May 26, 2015

New bill addresses Illinois concussion response in prep sports

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Athletic trainer Dustin Fink in the Mt. Zion High School training room where he has screened athletes for concussions. Photo taken on Friday, May 22, 2015.

Darrell Hoemann/CU-CitizenAccess.org

Athletic trainer Dustin Fink in the Mt. Zion High School training room where he has screened athletes for concussions. Photo taken on Friday, May 22, 2015.

Dustin Fink suffered his first concussion growing up in Lone Tree, Colorado, when he ran into a post on the playground in fourth grade. It was the mid-1980s and the school nurse looked him over, he recalled, sent him back to class and that was that.

Now, some 30 years and 12 more concussions later, Fink is the head athletic trainer of Mt. Zion High School in the Decatur area. He is trying to educate people about concussions and correct what he sees as a lot of misinformation.

Fink also writes posts on The Concussion Blog, a concussion information website he started in 2010.

Awareness about concussions has grown, especially since Fink suffered his first on the playground three decades ago. But even in just the past five years, the discussion has become more prevalent on a national level.

In fact, the Illinois state legislature sent its most extensive concussion bill to date to Gov. Bruce Rauner this week. But Fink still believes the knowledge about concussions is nowhere near where it needs to be.

“The actual injury of a concussion is not the true problem — the true problem in this area is the mismanagement of the injury,” Fink said. “The reason why we’re having the issues we have is because concussions have been mismanaged for so many years.”

The Center for Disease Control estimates about 4 million sports- and recreation-related traumatic brain injuries are treated in emergency departments every year. But that doesn’t account for the number of concussions that go untreated.

According to the CDC, a concussion is 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. A concussion can occur even if a person does not lose consciousness.

 

Oversight teams

The bill sent to Rauner was introduced in January. It was sponsored by State Senator Dan Kotowski (D-28th) and proposes the introduction of “concussion oversight teams” at each high school. Each school’s concussion oversight team would require at least one physician, plus one or more athletic trainer, advanced practicing nurse, neuropsychologist or physician assistant, if already employed by the school.

The legislation comes at a time when the Illinois High School Association is being sued by a former high school football player who alleges it did not do enough to shield him from concussions.

Senator Kotowski felt it was important to keep student-athletes safe. A high school football player himself at Loyola Academy in Wilmette, Illinois, in the 1980s, Kotowski can remember a few times when he had his “bell rung” but was never treated.

The Illinois High School Association does not require student-athletes to stay out of action for a certain number of days following a concussion. Much of the proposed concussion bill is already implemented by the IHSA and a 2011 state law requires high schools to educate students about concussions.

The bill would require students and their parent or guardian to sign a handout explaining concussions and the school’s concussion protocol before the student can participate in athletics for that school year. The 2011 state law requires a school’s concussion policy to be a part of any injury handout a parent signs before the season. The handout under the new bill would be more extensive, including information regarding concussion prevention, symptoms and treatment.

A similar system is already in place at Champaign Central High School, according to Athletic Director John Woods.

“We have a handout that the parent and kid have to sign off on outlining our protocol,” Woods said. “It includes a one-page document with symptoms. Parents have to sign of knowledge of the (concussion) policy.”

Central also requires that student-athletes take a baseline test before the season, testing their balance and other aspects that could be affected by concussions. This gives trainers something to compare performance before and after a concussion. Baseline testing is not required by the IHSA, nor would it be under the proposed bill.

Fink said one misconception about concussions is how long it takes to recover from one, including time that should be taken away from school.

“People don’t understand that just because you’re not walking around doesn’t mean you’re not using you brain,” Fink said. “If I break my arm, should I go use it to throw a ball? No. So why should I use my brain playing video games or texting or reading Facebook?”

It’s important for anyone who suffers a concussion to rest and turn off the TV, Fink said. He encourages Mt. Zion students not to go to school until they see a doctor. At Mt. Zion, concussed student-athletes are required to take at least eight days away from sports, and most are away for eight to 12 days.

 

Priorities questioned

Kotowski questioned the priorities of parents and coaches when it comes to school and athletics.

“Are (student-athletes) OK to go back and learn? That should be the first question,” Kotowski said. “Can they process information? Are they able to perform right in the classroom?”

Brian Easter, athletic director at Centennial High School in Champaign, said he can think of two or three examples in recent years of parents wanting their son or daughter back in the game after suffering a concussion.

“It blows my mind that parents, when being told your kid has a concussion, they argue you need to get them back on the court,” Easter said. “I’m a parent, I have two kids, I know what it means down the road if they get a second concussion — there’s no way I would let them back in the game.”

The term that’s been prevalent for years is “getting your bell rung.”

“When I was playing, if you got hit in the head, you got your bell rung,” Woods said.

During his time playing football in high school, Kotowski doesn’t know if he ever suffered a concussion, but he doesn’t doubt that he might have.

“There are times when I was getting my bell rung and was dizzy after getting hit,” Kotowski said. “There wasn’t testing in that time to determine a concussion.”

Kotowski said the proposed bill would strengthen the return to play policy across the state. But even so, one of the biggest problems is that athletes often hide concussions from coaches, and trainers are often pressured to clear an athlete.

“There’s pressure from parents, pressure from coaches, pressure from aunts, pressure from friends, pressure from the athletes — there’s pressure from everywhere,” Fink said.

Kotowski said one of the main concerns is to make sure a doctor or a trainer, not a coach, is determining whether an athlete should return to play.

“We want to make sure that students who get concussions during athletic competition are protected and safe,” Kotowski said. “That they don’t return to physical activity before they’re ready, and that they don’t return to the classroom before they’re ready.”