to current safety procedures.
Robert Bray, risk manager for the Sioux Falls School District said, “Having good, solid emergency action plans in place, training them, resourcing them and coordinating them with responders is really the key to preparedness and preventing loss of life.”
Bray says the legislature has been attempting a proposal like this for several years and he is happy that it’s finally being put into action.
Source: Blase, Cati. “Proposal Passes For Safety Plan In South Dakota Schools.”KDLT. N.p., 29 Jan. 2015. Web. 29 Jan. 2015.
Posted: January 29, 2015 Filed under: Concussions, Football, High School, Player Safety, Youth Sports | Tags: Concussions, emergency action plan, NFL, player safety, Player Safety File, Safety Tag, TBI, Youth Sports
By HOWARD FENDRICH and EDDIE PELLS
With a push from the NFL, all 50 states and the District of Columbia passed youth concussion laws over the span of about five years.
They were modeled after legislation passed in Washington state in 2009. But an Associated Press analysis shows just 21 of the laws that followed included all four key elements in Washington’s bill.
“Washington state is the ‘gold standard,'” said Peter Carfagna, the founder of a sports marketing company and a teacher at Harvard Law School. “I have a hard time thinking of a good reason why you’d deviate from it.”
Here’s an explanation of why those basic tenets are considered important:
IMMEDIATELY REMOVING ATHLETE SUSPECTED OF HAVING A CONCUSSION
This is the most rudimentary of the provisions, and yet it’s not mandated by two states, Illinois and Wyoming.
Immediately leaving a game or practice is important because a person is at increased risk for a second, more dangerous, concussion while the brain is still healing from one.
“One and you’re out. No same-day return,” said Richard Ellenbogen, co-chairman of the NFL’s head, neck and spine committee. “Anybody suspected — the key word is ‘suspected’ — of having a concussion, (is) pulled out.”
Arizona and South Carolina allow a player to return the same day if cleared by a doctor who’s present.
As news about head injuries connected to sports has spread, it’s become easier to drive home the importance of recognizing symptoms so a coach, for example, knows when to send a player to the sideline.
“Awareness has risen, and we’re evaluating more students for concussions than ever,” said Cynthia Clivio, a high school athletic trainer for the private Kamehameha Schools in Hawaii. “Part of it is, our coaches are more educated.”
New York’s law, for example, says schools’ coaches, gym teachers, nurses and athletic trainers must take a course that covers how to recognize, treat and monitor students’ concussions.
INFORMATION FORM SIGNED BY ATHLETE AND PARENT
Part of the process of increasing awareness is making athletes and parents aware of the dangers of concussions — and of the dangers of continuing to play or practice when suspected of getting a concussion.
Dr. Dawn Comstock, who is studying the laws’ effectiveness as part of a project funded by the Centers for Disease Control, called those forms “an important part of the overall education piece.”
WRITTEN CLEARANCE BY A HEALTH CARE PROVIDER WITH CONCUSSION TRAINING
The more specific this part of a law, the lower the chances an athlete will return to action before it’s safe.
This element of the laws was the least consistent. Only 30 states other than Washington contain both elements — that the clearance be in writing, and that it come from a health care provider with concussion training.
“That language was very carefully chosen,” said Jay Rodne, the Republican who sponsored the law in Washington state. “We wanted to make sure … a school district could not just have an uncertified or unlicensed athletic trainer who was given the title ‘athletic trainer’ but had no certification or no credentials to clear an athlete.”
Rodne, along with academics who tracked the laws, said advocacy groups for various types of health care providers tried to influence decisions on who would be allowed to clear athletes.
As for requiring something in writing, Harvard’s Carfagna said: “Without having something in writing to establish who gave the clearance, there’s a better chance it could be someone unqualified. There’s no fingerprint.”
EVEN LAWS THAT MEET ALL FOUR STANDARDS AREN’T AS STRONG AS THEY COULD BE
Rodne said enforcement mechanisms were too costly to get approved.
In Oklahoma last year, a bill that failed would have suspended athletic trainers, coaches or referees who allow an athlete with a concussion to return to action later that day.
Other attempted improvements were rejected, too. In Massachusetts, for example, baseline concussion testing for all high school athletes — to allow someone treating them to better gauge whether they have a head injury — was considered in 2013. In Maryland, a 2014 bill would have made players on one high school football team per county wear concussion impact sensors to track brain injuries.
“Our work is not done. It’s not even close to being done,” Ellenbogen said. “We’re changing the culture, but we’ve got to reach all Americans.”
Source: FENDRICH, HOWARD, and EDDIE PELLS. “Why What’s Missing in States’ Youth Concussion Laws Matters.” U-T San Diego. N.p., 29 Jan. 2015. Web. 29 Jan. 2015.
Posted: January 28, 2015 Filed under: Concussions, Football, Player Safety, Youth Sports | Tags: Concussions, NFL, player safety, Safety Tag, youth football, Youth Sports
BOSTON — NFL veterans who started playing tackle football before the age of 12 are more likely to have cognitive difficulties after their careers, according to a study published on Wednesday in the journal Neurology.
Researchers tested 42 former players on their short-term memory, mental flexibility and problem solving and found those who picked up the sport before they were 12 years old functioned about 20 percent worse. Both groups scored below average on many of the tests, according to Robert Stern of the Boston University School of Medicine.
“There is a known period of critical brain development that occurs around puberty. And if the brain is injured during that time, it may have both short-term and long-term consequences,” Stern told The Associated Press. “This study supports that idea that we need to protect the brains of our children while they’re going through this dramatic development period.”
The release of the study during Super Bowl week was a reminder for fans — especially those who are also parents — that the sport has bigger problems than deflated footballs.
For the study, NFL players were divided into two groups: those who played as young children, and those who did not. Those in the former group performed worse on the cognitive tests, such as being asked to recall words from a list they had learned 15 minutes earlier.
“The brain is the most critical organ in our body. It’s responsible for every aspect of thinking, feeling, moving, behaving; it’s responsible for who we are,” Stern said. “So the question is: Do we want to expose our children to anything that may have significant negative consequences for how that brain is going to work later in life?”
The difficulty faced by the former players, who reported an average of nearly 400 concussions each during their lifetimes, is separate from the problem of chronic traumatic encephalopathy, which can only be diagnosed after death.
Stern said the research does not lead to any simple solutions.
Among the limitations of the study, which he conducted with researcher Julie Stamm, were that it only looked at former NFL players; the conclusions cannot be generalized to a broader population. Youth sports also have many health benefits that need to be considered by policymakers, sports organizations and parents, Stern said.
It also looked back at people who played a long time ago; conditions could have gotten better as concussion education improved — or worse, because athletes are getting bigger and faster. “There is a need for so many follow-up studies,” Stern said.
“The issue for me is one of science being balanced with logic,” he said. “It does not make sense to me, as someone who studies the brain and as someone who has four kids, to foster repetitive hits to the kids’ brains at a young age. Does that really make logical sense? Do we want to do that to our children at that age whose brains are rapidly developing?”
Stern, whose research into CTE has helped lead to a greater understanding of the dangers of concussions, said he isn’t ready to write off the sport. Although he said he can no longer watch youth football, he is still a New England Patriots fan who is planning to attend the Super Bowl on Sunday.
“I’m not sure how to deal with this incongruity between what I know and what I like to watch,” he said. “I’m not saying we need to get rid of football. For me to be going to the Super Bowl this year, with the Patriots playing, I’m giddy with excitement. And that, along with watching the game on Sundays, makes for a huge amount of self-questioning.”
Source: “Brain Study Shows Ex-NFL Players Negatively Affected by Youth Football.”Oregon Live. N.p., 28 Jan. 2015. Web. 28 Jan. 2015.
Posted: January 28, 2015 Filed under: Concussions, Football, Lawsuit, Youth Sports | Tags: Concussions, player safety, pop warner, Safety Tag
PHOENIX — Criticized for its own handling of head injuries, the NFL launched an extensive lobbying campaign to pass laws protecting kids who get concussions while playing sports. The result: Within just five years, every state had a law on the books.
But are the laws strong enough?
An Associated Press analysis of the 51 youth concussion laws — one in each state and the District of Columbia — found that fewer than half contain all of the key principles in the initial bill passed in Washington state in 2009. That measure mandated education for coaches about concussion symptoms, removal from a game if a head injury is suspected, written clearance to return, and a concussion information form signed by parents and players.
About a third of the laws make no specific reference to which ages or grades are covered. Even fewer explicitly apply to both interscholastic sports and rec leagues such as Pop Warner or Little League. Certain laws make clear they cover public and private schools, others only refer to public schools, while some don’t say at all. Almost all lack consequences for schools or leagues that don’t comply.
“We did make compromises … in some states where we wanted to get something. A ‘B’-level law, as opposed to an ‘A’-level law,” said NFL Senior Vice President of Health and Safety Policy Jeff Miller, who testified about concussions before Arizona’s legislature on Tuesday while in town for the Super Bowl.
“Better to get something good, and get something in place,” Miller said, “as opposed to shoot for something fantastic in all places — and fail.”
The laws were passed with remarkable speed, and many were weakened because of concerns about cost. Jay Rodne, the Republican who sponsored Washington’s initial law, said putting expensive enforcement mechanisms in the bills would have caused many to fail.
Judy Pulice, in charge of state legislation for the National Athletic Trainers’ Association, helped guide the NFL as bills were written and was disappointed that the final products didn’t include penalties for noncompliance.
“What happens if you don’t pull the kid out of the game? What happens if you put them back in with no medical release?” Pulice said. “Nothing happens.”
The AP’s review of the laws passed after Washington found that only 21 have all four of the requirements in the model legislation.
All but two of the laws call for the immediate removal of an athlete from a game or practice if a concussion is suspected. All but four contain language about education for coaches.
Yet only 34 say that before returning to action, an athlete with a head injury must have written clearance from a licensed health care provider trained in the evaluation and management of concussions. Just 30 mandate that a concussion information form be signed both by the athlete and a parent or guardian.
“They don’t all have the (main) principles. Not every state has the same bite as Washington state,” said Dr. Richard Ellenbogen, chairman of neurological surgery at the University of Washington and co-chairman of the NFL head, neck and spine committee.
He treated Zackery Lystedt, the middle-school football player who nearly died after getting two concussions in a game. Washington’s law was named for the teen.
After that landmark bill was passed, Ellenbogen recalled, he had a conversation with NFL Commissioner Roger Goodell about efforts to replicate the legislation.
“The commissioner asked me, ‘What do (you) want to get out of this?’ I said, ‘I want to see, in my lifetime, 10 more states pass a Zack Lystedt law,’ ” Ellenbogen said. “And he said, ‘No. We’re going to get all 50 states. And we’re going get them in under five years.’ ”
Goodell pushed for the laws at a time his league was facing almost daily reminders of concerns about the link between football and head injuries.
Researchers studying brain tissue of deceased former players such as Junior Seau and Dave Duerson, who both committed suicide, found signs of a degenerative disease also found in boxers and often connected to repeated blows to the head. Thousands of ex-players sued the league, saying it didn’t do enough to inform them about, and protect them from, concussions. President Barack Obama suggested fans might have a guilty conscience while watching football.
Against that backdrop, Ellenbogen said, the NFL held weekly conference calls with state legislators, doctors and other advocates. Miller, who led the lobbying, estimated the effort cost hundreds of thousands of dollars.
Their success was swift. By comparison, it took more than twice as long to get mandatory seat belt laws passed in 49 states; New Hampshire still doesn’t have one for adults.
“We wouldn’t have had 50 states pass these laws,” Ellenbogen said, “if it wasn’t for the financial backing and political gravitas of the NFL.”
Goodell wrote 44 governors whose states had not enacted laws. He spoke about the topic at Harvard’s School of Public Health and in an address to the Congress of Neurological Surgeons.
And when, a few days before last year’s Super Bowl, Mississippi became the last state to finalize its law — albeit a measure missing elements — the league patted itself on the back, saying it had “actively advocated” for the regulations. In October, the NFL trumpeted that Goodell would accept the Brain Injury Alliance of Washington’s 2014 Leadership Award.
Now the question becomes how effective these laws might be in a country where, according to the Centers for Disease Control, nearly a quarter-million people under 19 were treated in emergency rooms for nonfatal, sports-related concussions in 2009.
For 10 years, Dr. Dawn Comstock has collected data from athletic trainers at hundreds of U.S. high schools, and she is comparing state-by-state concussion statistics from before and after each law was enacted to try to understand the practical effect the legislation is having.
“I’m sensitive to people getting a false sense of security,” said Comstock, of the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus. “It’s great what (state lawmakers) did. But has it made a difference for any player playing any sport?”
Larry Cooper, athletic trainer at a school for grades 7-12 outside of Pittsburgh, charts concussions reported in all sports. In the 2007-08 academic year, three years before Pennsylvania passed its law, there were 10 concussions reported at his school, he said. That rose to 15 in 2013-14, and 18 already in 2014-15.
“Parents and student-athletes are much more aware of signs and symptoms,” Cooper said.
He’s not the only one noticing. Despite the weaknesses in a majority of the laws, there does seem to be consensus that they have increased awareness.
The NFL’s Miller said they can always be amended.
“I say, ‘Let’s go back and make them better.’ That’s OK, too,” he said. “There’s only 10 laws that are etched in stone and those are the Ten Commandments. Everything else can be changed. Everything else can be improved.”
Source: “Youth Sports Concussion Laws Are Found Lacking in Enforcement, Consequences.” Oregon Live. N.p., 28 Jan. 2015. Web. 28 Jan. 2015.
Posted: January 28, 2015 Filed under: Concussions, Player Safety, Youth Sports | Tags: Concussions, player safety, Safety Tag, Youth Sports
By DEIRDRE BAKER
The Mayo Clinic threw its prestige behind a sidelines test for concussions in contact sports Tuesday, calling it the “gold standard” of such examinations.
Known as the King-Devick Concussion Screening Test, it initially was developed several years ago. But evidence of its benefits has been proven more recently in no less than 25 studies, it was reported at a news conference to announce the partnership.
The test objectively measures an athlete’s reaction time, eye movement and mental clarity.
“Studies have indicated that the King-Devick test is an effective tool for the real-time evaluation of concussion because it looks at rapid eye movement and attention, both of which are affected by concussions,” said Dr. David Dodick, a neurosurgeon and the director of the Mayo Clinic’s concussion program in Phoenix.
The recent studies have shown the examination is both quick and accurate, said Steve Devick, the test’s founder. It costs $5-$10 for each child in an athletic program. It is based on reading numerals and is used on traditional flip-charts, a tablet or a laptop computer. A smartphone app also can be utilized.
Parents as well as coaches and personnel like athletic trainers can administer the test, which can be used for all team sports with the aim of helping to determine whether an athlete really has to leave a game due to a concussion or not.
Deciding when an athlete should be removed from the field of play is a key to preventing more serious injury, and athletes routinely deny, or do not realize, that they have concussion symptoms. According to the Centers for Disease Control and Prevention, or CDC, an estimated 1.6 million to 3.8 million young athletes per year are concussed.
Dodick, the Mayo Clinic neurologist, expects the CDC estimates to grow since he said that up to 50 percent of athletes do not disclose their symptoms. The test has also been proven to detect unwitnessed, unreported and so-called “silent” concussions.
The King-Devick test is already used at the NCAA Division I college level, including the sports team at the universities of Miami and Florida.
In partnership with the Mayo Clinic, the test was introduced to the Pop Warner youth football leagues in Arizona and at 30 schools around Phoenix.
In 2011, the state legislatures in both Iowa and Illinois mandated that school districts become more proactive in terms of preventing brain injuries.
Quad-City area school athletic directors said they are protecting young athletes as much as they can with current programs, including Vital Signs, a service of Genesis Health System.
However, the various officials note that information about concussions is something that changes often, and they recognize that the new test may be helpful.
“It seems like this may be the next step,” said Kurt Kreiter, the athletic director and former football and wrestling coach at Central DeWitt (Iowa) High School.
Kreiter said there has been an emphasis on head injuries at all levels of competition, but the testing and care of the student-athletes is becoming more refined.
Central DeWitt currently uses the Vital Signs program, as does the North Scott School District in Eldridge and United Township High School in East Moline.
“We are learning as we go,” said Mike Tracey, the longtime athletic director at United Township. He termed the concept of the King-Devick test “intriguing” and said school officials likely would take a look at it.
“Anything to keep our kids safe,” he added.
Jason Schroeder, the athletic director at North Scott, agreed. “We look at anything that’s new and will use what we think is best for the kids,” he said.
The Geneseo (Ill.) School District also uses a proactive brain injury program, athletic director Travis Mackey said. That includes a battery of tests — some physical and some cognitive in nature — before a sports season begins.
Like other districts in the Quad-City region, Geneseo routinely uses an athletic trainer and has a physician on the sidelines who can do brain injury assessments. If there is a question, the athlete is kept out of the contest, Mackey said.
Source: Baker, Deirdre. “Mayo Clinic Adds Its Name to Sidelines Concussion Test.”The Quad-City Times. N.p., 28 Jan. 2015. Web. 28 Jan. 2015.