News From Terre Haute, Indiana

June 26, 2012

New law requires team approach on concussions

Parents, high schools being asked to work together to assure athletes’ safety

Maureen Hayden
CNHI Statehouse Bureau Chief

INDIANAPOLIS — Backers of an effort to protect high schools athletes who’ve suffered head injuries will soon get a new set of recruits: The players’ parents.

Beginning July 1, Indiana schools will be required to inform parents and their student-athletes of the symptoms of a concussion sustained during play or practice and the risks associated with ignoring them.

Parents and players both will have to sign forms saying they’re received the information and understand the new rules that, by law, require coaches to remove players from competition if they suspect the athlete has sustained a concussion.

Those athletes can’t return to play or practice until they’re cleared by a licensed healthcare provider specifically trained in the evaluation and management of concussions and head injuries.

The requirements are part of state law passed in 2011 aimed at reducing the number of potentially catastrophic head injuries suffered by young athletes.

The law already requires coaches to be more vigilant, but the part of the law that goes into effect July 1 creates a kind of team approach that concussion-management experts say is needed in response to the numbers: At least 10 percent of student-athletes suffer concussions each year and too many return to play before they’re ready.

“The goal is to educate everyone — athletes, parents, and coaches — about how significant a concussion injury is and about how important it is that we don’t hide these, just so a kid can play,” said Dr. Daniel Kraft, director of Riley Hospital for Children Sports Medicine at Indiana University Health.

Indiana is one of 38 states with laws designed to protect the brains of young athletes. They vary in scope but most have been passed since 2009, when the State of Washington passed what’s known the Lystedt Law.

It’s named after Zachary Lystedt, a teenager who suffered a near fatal brain injury during a middle school football game in 2006. Olmsted hit his head on the ground during the first half of the game, but returned to play. When he was struck in the head a second time, the injury was devastating.

Like the Lystedt Law in Washington, Indiana's youth concussion law requires that student-athletes suspected of sustaining a concussion during practice or play be immediately removed from competition and obtain medical clearance before returning to play. The aim is to prevent student-athletes from trying to hide their symptoms to continue playing.

“By nature, student-athletes are competitors,” said Dr. Mark Booher, medical director for the Hendricks Regional Health sports medicine program. “They want to be in the game. The last thing they want to do is to quit.”

Booher said it’s critical that they do stop playing when they’re injured, since young athletes are most vulnerable to what’s called the “second impact syndrome.” It’s a condition in which the brain swells rapidly after a person suffers a second concussion before the symptoms of the first concussion clears.

Indiana’s law only applies to high school sports. Other states, including Washington, have laws that cover middle schools, club sports, and private youth organizations.

Both Kraft and Booher think Indiana’s law should go farther, sweeping in all youth sports and doing more to educate teachers as well about how to accommodate students with concussion symptoms, which include memory impairment and inability to concentrate. The best concussion treatment is rest — both for the body and the brain.

“We need to help parents and teachers understand that kids who suffer concussions are just not themselves,” Kraft said. “It can take a long time for the brain to heal.”

Indiana’s concussion law puts into force regulations that had already been issued by the Indiana High School Athletic Association in 2010, after the National Federation of State High School Associations issued rules on concussion protocol.

The IHSAA rules covered only IHSAA-sanctioned sports and didn’t address injuries sustained during practice. IHSAA Commissioner Bobby Cox said Indiana high schools have embraced the new concussion rules since they were passed in 2010; he also said he doubted there was a need for the Indiana General Assembly to pass what he called a “feel good” law that mandates how schools manage concussion injuries.

“The law in itself is not going to protect our kids,” Cox said. “Proper teaching of the rules of play and the use of proper equipment is essential to preventing injuries from occurring.”

Still, Cox said he’s glad to see a coordinated effort to educate student-athletes, their parents, and their coaches of the need to play smart. “We all need to remind our athletes that it’s not a sign of weakness to say you’re injured,” Cox said. “It's a sign of intelligence.”

Maureen Hayden is the Statehouse Bureau Chief for the CNHI newspapers, the parent company of the Tribune-Star. She can be reached at