Student athletes still reluctant to report concussions, Nationwide Children’s study finds

Canton Repository (

Posted Nov 24, 2019 at 7:01 AM

Written by: Max Filby

A number of barriers may be keeping athletes, parents and coaches from reporting suspected concussions, the Nationwide study found. Some say Ohio should update its 2013 youth athlete concussion law.

Despite the widely-reported toll concussions can take on one’s brain, a new study shows that student athletes, parents and coaches still don’t always take head injuries as seriously as they should.

Attitudes toward head trauma were among issues identified as barriers to concussion protocol and treatment in the study published last week by the Center for Injury Research and Policy at Nationwide Children’s Hospital.

“Athletes, coaches and parents need to understand the consequences of a concussion. It is very important parents encourage student athletes to report a concussion,” said Dr. Ginger Yang, author of the study and an investigator for the center. “It is better to sit out for one game than to get injured worse and be out the rest of the season.”

Symptoms of concussions include nausea, headaches and confusion, and if left untreated they can lead to memory loss, mood or personality changes, depression and more, according to the federal Centers for Disease Control and Prevention.

Chronic traumatic encephalopathy, or CTE, a degenerative brain disorder associated with repetitive head trauma, is a major concern for football players and participants of other high-contact sports. Among high school athletes, 71.5% of concussions are due to a football injury, Yang has said.

A 2017 study published in the Journal of the American Medical Association examined the donated brains of deceased former football players and found the disorder in 21% of high school players.

Getting “buy-in” on the dangers of concussions has proven difficult, Yang said. Though area school leaders said there has been a positive shift in understanding concussions over recent years, they admit more work needs to be done.

That continued lack of understanding means student athletes don’t always speak up when they take a hit to the head, said Chris Troyer, an OhioHealth athletic trainer who works with Dublin Scioto High School. Around 15% of U.S. student athletes reported suffering from a concussion in 2017, the most recent year for which data is available, according to the CDC.

Dublin City Schools has tried to navigate the issue of student athletes being afraid to come forward themselves by encouraging their peers to do so. Often, an injured student’s friend is the one notifying school officials, Troyer said.

“We tell students that this isn’t a knee or an ankle, this is a brain and it’s really important,” Troyer said. “We try really hard to get athletes to look out for one another ... I think that message is getting out there.”

>>Read more: Are blows to the head in youth football linked to cognitive decline?

Another way to improve concussion reporting and attitudes on it may be by bolstering the educational tools available to school districts, Yang said.

Educational materials usually don’t require active learning and often include medical terminology unknown to the general public, the study found. Sometimes, educational pamphlets and other information is also unavailable in languages spoken by students or their families, according to the study.

While laws differ from state to state, the Nationwide Children’s study found they all include education, removal from play after a concussion, and return-to-play requirements.

Ohio’s return-to-play concussion law took effect in April 2013.

The law requires a youth athlete be removed from play or practice if they are suspected of having suffered a concussion. Athletes can return to play the following day if they have been cleared by a physician, according to the law.

“In light of the new report by Nationwide Children’s Hospital, the governor has directed staff at the Ohio Department of Health to examine the findings of the report,” Lisa Hackley, a spokeswoman for the governor’s office, said in an email.

The state has also developed a model for districts to use that focuses on returning students to the classroom before the field, court or rink. The plan, available on the Ohio Department of Health’s website, is followed by Dublin schools and Columbus City Schools, though the state does not require it.

Because the model is already used by several districts, it may help to codify the return-to-learn plan in state law, said Sara Timms, a school psychologist and leader of Columbus City Schools’ concussion program.

Ohio’s 2013 law was a good start to addressing youth concussions, Timms said. But as the science and knowledge on head trauma has evolved, so should state law, Timms, Troyer and Yang all said.

“We shouldn’t really have a child return to play when they aren’t ready to return to the classroom,” Timms said. “We would love to see that in legislation.”

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AEDs, once not required, now a standard at schools. But what about athletic trainers?

Cincinnati Local 12 WKRC

by Chris Renkel & Stephanie Kuzydym, WKRC

CINCINNATI (WKRC) - The Sunday afternoon in mid-May was one of Moeller High School lacrosse team’s last home games. Athletic trainer Craig Lindsey remembers everything about that day three years ago.

“It was another day, like any other game," he said. “I was into the game and I was watching my guys and helping them when they came off the field. “Then we had the Centerville kid that got hit in the chest with a lacrosse ball." 

Grant Mays, a senior for Centerville, was just weeks away from graduating.

“He blocked the shot, scooped up the ball, probably ran 50 yards down the field,” Lindsey said. “As he is crossing midfield, you can start to see his legs are getting weak. His legs are getting kind of wobbly, and the next thing you know, he goes down.”

Lindsey ran onto the field with a student athletic trainer from the University of Cincinnati. He ran through his ABCs: airway, breathing, circulation.

“He appeared to be in a seizure-like state,” Lindsey said. “He was very clenched, and he was nonresponsive to any cues.”

So he did what he never had done in his 22 years as an athletic trainer, but practiced many times.

“That is the first time I’ve ever called for an AED,” he said. “You always have it with you. You always have it by your side.”

After one charge, Mays began breathing on his own.

“They always say, ‘Train for and expect the unexpected.’ But honestly, it never -- 15, 20 years into my practice, I never knew or thought it would happen to me or be presented where I had to take action,” Lindsey said.

Thanks to Lindsey’s quick actions, Mays celebrated his 21st birthday last summer.

Just like AEDs can save lives, experts say so can athletic trainers. Schools are not required to have an athletic trainer. However, coaches are required to have a permit for training in things like concussions and CPR.

OHSAA Commissioner Jerry Snodgrass said there are no requirements to have an athletic trainer present at regular-season events.

“We want our kids to be safe,” Snodgrass said. “We want everything to be safe, so most schools will make that conscious effort, but there can be no mandate that we have a trainer at a contest.”

The OHSAA says it doesn’t have the ability to force schools to add something that would cost the schools money: an unfunded mandate. It would take a government entity like state legislators or the Ohio DOE.

It wasn’t long ago that AEDs were not required by schools. But an Ohio law passed in 2004 helped shed light on their importance.

The law says a school “may require the placement of an automated external defibrillator (AED)” and that “all persons employed by a school district shall receive training in the use of an AED”

Snodgrass said, “I think it’s a standard of prevention. I think that’s necessary.”

Mike Gordon is the president of the Greater Cincinnati Athletic Trainers Association.

“AEDs are now a standard of care that if an athletic trainer or a medical site doesn’t have an AED, there’s a significant liability there,” Gordon said. “Shouldn’t athletic trainers also be the standard of care? Shouldn’t athletic trainers, having one on site or on a campus or at a sporting event, shouldn’t that be a standard of care? I believe so.”

So wouldn’t the OHSAA say a standard of prevention would also be an athletic trainer?

Snodgrass said, “It would be hard to. It would be hard to say anything different than that. I would agree.”