How suburban schools are changing concussion protocols
They look quite unfootball-like: Pillowy, puffy, padded camouflage coverings over the helmets worn at practice by the St. Edward Central Catholic football team.
Called Guardian Caps, they've led to a dramatic reduction in concussions during practice, said head football coach Mike Rolando. By reducing contact and wearing the special caps, the Elgin school might see one concussion per season at practices, compared to five to seven in prior years.
For game day, the school equips its players in Riddell helmets, the brand deemed safest at "the highest level of collegiate play," Rolando said.
"We're ahead of the curve," he said. "We've always tried to maintain the absolute, most up-to-date helmet protection for our players."
Those precautions show how some schools have gone above and beyond state-mandated concussion protocols approved by legislators this summer. State law now requires all high schools and middle schools to administer concussion screening and develop standard procedures to ensure athletes can safely resume sports and classroom activities after an injury. The law applies to all public, charter and private schools that participate in interscholastic sports, and all sponsored youth sports.
Schools also must form a concussion oversight team that includes coaches, athletic trainers, game officials, nurses, teachers and administrators. Members of that team must complete concussion management training by next school year.
Previously, the Illinois High School Association required coaches and athletic trainers to undergo online concussion management training every two years. More than 28,000 coaches statewide completed the course last year -- the first time it was offered.
"We're going to see a better understanding by all coaches and teachers on what steps a student needs to follow following a concussion," said Kurt Gibson, IHSA associate executive director.
Still, adopting changes such as the St. Edward practice helmets may be a ways off. IHSA rules forbid modifying helmets for competition. And the National Federation of State High School Associations, which writes the playing rules for interscholastic sports, has discussed equipment supplements and modifications to make sports safer, but it has stopped short of allowing them.
If there is scientific evidence showing they work, "the federation would look hard at approving that," Gibson said.
Meanwhile, some suburban districts are working with local hospitals to develop pre-concussion tests for athletes, having doctors on hand during games, adopting extra protective gear to prevent injuries, and minimizing the risk of injury through strengthening exercises, beyond the requirements of state law.
Gibson said while most schools have return-to-play protocols, "there hasn't been enough discussion on return-to-learn, nationally."
"(Athletes) might be ready for full resumption of activity in the classroom before they return to play athletically because we know so much more about concussion now than we did five years ago," he said.
According to sports medicine experts, post-concussion tests should be administered between 24 and 72 hours after an injury. They help detect general symptoms, such as headache, sensitivity to light, slow reaction and processing of information, and confusion.
Some school districts have taken an extra step in this area, too. They have opted to perform baseline tests -- a preseason exam conducted by a trained medical professional -- to assess an athlete's balance and brain function and the presence of concussion symptoms. The results can be compared to a similar exam administered during the season if the athlete is suspected of having a concussion.
Centegra Health System provides training and concussion screening services for several school districts in Kane and McHenry counties, including Huntley Community School District 158.
Students take an online test, responding to a collection of questions that establish a baseline for neurological activity, Huntley High School athletic director Chris Rozanski said.
During play, they might be tested again after receiving a blow to the head.
Then a Centegra neurologist is notified if the athlete's test performance displays any of the symptoms suggesting a concussion, and the athlete is "immediately removed from play," Rozanski said.
"They will be evaluated by an athletic trainer and also a team physician, if available," he said.
Also, many school districts now have doctors on the sidelines at games to respond immediately to potential concussions -- a new practice at Huntley High School.
"Our goal is to have one at every home football game," said Rozanski, adding that host schools often are expected to have a physician on hand for such emergencies. "That same individual will be a resource to guide our parents regarding athletic injuries. They are still expected to consult a physician."
Though concussions and traumatic brain injuries often are associated with football, they can happen in any sport, including soccer, ice hockey, lacrosse, basketball and baseball.
"It's been seen in sports like volleyball, wrestling, even the competitive flips of your cheerleading team," Rozanski said. "It's inevitable. Our athletic training staff has begun to review and determine what is that return-to-play process for students who exhibit concussion symptoms. There is a connection between symptoms and academic performance."
Preventing concussions is difficult because shaking of the brain -- an inevitability of many contact sports -- causes a chemical imbalance, but strengthening athletes' necks and shoulders has helped reduce them, said Chuck Marth, head athletic trainer for Maine West High School in Des Plaines.
"The numbers have significantly reduced. We're talking like half," Marth said. "We see about 30 to 35 kids a year with concussion at different levels. ... There were years that we've had as many as 50 kids."
Coaches further try to minimize risk by teaching athletes proper techniques for tackling and blocking, he said.
When concussions do occur, a series of field tests confirm whether the athlete's motor and cognitive functions, such as balance, coordination and memory, are affected.
In addition to having a doctor on hand during home games, athletes are assessed once a week for all injuries.
The doctor will monitor symptoms and devise a "care plan."
"We've been doing this for almost three years now," Marth said. "We are improving it every year."