University of Virginia Health System

Coaches Learn More about Concussions during Sports

New research suggests that high school football coaches are getting much better at spotting a concussion and managing the problem, although there is still room for improvement.

"The traditional idea was that 'getting a bell rung' was not serious, but those symptoms can be a sign of a concussion and need to be evaluated," Broglio adds.

Symptoms of concussion include dizziness, headaches, poor concentration, vision disturbances, balance disturbances, amnesia and loss of consciousness.

Each year, more than 7 million high school students participate in interscholastic sports in the U.S., and there are approximately 1.4 million sports injuries, according to a 2006 national sports injury survey.

The good news is that injury rates have dropped by half in the last decade as sports medicine techniques have improved, along with a growing awareness of the importance of preventing and treating injuries, says Dawn Comstock, Ph.D., of Ohio State University.

She administers the survey which tracks sports-related injuries at 100 high schools throughout the country.

But the injuries reported today are more serious.

Awareness Leads to Better Care

"There are more fractures, severe knee injuries, and the proportion of injuries requiring surgery is higher," Comstock says.

This could be due to an increase in chronic overuse problems - more young athletes are playing one sport year-round, using the same muscle groups over and over.

But the increase could also be due to improved sports medicine techniques, with earlier diagnosis and treatment of many injuries before they become serious, leaving the more serious ones for the statistics charts, notes Comstock.

Whatever the reasons, the emerging data and new research into sports injuries among high school athletes is bringing needed attention to what athletics professionals say has been a long neglected area.

"There are 1.2 million high school football athletes, compared to 38,000 college and 1,700 professional football players," says Broglio. "At the high school level, where there are the greatest number of injuries, there is the least amount of medical attention - one athletic trainer for 300 to 500 children, compared to three or four for one college football team of 120."

Tight school budgets are part of the reason, explains Jon Almquist, the athletics training program administrator for the school division in Fairfax County, Va. Schools necessarily focus on educational priorities rather than athletics.

But a second reason for the lack of attention, according to Comstock, has been the incorrect assumption that high school sports injuries are inevitable.

"There's a general perception that sports injuries are just the price you have to pay for playing, which isn't true," she says.

At a meeting of the National Athletic Trainers' Association (NATA), Broglio presented the results of a study that measured the varying speeds at which high school football players took hits to their heads, and where on the head the hits occurred.

The findings will not only help researchers pinpoint how and when concussions are most likely to occur, they should help coaches retool a player's on-field technique to avoid unnecessarily risky moves.

Developing Proactive Awareness

Also at the meeting, certified athletics trainer Erin O'Donoghue reported that high school coaches in a survey she conducted scored an average of 80 out of 100 points on questions testing them on their expertise in recognizing concussions.

Those who had attended workshops about concussions - approximately one-fifth of the coaches - or had a Centers for Disease Control and Prevention (CDC) published kit about concussions were the most informed.

"Our educational efforts have been effective," she says.

To further improve safety for young athletes, NATA has published a summary statement with 11 strategies for anyone - coaches, athletics directors and parents - interested in providing comprehensive medical care to high school athletes.

Among the recommendations:

1. Organizations that sponsor high school athletics should put in place a healthcare team to ensure timely and appropriate care for all athletes.

2. Those same organizations need to develop an emergency action plan to ensure injuries and illnesses are treated promptly.

3. Students participating in sports should have a physical exam to detect any health problems that might be aggravated by physical activity.

"Our hope is that the summary statement and strategies will together provide an opportunity for all high school athletes to get appropriate medical treatment whenever and wherever they play sports," says Almquist, who chaired the task force and is lead author of the statement.

For more information about sports safety and other children's health issues, visit www.uvachildrenshospital.com.  

Always consult your physician for more information.