The national conversation about concussions has ramped up in recent months as details emerge about sports stars in the NFL and NHL suffering the long-term effects of head injuries.
Part of the $765 million settlement between the NFL and 20,000 retired players and their spouses includes funding for concussion education in youth football. A total of $10 million has been set aside for education, but not all of it will be directed toward young people.
Meanwhile, peer-reviewed studies about concussion hazards continue to emerge. Researchers in the U.K. reported today in the journal JAMA Psychiatry that people who suffer a traumatic brain injury are three times more likely to die premature deaths, particular from suicides, injuries, or assaults.
In the U.S., educating high school athletes about the dangers of concussions is now the law in almost every state. Unfortunately, money to pay for the programs remains elusive.
So hospitals, universities, community foundations, and even minor league sports teams have pitched in to help schools around the country protect student athletes and abide by state regulations.
A National Model in Virginia
In Prince William County, Va., a $1.2 million grant from the Potomac Health Foundation has helped pay for an extensive concussion education program called ACHIEVES, or Advancing Healthcare Initiatives for Underserved Students.
The money has been used to educate almost 200,000 students, parents, coaches, trainers, and others about concussion hazards. It even paid for an electronic tracking system for student athletes who suffer concussions. A report released last year by the Institute of Medicine and National Research Council called on the Centers for Disease Control to create such a system nationwide.
Shane Caswell, executive director of the Sports Medicine Assessment Research and Testing (SMART) Laboratory at George Mason University, directs ACHIEVES. “You would be hard-pressed to identify a project that's similar to this,” he told Healthline. “We feel very fortunate to have created a sustainable model.”
Protecting Kids from Themselves
In a metropolitan community known as the Quad-Cities in Illinois and Iowa, the Genesis Health System provides concussion education for high school athletes in both states. Genesis teamed up with the Quad-City Mallards, the local minor league hockey team, to offer the program free to schools.
Part of the curriculum includes a Web-based concussion assessment program called Concussion Vital Signs. It helps athletes establish a baseline for cognitive function (how well their brain processes information) and assess them after an injury.
Athletes have found ways to cheat on such tests in the past by sandbagging their results to achieve a lower baseline. Their thinking is that if they take the test again after an injury, they can try harder and make it look like they're ready to return to the field even if they're not.
Connie Tauke, who directs the Genesis program, told Healthline that Concussion Vital Signs is different. “You can't learn this test, which is why we chose it," she said. "It will flag you if you're trying to do a bad baseline or just aren't taking it seriously.”
Eric Knudson, an athletic trainer at a Bettendorf, Iowa high school, told Healthline that people in jobs like his need to establish trusted relationships with players, which isn't easy when you're dealing with 500 or more athletes.
“They don't always understand the ramifications of the injury they have; they just want to play," he said. "It's more important to a teenager to fit in socially than to take care of their bodies, and they prove that with things like sex and drugs.”
Crowdfunding Concussion Education
Dr. Greg Stewart of the Tulane Sports Medicine Program has turned to crowdfunding to help pay for a program to educate high school students in Louisiana. Using a site called Microryza, Stewart hopes to gain support for his interactive plan to teach young people about the hazards of a blow to the head.
“What I know now in dealing with these kids is that they have a completely different method of learning than when I was growing up,” Stewart told Healthline. “While they understand the lecture part of what a concussion is, they don't get it altogether.”
Most methods of concussion education exist in paper form, Stewart said, but he believes the Internet is a better ways to reach teens.
He's seeking money to buy an interactive white board and tablets. With the help of a graduate student, he plans to travel around Louisiana to better understand the learning habits of the athletes and hone his interactive system.
“What we find with a lot of our high school kids is not so much a culture of resistance, but not completely understanding the risks of the first concussion,” he said. “We can tell them the symptoms, and then ask them if they've had a concussion and they say 'no.' But when we say, 'Have you played with dizziness?' They say 'Yes.'”
When young athletes admit they're having symptoms of a concussion and give themselves time to recuperate, they're generally back in the game within a week. Those who don't can find themselves on the sidelines for several months, Stewart added.
“If kids are honest and tell us they have symptoms and let us manage them the way they should be managed, they're fine,” Stewart said. “They have to be honest and upfront, so we must come up with an educational program that works.”
Stewart said he plans to share his findings about the best ways to educate young athletes with officials in other states.