4. Coaches. While there are many coaches who take concussions very seriously, there are still far too many in this country, from youth football, hockey, soccer, lacrosse or basketball all the way up the ladder to the professional level, who:
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ostracize players who complain of concussion symptoms,
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challenge a player's toughness or, especially in the case of boys, their very masculinity for not shaking off concussion symptoms;
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give doctors and athletic trainers a hard time if they refuse to let a player with concussion symptoms go back into the game,
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take away a child's position in the starting lineup or reduce their playing time simply because they and their parents decided, for safety's sake, that the child should not to rush back to the field or gym because the symptoms had not yet cleared or have recurred with exercise;
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in extreme cases have even had a star player suffering symptoms don another player's jersey to get back into a game; and/or
- value winning over safety, so much so that they are willing to risk the health of their "star" athletes for the sake of team success by employing a double standard when it comes to concussion safety - one for regular players, another, more lienient one for "stars" - which helps them justify putting a key player who has been "dinged" or "had his bell rung" back into the game.
Coaches need to be part of the concussion solution, not the problem. This means that a coach needs to:
- Actively, consistently and repeatedly encourage honest self-reporting by athletes of post-concussion symptoms, both their own and those of their teammates (such as by employing the same kind of buddy system football programs often employ to protect athletes from heat illness during hot weather practices and games).
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Reassure athletes that they will not jeopardize their position as a starter or place on the team if they self-report, that he will not question their toughness, call them "wimps" or "sissies," or ostracize them;
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Inform players that deliberate hits to another player's head will subject them to disiciplinary action; and
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Advise athletes that they will be considered in violation of team rules, subjecting them to possible discipline from game suspensions up to and including disqualification for the season if found to have impeded appropriate evaluation and management of his own concussion by:
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failing to report or underreport symptoms (theirs or a fellow player's);
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intentionally underperforming on baseline neuropsychological tests in order to maximize chances of being cleared to play even with symptoms; or
- indicating they are symptom-free so that they can be cleared to play in the next game when they are still experiencing symptoms (which can put an athlete at risk of death from sudden impact syndrome)
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Taking these kinds of safety precautions will undoubtedly meet resistance from those concerned more about winning than about the safety of children, but parents and every other stakeholder in youth sports owe them nothing less
Concussion education is critically important
Regardless of who the program calls to make presentations at the meeting, the goal should be to provide parents and athletes with the all-important information they need to decide when it is safe to return to play, whether it be the next game, next season or not at all. To reinforce the message of the meeting, parents should be furnished with information to take home, such as articles from this website or obtained from the Center for Disease Control (CDC) as part of its "Heads Up" kit (which contains a good video on concussions that can be a substitute for live presentations, along with fact sheets for parents, athletes, and coaches).
1. Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br. J. Sports Med. 20090: 43:i76-i84.
