The Concussion Blog

We have stated on here that legislation is only a small step in the way of stemming the concussion issue.  Awareness is the of the highest priority for the general public (and partly for the medical providers) and both Maryland and Indiana reported some good news today.

In Maryland the State Board of Education discussed the information that Parent Advocate Tom Hearn presented in May.  The Baltimore Sun has the report;

Thomas Hearn, a Montgomery County parent whose son received a concussion playing football at Walt Whitman High School, has testified before the state school board and Montgomery County school board, asking members to consider requiring parents to get more training in recognizing the signs of concussions and limiting the number of contact practices. He said the new state law doesn’t go far enough.

High school students can still have contact practices twice a day and five days a week, Hearn said. While there are no reliable statistics on how many of the 115,000 athletes in public schools in the state suffer concussions while playing sports, he suggested that if you extrapolate from the experience of Virginia school systems that have kept careful records, there may be as many as 6,000 a year in Maryland.

“Between now and the start of football season in August, you need to consider why you shouldn’t at least adopt the NFL and Ivy League limits for Maryland high school football,” Hearn said in his testimony before the board last month.

In 2011, the NFL limited practices with contact to about one a week. While the NCAA does not have the limits, the Ivy League adopted rules last July that permitted no more than two practices with contact a week.

The limits are intended to reduce the number of concussive hits players experience. Tackles or hits also can produce subconcussive injuries that do not have symptoms but over time have been shown to increase the risk of long-term health issues.

State school board members said they found Hearn’s testimony so compelling that they asked for a briefing on the subject.

Edward Sparks, who heads the Maryland Public Secondary Schools Athletic Association, said most teams only have contact practices about twice a week. He said questions have been raised about whether cutting back on contact can “lessen your skills, lessen your technique and increase your chances for other injuries. No one has answered it yet.”

Board members repeatedly asked Sparks whether anyone in Maryland is looking into prevention as opposed to actions that should be taken once a student suffers an injury.

“We keep using the word concussion, and what we are really talking about is traumatic brain injuries,” said Ivan C.A. Walks, a board member and medical doctor. Walks proposed the board form a committee to look at whether the school board should further regulate sports. Sports issues are usually controlled by the schools’ athletic association.

Prevention of the actual injury may be one of the most difficult things to do while playing sports.  One thing that can possibly lead to less injuries is less exposure; hence the suggestion for HS and younger sports to reduce full contact practices.  Another aspect in “prevention” of the injury is to enforce the rules about contact in all sports more vigorously – examples include: flagging more spearing in football, reducing rough play in soccer, and adopting technology for the head in girls lacrosse.  Moreover, putting an emphasis on neck strength for all participants in sports may lead to stemming the tide as well.  The most intriguing aspect of these ideas is that it costs $0 to implement.

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July 1st in Indiana is the date when concussion legislation goes into effect, their law similar to that of Illinois, from the Trib Star;

The law already requires coaches to be more vigilant, but the part of the law that goes into effect July 1 creates a kind of team approach that concussion-management experts say is needed in response to the numbers: At least 10 percent of student-athletes suffer concussions each year and too many return to play before they’re ready.

“The goal is to educate everyone — athletes, parents, and coaches — about how significant a concussion injury is and about how important it is that we don’t hide these, just so a kid can play,” said Dr. Daniel Kraft, director of Riley Hospital for Children Sports Medicine at Indiana University Health.[…]

Both Kraft and Booher think Indiana’s law should go farther, sweeping in all youth sports and doing more to educate teachers as well about how to accommodate students with concussion symptoms, which include memory impairment and inability to concentrate. The best concussion treatment is rest — both for the body and the brain.

“We need to help parents and teachers understand that kids who suffer concussions are just not themselves,” Kraft said. “It can take a long time for the brain to heal.”

Although it is too early to determine how notifying parents and athletes about concussion has helped in Illinois, one thing is certain they can no longer play the “I didn’t know/understand card”.  Both docs bring up a very salient point, the legislation in most states is rather partial when dealing with all competitors of sports.  Those laws mainly address high school sports and do little or nothing for a vast majority of participants; those in youth/club sports outside of the school system.  This is definitely a small step in the right direction.  Perhaps we can take more prudent steps forward in the near future (see contact limitations).