Concussion prevention for HS athletes is a slippery slope

The evolving effort of protecting high school athletes from the damaging effects of concussions is proving to be something of a moving target.

The state of Arizona is doing its part in the crusade to get a handle on the problem.  It’s the first state in the country to mandate testing for high school athletes through an online testing program designed to prevent second concussions since athletes who sustain one concussion are at greater risk for future injury.  (See 8/17/11 phxfan article: AIA mandates concussion testing)

There are 47 states that have enacted some kind of concussion laws to help protect youth participating in sports, but Arizona is the first to require testing.  The Arizona Interscholastic Association (AIA), the state’s high school sports governing body, partnered with the Barrow Neurological Institute at St. Josephs Hospital and the NFL Arizona Cardinals to create the program.

The Arizona law is also a step ahead of the other states because it says that an athlete diagnosed with a concussion cannot return to play without a written clearance from a health care provider.

Awareness of the problem of concussion-related injuries in sports was thrust into the spotlight and the public’s consciousness after the suicides of several former NFL players who had lived for years with the debilitating effects of brain trauma.

The high-profile cases drew attention to the long-term damage that comes with concussions, and re-ignited the need to address the problem beginning at the youth level.

Research shows that there are nearly 4 million sports-related concussions each year, from school and professional teams to recreational programs.  And studies also show that about nine percent of all high school athletic injuries are concussions.  It’s estimated that one in every 10 high school students that play sports this year will suffer a concussion.

And Arizona ranks second in the nation for the incidence of traumatic brain injuries.

So the time had definitely arrived for the development and implementation of the educational module called the Brainbook, which is the online test developed at Barrow that establishes a benchmark for normally-functioning brain activities that can later be used to test for a suspected concussion.  It has even been designed to resemble a social-media network to make it more user-friendly to young participants.

The AIA-initiated program has reportedly tested more than 150,000 high school athletes over the past two years.

But it’s becoming obvious that these prevention efforts can only be effective if the parents and players lend their support.

Now they’re finding that many of the high school players taking the tests have found a way to beat the system by purposely scoring low on the original testing so that follow-up tests after an injury will likely mask the severity of the concussion – and keep them in the game.   One study done in Alabama showed that ‘sandbagging’ was taking place in 23 percent of the cases with college athletes and about 16 percent at the high school level.

Another survey showed that, despite knowing the symptoms and dangers of a concussion, about half of the high school students surveyed said they wouldn’t report their symptoms to their coaches.

Whether it’s pride or the inability to look into the future to realize the far-reaching effects of brain injury, these young players want to stay in the game and not let on that they have a problem.

It didn’t help that one of the most-respected NFL players in the game, Payton Manning, admitted he intentionally failed a baseline test so that it would be easier to avoid being removed from the game the next time a concussion occurred.

And sometimes it’s the parents that are aiding and abetting their children, allowing them to play with concussion symptoms just because it might not look good for them to leave a game if a college recruiter is in the stands.

There’s also the conflicts that come with continued study on the issue that make the job of educating and preventing that much harder.

For example, the AIA focused a recent ruling on the football program, knowing that’s where the majority of injuries are reported each year.  Its Executive Council approved a measure a couple of months ago that will restrict the amount of time coaches can devote to full-contact scrimmage time.  The idea was to minimize the opportunity for injury.

But then a new study comes out that shows more youth injuries are likely in games than in practice, and the effect of cutting back on contact in practice might actually be harmful because it gives the kids less time to learn the right techniques to avoid injury.

That study focused on players in the 8-12 year-old group, but the implications are there for high school programs as well and the study will likely be expanded to include teenagers.

With all the discouraging publicity surrounding the dangers of concussions at the youth level, parents have a right to be worried.  The fear of their child suffering a second concussion that could create serious issues later in life can easily lead to discouraging participation in sports in high school or college.

Programs like the one developed at the Barrows Institute and implemented by the AIA are a good step toward lessening the problem, and these programs are sure to continue to evolve and become even better.

But in the final analysis, there’s still a simple way to help protect the athlete by following the advice put forth by medical experts across the board:

“If in doubt, sit it out.”