CommentaryThe Centers for Disease Control and Prevention estimates that as many as 3,900,000 sports-related and recreation-related concussions occur in the US each year. While this number is shocking, additional statistics indicate that only one in six concussions are actually diagnosed correctly. Therefore, 3.9 million could be a low estimate of the actual concussions seen per year.
Some initial symptoms resulting from a concussion include a headache, short-term memory loss and dizziness. While some student athletes’ symptoms include post-concussion syndrome (PCS) with symptoms lasting six weeks or less, others’ symptoms last longer than this.
To address these alarming statistics, the Illinois High School Association (IHSA) created a formal concussion management policy in 2011 that included concussion and head injury information. On August 3, 2015, Illinois Governor Bruce Rauner revised this policy by signing into law Senate Bill 7 (later becoming the Youth Sports Concussion Safety Act), requiring students who suffer a concussion to receive permission from a doctor or trainer before they are allowed to fully return to sports. This act pertains to any youth sports activity sponsored or sanctioned by a youth sports league, including, but not limited to school district and park district sporting teams.
With the passage of this significant bill, Congress recognized that continuing to play with a concussion or symptoms of a head injury leaves a young athlete especially vulnerable to greater injury and even death. The General Assembly acknowledged that, despite having generally recognized return-to-play standards for concussions and head injuries, some affected youth athletes are prematurely returned to play, resulting in actual or potential physical injury or death.
Concussion Oversight Team
First, the Youth Sports Concussion Safety Act requires appointment of a Concussion Oversight Team. Each team is charged with establishing a return-to-play protocol for a player’s return to activity following a force or impact believed to have caused a concussion. This policy must be both based on peer-reviewed scientific evidence, and follow the Centers Disease Control and Prevention Guidelines. Participants on the team must include, to the extent practicable, at least one physician. In addition, if the youth sports league employs a personal trainer, that individual must be included as well.
While the presence of physicians and personal trainers would prove advantageous, including additional personnel is not a viable reality for most youth leagues in Illinois. Most school districts in Illinois do not have access to a personal trainer. In addition, due to current financial constraints, most districts do not have the ability to hire medical personnel. Such expertise, in theory, would be advantageous, but is just not a realistic option for most agencies. This consequently leaves the concussion teams without the medical guidance that it requires.
Return-to-play restrictions and procedures
Secondly, the Youth Sports Concussion Safety Act requires the player’s parent/guardian or another person with legal authority to make medical decisions for the player through use of written, informed consent. The consent must explain concussion prevention, symptoms, treatment and guidelines for safely resuming participation in an athletic activity following a concussion. The player shall be removed from a sponsored youth sports activity immediately if any of the participants feel the player might have sustained a concussion. This includes a coach, physician, game official, athletic trainer, licensed healthcare professional, player’s parent or guardian, or the player himself or herself.
These guidelines are in effect during game situations and practices. According to a study published in May 2015 in the Journal of American Medical Association—Pediatrics, 58 percent of concussions are suffered at practices. Often times, limited personnel are available to monitor for the potential of concussions during practices. It is crucial, then, to ensure appropriate training and awareness of all coaches who are involved.
The Youth Sports Concussion Safety Act further stipulates that a player removed from a sponsored youth sports activity with the potential of a concussion is not permitted to practice or compete again until:
(1) the player has been evaluated by a treating physician or by an athletic trainer under physician supervision;
(2) the player has successfully completed each requirement of the return-to-play protocol established by the Youth Sports Concussion Safety Act;
(3) the treating physician or athletic trainer has provided a written statement including that, in the physician’s professional judgment, it is safe for the player to return to play; and,
(4) the player and the player’s parent/guardian have:
(a) acknowledged completion of the return-to-play requirements;
(b) provided the physician’s release; and
(c) signed an informed consent.
While these new restrictions seem unrealistic, most high school coaches are not medically trained to recognize concussions. Within the initial guidelines from 2011, coaches were required to pass an on-line concussion training. However, this “training” allowed for a 100 percent passage rate and did not educate coaches as intended.
Furthermore, parents are often removed from practices and game situations. Parents have been given a substantial role within the Youth Sports Concussion Safety Act, as they should have. Sports are second only after motor vehicle crashes as the leading cause of traumatic brain injury among people aged 15 to 24. We, as parents, should have the right and responsibility of making the crucial decision regarding our children’s readiness to return to and continuation of sporting events under these critical situations. When it doubt, sit them out!
According to NCAA statistics, of the nearly eight million students currently participating in high school athletics in the US, only 460,000 of them will compete at NCAA colleges. That is less than 6 percent. And of that group, only a fraction will realize their goal of becoming a professional athlete. These percentages confirm that participation in sports at the elementary and high school level is not to prepare children for a lifetime of competition, but rather to teach valuable life-lessons. With the potential of catastrophic long-term effects from concussions, it is just not worth the risk to continue playing when a concussion is potentially present!
The Youth Sports Concussion Safety Act certainly heightens community awareness about long-term effects for our children who experience concussions. While some portions of the Act are not feasible, awareness of the concerns should benefit those affected by concussions. The Centers for Disease Control and Prevention says it best: “When it doubt, sit them out!”
Carrie Clodi is a second-year law student at Valparaiso University Law School, where she serves as a Teaching Assistant and Class Representative for the Honor Board. She also serves as a Director of Special Services for Grant Park School District No. 6 in Illinois.
Suggested citation: Carrie Clodi, When in Doubt, Sit Them Out: Youth Sports Concussion Awareness, JURIST – Student Commentary, Dec. 21, 2015, http://jurist.org/student /2015/12/carrie-clodi-youth-concussions.php
This article was prepared for publication by Val Merlina, an Assistant Editor for JURIST Commentary. Please direct any questions or comments to her at
