WASHINGTON – The NFL’s concussion-awareness campaign picked up more steam on Sunday when Commissioner Roger Goodell wrote a letter to 44 governors advocating for new laws protecting young athletes from returning to competition too soon after a head injury.
But the National Federation of State High School Associations, whose members comprise the high school athletic associations of all 50 states and Washington, D.C., has already been implementing guidelines of its own to help mitigate the problem.
At an NFHS meeting in January, the football rules committee changed its guidelines for dealing with concussions to read:
“Any player who exhibits signs, symptoms or behaviors consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, shall be immediately removed from the game and shall not return to play until cleared by an appropriate health care professional.”
This course of action is similar to Lystedt’s law, which was enacted in Washington in July 2009 after middle school student Zachery Lystedt almost died from a brain injury he received after returning to a football game in which he had already gotten a concussion.
The major deficiency with the NFHS guideline is that it lacks the power to enforce its rules, leaving it up to each state to determine its own course of action.
“We cannot mandate our rules, were not like the NCAA,” said Bob Colgate, an assistant director for NFHS. “With our 50 state high school associations and DC, it’s up to them to adopt our rules as written.”
In football, where more injuries are sustained than in any other high school sport, Texas and Massachusetts are the only two states that follow NCAA rules instead of the NFHS guidelines.
Six states have already passed legislation to ensure that young athletes don’t return to the field of play too early after sustaining a head injury. Some of those states, like Virginia, have not yet put the law into effect.
Tom Dolan, an assistant director for the Virginia High School League, said that his state has been, and will continue to follow NFHS guidelines until the law becomes effective July 1, 2011. According to Dolan, the major difference between the pre-law and post-law regulation is who actually enforces the rules.
“Without legislation it comes down to the member school and what they do. With the legislation, it now puts the onus on the state association to ensure that those member schools are enforcing the law,” he said. “The law itself gives more emphasis on what you need to do, not that we haven’t been encouraging that process and procedure all along. Having a state law gives pretty clear direction of what needs to be done and how it needs to be done, and we’re very supportive of that.”
High School Concussion Facts
• Two states don’t use NFHS rules for football, which include the guidelines for returning to competition after sustaining a head injury—Texas and Massachusetts.
• Six states have passed legislation to prevent young athletes from returning to competition too quickly after a head injury: Washington, New Mexico, Virginia, Oregon, Oklahoma and Connecticut.
• Concussions account for 16 percent of all high school sports-related injuries suffered in official competition.*
• Concussions account for 7 percent of all high school sports-related injuries suffered in practice.*
• More injuries were sustained to the head and face during official high school competition than to any other specific area of the body.*
In his three years at VHSL, Dolan said he has never heard of any situations where a coach put an athlete back into competition too soon after a head injury.
Maryland had a concussion bill die in the state legislature last year, but Maryland Public Secondary Schools Athletic Association Executive Director Edward Sparks said it’s more important to change attitudes than laws, noting that the MPSSAA already adheres to the NFHS sports guidelines, which detail how to deal with concussions.
“I’m not sure you need state laws, it’s an important thing, but I think this is an attitudinal change not only at the high school level, but even levels below that,” he said.
Sparks pointed towards the antiquated maxim “water makes you weak,” a popular notion in athletics several decades ago that has long since been derailed by the medical community.
“Back in the ‘50s and ‘60s, the idea of withholding water form athletes was considered to make them tough,” he said. “That is so far from what should be done and what is done today it’s almost shake your head and laugh at it and say ‘How could we have been so stupid and dumb and foolish in those days?’”
New state legislation may not come without its own set of problems. One component of the Lystedt law, which will be used as the template for many states, is that a licensed health care professional must clear an athlete to return to the field.
Dolan said that determining what health care providers can and cannot sign off on these athletes is an important part of the legislation.
“The biggest issue, and I think it has come about in every state, is when you say an ‘appropriate medical provider that can release an athlete to return to play.’ For each state to determine what that involves and who those people are, to me that is the key to this whole situation.”