May 26, 2015

Indiana high school athletic association tries concussion logging system; Illinois considers similar plan

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Dr. Jerrad Zimmerman is a physician in Carle Foundation Hospital’s sports medicine department.

Dr. Jerrad Zimmerman is a physician in Carle Foundation Hospital’s sports medicine department.

The Indiana High School Athletic Association logged 1,217 concussive events in high school athletics throughout Indiana during the fall season.

How many occurred in Illinois? Nobody knows for sure.

The Illinois High School Association does not keep track of how many concussions are occurring statewide, according to assistant executive director Matt Troha. Meanwhile, Indiana is in the first year of its concussion monitoring experiment.

The Center for Disease Control defines “concussion” as a type of traumatic brain injury caused by a bump, blow or jolt to the head that causes the brain to bounce within the skull.

The state of Illinois does require high school coaches to be taught about concussions and concussion information has to be given to parents. Although no counting system has been implemented, there have been discussions for implementing a similar system in Illinois.

Beginning July 1, the Indiana association began requesting athletic trainers and athletic directors at member schools to log any “concussive event” that might happen in a game or practice. Any incident in which a concussion might have occurred is logged onto the association’s member website. The association can then tally the numbers.

Information about each incident is logged, including the sport it occurred in, the playing surface and the gender of the athlete. The system logged the 1,217 concussive events between July 1 and Nov. 30. Concussive events during the winter and spring season are being logged but will not be tallied until after the school year.

 

Need to implement

Commissioner Bobby Cox of the Indiana association said that after discussions with legislators and reporters, the association felt it needed to implement a counting system.

“We’re trying to see if there are any statistical trends or data that would help us with regards to which sports it occurs the most in,” Cox said. “Over the course of several years, we can take that data and make some intelligent comparisons.”

Cox said Indiana did not base its reporting system off anything done at other high school associations across the country.

Dustin Fink is an athletic trainer in Mt. Zion, Illinois, and the primary writer for The Concussion Blog, which he started in 2010. Fink said he’s been advocating for the IHSA to count concussions in Illinois for years.

“How do we know if the concussion stuff we’re doing, the education, how do we know that’s making a difference?” Fink said. “In order to get to the real root of the problem, we have to see every concussion. We don’t see every concussion.”

Fink said it’s still common for athletes to hide concussions, even with today’s increased awareness about the injury.

The Indiana association doesn’t know if the 1,217 concussive events are high or low because there is nothing to compare the numbers with. But a few years down the road, Cox could see how the numbers could influence change throughout high school athletics.

“If we see X number of concussive events during football season and 78 percent are occurring in practice, maybe that suggests we need to look at what we’re doing in practice,” Cox said. “Maybe we need to limit the number of full contact days in practice during the regular season. If we see an upswing of concussions in soccer, maybe we need to look at what we’re doing in soccer practice.”

 

Need true rate

Dr. Jerrad Zimmerman, a physician in Carle Foundation Hospital’s sports medicine department, said with any injury or illness, if you don’t know the true rate of the ailment, it’s impossible to implement change.

“It’s super important that you know the injury rate was before you implemented change, otherwise you’re not going to be able to judge: Did these changes improve our outcomes?” Zimmerman said. “That’s the big step in that reporting system. You’re trying to figure out what truly is the rate of concussions in high school sport.

Carle Sports Medicine provides the Champaign-Urbana area high schools with athletic trainers and physicians, as well as University of Illinois athletics. While implementing a similar concussion monitoring system in Illinois could be beneficial, Zimmerman said it has to be done right.

“If you don’t have a way to make the system accountable, bad data in equals bad data out,” Zimmerman said. “I could see how the data could be extremely skewed.”

Zimmerman said any system would have to be easy to use and there has to be a reason for athletic trainers to log concussions. Whether Indiana’s numbers are accurate is impossible to know for sure.

Cox emphasized that each state is different and what works for Indiana might not work for other state high school associations.

“Every state association needs to make a determination based on the conversations they’re having about concussions as to what’s appropriate,” Cox said. “State size, level of medical support at schools, all of that plays into the discussion. Everybody’s different — you’ve got to attack the issue based upon what those discussions are in your state.”