Concussion Statements from High School and College Athletic Organizations
A 2011 Football Point of Emphasis issued by National Federation of State High School Associations (NFHS) states the following:
All coaches should undergo education and utilize available professional development tools regarding the signs and symptoms of concussion and the proper management of athletes with a suspected concussion. The NFHS offers the free course "Concussion in Sports: What You Need to Know" that is available at www.nfhslearn.com, and many states have developed their own education programs. It is incumbent upon coaches to lead by example in recognizing the seriousness of all suspected concussions.
The NFHS further states that: "Coaches and athletic trainers must use due diligence and care when fitting their athletes with that equipment, as well as instructing them how to correctly use such equipment." To emphasize the importance of a properly-fitted helmet, NFHS recently passed a rule for 2012 requiring high school football players to sit out one play if their helmet comes off. According to Mark Drebelbis, an assistant commissioner of the North Carolina High School Athletic Association, "one of the most important aspects of concussion prevention is a properly fitted helmet."
At the college level, the NCAA states its expectations on player safety as follows:
Participation in intercollegiate athletics involves unavoidable exposure to an inherent risk of injury. However, student-athletes rightfully assume that those who sponsor intercollegiate athletics have taken reasonable precautions to minimize the risks of injury from athletics participation.
Coaches should appropriately warn student-athletes about the sport's inherent risks of injury and instruct them how to minimize such risks while participating in games, practices and training.
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4. Acceptance of Risk. Any informed consent or waiver by student-athletes (or, if minors, by their parents) should be based on an awareness of the risks of participating in intercollegiate sports.
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6. Minimizing Potential Legal Liability. Liability must be a concern of responsible athletics administrators and coaches. Those who sponsor and govern athletics programs should accept the responsibility of minimizing the risk of injury.
There are potentially serious complications of multiple or severe concussions, including second impact syndrome, post concussive syndrome, or post-traumatic encephalopathy. Though there is some controversy as to the existence of second impact syndrome, in which a second impact with potentially catastrophic consequences occurs before the full recovery after a first insult, the risks include severe cognitive compromise and death. Other associated injuries that can occur in the setting of concussion include seizures, cervical spine injuries, skull fractures and/or intracranial bleed. Due to the serious nature of mild traumatic brain injury, and these serious potential complications, it is imperative that the health care professionals taking care of athletes are able to recognize, evaluate and treat these injuries in a complete and progressive fashion. In April 2010, the NCAA Executive Committee adopted a policy that requires NCAA institutions to have a concussion management plan on file. (See information box on page 56.)
In July of 2011, the Ivy League released a Review of Concussion in Football report that recommended the number of full-contact practices be limited to two per week to reduce hitting and keep players healthy. The report stated the following with respect to the education of high school and youth coaches:
Education to high school and youth coaches. It is hoped that with the increased awareness of and attention to concussions, an emphasis on proper injury management, improved technique, education and an overall reduction in hard hitting will trickle down to the youth levels.
