Open Letter and Proposals to IHSA about Concussions

15 May

I have been working on this letter for a little while but was really spurred to action by the parent in Maryland, Tom Hearn who discussed his concerns with the local school board.  I have tried and tried to use the “chain-of-command” with these thoughts and ideas, however at every step I got the feeling I would have to go alone on this, so I have.  This letter may or may not reflect the opinions of my employer, high school, athletic training sanctioning bodies, or others I am involved with.  This letter is from a concerned individual who feels I can spread the message effectively by these means.  I have emailed the letter, proposals and the Sports Legacy Institute Hit Count White Paper to all Executive Directors and Board of Directors of the Illinois High School Association.

OPEN LETTER

May 15, 2012

Illinois High School Association
c/o: Marty Hickman, Executive Director
2175 McGraw Drive
Bloomington, IL 61704-6011
(309) 663-7479 – fax

Dear IHSA – Executive Directors, Board of Directors and Sports Med Advisory Board:

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.

As a licensed and practicing Athletic Trainer, researcher, commenter, father, and survivor of too many concussions, I feel that in order to keep the sports we love, proactive steps must be taken.  Often being proactive is a painful process and easily dismissed because of the trouble it will cause.  I urge all involved to think about what the future of all sports will be if nothing is done.

The Illinois State Legislature with the IHSA took the initiative by creating a mechanism of concussion education and awareness in response to the mounting scientific evidence of potential long-term impairments resulting from mishandling of this injury.  However, this only represents a first step in the process; passing out a flyer or having parents and athletes initial that they have read the information is one small element of the issue.  Another crucial element of the issue is coaching. We must ensure that those we entrust with the care and leadership of our children understand that the first step in concussion management is removal of an injured athlete from play.   On May 13, 2012 Chris Nowinski, Director of the Sports Legacy Institute of Boston University, was the keynote speaker at the Illinois Athletic Directors conference in Peoria.  He asked a crowd of 200+ Athletic Directors (ADs) to raise their hand if they were using the Centers of Disease Control’s (CDC) “Heads-Up” program for coaches – a short video about concussions – to inform and educate their staffs.  I asked Nowinski how many AD’s put up their hand; “Zero, as in none, and it was shocking.” The program is free and is already widely used in Chicago by the Public League schools.  The notion that downstate schools’ are missing the point amplifies the need for concussion education.

Scientific evidence is showing growing concern over long-term issues related to multiple brain traumas.  Given the litigious nature of our society, it is only a matter of time before the sanctioning bodies of high school sports will be named as defendants regardless of their liability.  This would threaten the very existence of all sports played in our schools.

Recent evidence suggests that even the subconcussive hits – those that effectively “rattle” the brain but do not produce signs or symptoms – become problematic as the season wears on, let alone a career.  As the researchers in this field gain focus and more specific diagnostic tools, I feel we will see damning evidence that will put collision sports in jeopardy as they are currently constructed – the key being “as they are currently”.  There can be a change, both positive and proactive, that will signal to everyone that the IHSA is taking this matter seriously and can set a nationwide standard.

Attached are proposals the IHSA should consider in order to fully grasp the concussion issue as it relates to football.  Moreover, the IHSA should seek to adapt the proposals to apply to other sports including but not limited to soccer and lacrosse as they also have high incidences of concussions and sub-concussive injuries.

Thank you for your time.

Sincerely,

Dustin J. Fink, MS, ATC

PROPOSALS

2012-2013 – Proposal (Boys Football)

Amend/Add By-Law

Submitted by: Dustin Fink, MS, ATC – Athletic Trainer

———–

There shall not be more that two (2) full-padded and full-contact (any sort of collisions) days for any one player during the week from Sunday to Saturday.  This would include both practices AND games.

 

Rationale of Submitter

Subconcussive and cumulative hits represent a silent problem in all sports, particularly football.  It has been my observation and the observation of other professional health care providers that the majority of football concussions occur after the fourth week of regular season action.  It has also been an observation that the student-athletes who compete on multiple levels (JV/Varsity or Freshman/JV) represent a disproportionate number of concussions in football.

In both cases – time of season and multiple level of play – the issue could be attributed to excessive accumulation of hits.  This would be consistent and supported by the “Hit Count Initiative” by the Sports Legacy Institute of Boston University (see attached).

Reducing and limiting contact is also consistent with such entities as the NFL (only 14 full-padded and full-contact days allowed all season outside of games) and the Ivy League who limits contact days to twice a week as well.  This measure will decrease exposure to brain traumatic forces and cost nothing to implement.

This proposal would also include pre-season and two-a-days.

As for “policing” this by-law it will have to be self-monitored like a vast number of current by-laws in place.

==========

2012-2013 – Proposal (Boys Football)

Amend/Add By-Law

Submitted by: Dustin Fink, MS, ATC – Athletic Trainer

———–

There shall be at least 24 hours between full contact practices and/or games for each individual.

Rationale of Submitter

Allowing the brain to rest after exposing it to traumatic forces will only help with limiting the cumulative effects of brain trauma. (See previously submitted proposal for 2 contact days for further rationale)

Possible Problems:

-          JV game on Saturday where some varsity players may be needed

-          Using a player in a varsity contest who played on Thursday

-          Exposing a player to a full-contact practice on Wednesday then needing them in a contest on Thursday.

Regardless of the immediate concerns, this issue will take creative and new problem solving techniques.  I would suggest the following:

-          If you cannot have independent rosters for each level of football then perhaps there should be a contraction of teams

-          If you have enough but need them for practicing then I suggest a modified game/practice week (this will have to be adopted by conferences)

  • Sunday – Rest
  • Monday – Junior Varsity Contest
  • Tuesday – No hitting practice
  • Wednesday – Full contact practice
  • Thursday – No hitting practice
  • Friday – Freshman Contest prior to Varsity Contest
  • Saturday – Rest or no hitting practice or Freshman Contest

==========

2012-2013 – Proposal (Boys Football)

Amend/Add By-Law

Submitted by: Dustin Fink, MS, ATC – Athletic Trainer

———–

A certified Athletic Trainer or Physician (MD or DO) must be present for all contests.

Rationale of Submitter

They are the only allied health care providers allowed to assess and clear student-athletes for concussion in the state of Illinois.  It is only natural to have one on site for each contest.  Preferably one of the above health care providers should be on site for all full-contact practices or contests.

Cost is a barrier, understandable, however schools, districts and conferences must get creative to clear this hurdle.  This initiative should be paramount to keeping sports going.

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9 Responses to “Open Letter and Proposals to IHSA about Concussions”

  1. tapingthroughlife May 15, 2012 at 14:06 #

    It is great to see such initiative being taken by a fellow professional. I am an athletic trainer at Lindenwood University in St. Louis and although I do not deal with these problems at the high school level everyday I do provide outreach coverage to area high schools. In the short time I have been around the high school setting it is more and more apparent that there is a need for change. It is fellow professionals like yourself that make athletic trainers truely valuable. A true athletic trainer has emmense concern for athletes…all of the time. Keep up the great work and dont get discouraged. Together we can accomplish great things and save many lives in the process.

  2. tapingthroughlife May 15, 2012 at 14:11 #

    It is great to see that fellow professionals are taking such initiative on this subject matter. I am a athletic trainer at Lindenwood University in St. Louis, MO and although I mostly work at the college level I do occasionally provide outreach to area high schools. In the short time I have been exposed to the high school setting I have seen that there is a great need for change. It is professionals like yourself that are going to make the difference. In my opinion this shows just how valuable ATCs are. A good ATC cares about these athletes on and off the field, which is why we push so hard for these changes. Keep up the great work and dont get discouraged. Together we can make big changes, and in the process save lives.

  3. Michael Hopper May 15, 2012 at 14:56 #

    Dustin:

    I think you are on to something. Unfortunately I have a hard time seeing it happen. I will forward you some information tonight or tomorrow regarding some thoughts I have had with regards to athletic trainers and the IHSA.

    Katie: We will continue to fight. As you know, Athletic Trainers Save Lives. And like I like to say, Every Athlete Deserves an Athletic Trainer.We must continue to improve the healthcare available for the student-athletes at the youth, high school, and college level. It is time we put the excuses away and get it done.

  4. A Concerned Mom May 15, 2012 at 15:26 #

    Good for you Dustin. I hope you get a positive response. I would like to see schools and high school associations be proactive, because it’s the right thing to do for the kids. We are at the point where in addition to full disclosure to students and parents about the risks of brain trauma, all responsible adults involved with sports should be looking at ways to minimize injuries.

    This link isn’t related to your letter, but I can’t help but vent a little … some guy actually said that females are the weaker vessel in response to the concussion problems in girls soccer.

    http://www.fox59.com/news/wxin-soccer-concussions-concussions-among-girls-playing-soccer-rising-20120515,0,5022494.column

    “The head of Indiana soccer, Dave Guthrey is well aware of a new study released by the American Journal of Sports Medicine. It claims female soccer players are often suffering concussions and they take longer to recover than the boys and any adult player.

    “The female is the weaker vessel and you’ll see when she falls the neck not being as strong. She’ll hit and have that whiplash effect when her heads hits the ground,” said Guthrey.”

  5. Jason Viel May 15, 2012 at 15:40 #

    Dustin,

    I love it. I hope that it goes somewhere. I remember from my time in Illinois how similar the IHSA and state government are. In my opinion the NFHS needs to hear this as well. But if we as the first line of defense being AT’s start this grassroots effort we might be able to change the games in order to keep them around. Because I dont think that anyone really wants to get rid of football.

  6. A Concerned Mom May 15, 2012 at 17:32 #

    Food for thought for programs below high school level:

    http://www.leaderpost.com/sports/Flag+football+league+popularity+control/6614398/story.html

    “A small army of teens and pre-teens took to the sports fields at the University of Regina on Saturday as the popular NFL Youth flag football league hosted its opening weekend. Close to 1,200 kids are playing this year in the league, which has experienced considerable growth since it was introduced five years ago. Each year, the participation numbers in the league have multiplied.”

  7. A Concerned Mom May 19, 2012 at 11:57 #

    Did you see this article Dustin? I like the part where the coaches argue that the issue is being blown out of proportion and that concussions aren’t a serious problem at the high school level. (It’s so common for people not to understand that younger athletes can be more at risk of concussion, and that concussions can be more problematic for developing brains.)

    http://www.csnchicago.com/preps/news/High-school-coaches-are-aware-of-concuss?blockID=710186&feedID=629

    “Brucker, who has been coaching for 40 years, and the others don’t want to make light of a serious issue. They admit from time to time that they observe some coaches who teach defensive backs to dive at opponents’ legs, increasing the chance of a knee striking the helmet and causing serious head injury.

    But, to a man, they argue that the issue is blown out of proportion, that the media has chosen to sensationalize some stories, that it isn’t a serious problem at the high school level and that spearing or using the head as a weapon isn’t as much in vogue as it once was.

    “Some people are over-reacting,” Andriano said. “Look at all the kids who have played high school football. How many are injured?”

  8. A Concerned Mom May 20, 2012 at 14:09 #

    From Steelers and USA Football training camp for youth coaches – LIMIT FULL-CONTACT PRACTICES!!! Good call.

    http://www.post-gazette.com/stories/sports/steelers/concussions-at-head-of-youth-coaches-camp-636675/

    “Coaches also were urged to limit full-contact, padded practices.

    “One thing that we’re teaching throughout the country is that you don’t have to hit every day in practice,” Passino said. “It’s not 1950 anymore. Update the way you handle practice.

    “Maybe you only hit one day a week, you can still conduct form tackling without full-on collisions.”

    Much of the concussion discussion came in the wake of Junior Seau’s suicide and Kurt Warner’s statement that he does not want his children to play football.”

Trackbacks/Pingbacks

  1. Legislation Regarding Contact Practices in Football « Athletic Training and Fitness - February 11, 2013

    [...] The continued attack on football with regards to concussions is once again taking shape in our nation’s legislative bodies. In recent weeks, there have been a few states who have had bills introduced that would limit contact in football practices at the high school. Illinois and Texas are two states who have proposed such laws. Representative Eddie Lucio filed one such bill in the state of Texas last week. He believes high school and middle school teams should be limited to one contact practice per week. Citing what are known as “subconcussive impacts” Lucio believes this bill is needed to protect the student-athletes from the cumulative effects of such blows. While Texas has a concussion law on the books, he believes this bill would complement it by being a preventative measure that is currently lacking. In Illinois Carol Sente has introduced legislation that would also limit contact to one practice per week at the high school and middle school levels. But she isn’t sure that’s enough. She said she introduced the bill to stem conversation and she recognizes this probably is not the end-all solution. Sente has scheduled a community forum tonight, February 11, in her district to get input. The Ivy League and the National Football League have already implemented contact restrictions for its players. In the NFL, teams are limited to just 14 contact practices over the course of the season. Pop Warner football has also taken steps to limit contact in practices. Dustin Fink, an athletic trainer and blogger at The Concussion Blog, wrote a letter to the Illinois High School Association executive director Marty Hickman a year ago proposing similar action. Hickman’s response basically said that anything of the sort would have to come from the IHSA membership. And from what I’ve seen, such action has not surfaced since. You can read his open letter here. [...]

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