I have been asked by many people what my thoughts are on the first law suit filed against a state high school association in regards to concussion. With this coming in my “home” state of Illinois, people figured I would have a strong statement or unique perspective. I have struggled with coming up with exactly what I wanted to say and could not figure out why. This is in my wheelhouse, commentary on recent and public events; one would think it would have been natural.
Then, I figured out why I couldn’t come up with something… BECAUSE I ALREADY DID, 29 MONTHS AGO!!!
Almost like I could see into the future. Below is what I wrote here and sent off to the Illinois High School Association in May of 2012. Looking back on it I still feel strongly in the proposals and the rationale. Take a quick look for yourself:
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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 – faxDear 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 understandthat 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
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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.
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2012-2013 – Proposal (Boys Football)
Amend/Add By-Law
Submitted by: Dustin Fink, MS, ATC – Athletic Trainer
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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
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2012-2013 – Proposal (Boys Football)
Amend/Add By-Law
Submitted by: Dustin Fink, MS, ATC – Athletic Trainer
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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.
The Concussion Blog 
Dustin Fink hits all the correct notes and the most important take away is “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.”
Instead of pointing fingers and assigning blame by filing lawsuits – which, by their very nature, are adversarial and lead to conflict – we need to involve all those with a stake in making sports safer, from parents and athletes to coaches and athletic trainers to administrators, from equipment manufacturers to school boards, municipal and town recreation departments, in a collaborative, cooperative effort to create meaningful change.
Those of us with a significant body of solution based works, who spend our days protecting sports active children by educating, need to make sure that those who spend hours digging up dirt and filing legal complaints are called out as reactive individuals who are seeking to make financial gains by highlighting and jumping on the problems instead of actually providing important solutions.
I thought it was absolute genius to use litigation and insurance to improve child rights in sport. I used Justice Ruth Bader Ginsberg book as inspiration. http://www.goodreads.com/book/show/275291.Raising_the_Bar
Also the Women’s Law Center, Public Justice & Women’s Sport Foundation have used Title IX litigation to further women’s rights in sport.
Perhaps you were not aware of that American business is ran by litigation and insurance. We didn’t make the system or it’s hierarchy but we owed it to those we work for to utilize most effective means necessary.
I will never apologize for orchestrating attorneys to defend children who have been abused, neglected and exploited in sport. It’s my life’s work to ‘even the playing field’ in youth sports where kids have as great a litigation team as the NFL, NCAA or any sporting good manufacturers who’s vehicle to make profit are kids.
Please tell everyone what I did and that you don’t agree. Helps me get the word out.
Improving Concussion Safety In Youth Sports: Why I Opt For Grass Roots Activism Over Class Action Lawsuits | My new Blog with a special Thank you to Mr. Fink for allowing this comment in a link.
http://www.momsteam.com/blog/brooke-de-lench/improving-concussion-safety-in-youth-sports-why-opt-grass-roots-activism-over-class-action-lawsuits
Ms. Archie,
Appreciated your logical, thoughtful and reflective perspective shared within this blog.
Another thought provoking blog by Mr. Fink with an equally thought provoking call to action reply by Ms de Lench. In fact this conversation reminds me the old commercial for Fram oil filter’s; a mechanic is seen wiping his hands on a rag, standing in front of a car with the engine disassembled, in a state of major repair. The mechanic intones dramatically, “You can pay me now or pay me later.” His meaning is clear: Changing the oil and the filter on a regular basis is a necessity that can’t be ducked. You can pay a modest fee every 3,000 miles to replace oil and filters (pay me now) or you can pay a much larger fee when the engine has to be rebuilt (pay me later).
So, as a nation, (and I speak as a medical doctor with a specialty in sports med), do we allow ongoing complaints to be filed, do we applaud and support Ms de Lench and her noble and obviously brilliant organization of experts in their fields, to educate and safeguard our sporting children to keep them out of the emergency departments (or worse yet the morgues) or do “pay later” and settle on letting so called attorneys and “injury experts” troll twitter and the media only to develop said complaints that encourage others to swoop in and profit from tragedy and our apathy (for enforcing standards proactively)?
Keep in mind that each time a grieving family wins an award in court it is usually a case that is settled for millions. The pie is carved up. The educated legal team takes the lions share, the so called “experts” or “rain makers” (in the past mostly without medical training or even athletic training) take their share and little is left for families. Now, of late, thankfully the courts are demanding that these “experts” have proper credentials otherwise mistrials are being called more oft than not.
Yes, occasionally we see change in the laws – after the fact- but we rarely see these law firms and rain makers and “injury experts’ hand over the cash to fund ATs from their “pro bono” work.
The answer is easy and we all should be repulsed at those whose financial existence relies on financial gains once a child is injured or dies. Let’s do the right thing and pay for ATs and education and reputable information beforehand to eliminate this folly.
sorry for the late approval on this, it slipped my detection… However, thank you for a wonderful comment!