Professional and Youth Leagues Update Concussion Policies

 Editor

April 21, 2011- 

As data reveal the seriousness of concussions and the potential for long-term effects, both professional and youth sports organizations are addressing the issue in various ways, all designed to enhance player safety. 

Having the benefit of team physicians and certified athletic trainers, professional teams are far better equipped to deal with concussions than youth teams.  While struggling to maintain membership, purchase equipment and secure volunteers, most youth sports organizations are without medical care beyond a trained coach or interested parent.

Youth athletes, particularly those involved in clubs and private non-school organizations, benefit from state legislation if their leagues do not have a concussion policy.  Some comprehensive state laws encompass all youth athletes under a certain age (usually 19) and close the gap between concussion recommendations put forth by the Centers for Disease Control and Prevention (CDC) and the National Federation of State High School Associations, and non-profit organizations that may not have a concussion policy.

Professional league information appeared in USA Today, April 13, 2011.

An overview:

Football

Pro/NFL:

Instituted in 2007, the NFL's first concussion policy stated that a player could not return to a game or practice if he lost consciousness. The list of symptoms indicative of concussion has expanded to include amnesia, dizziness, loss of balance, and more.  Current recommendations as of the 2009 season prohibit a player from returning to activity until he is fully asymptomatic at rest and after exertion, passes a neurological examination, a neuropsychological evaluation, and has been cleared by a team physician as well as an independent neurological consultant.  Baseline testing began in 2008 and fines for illegal hits to the head were levied starting in 2010.

Youth/USA Football:

According to USA Football there are about three million youth athletes playing organized tackle football in the U.S., 1.14 million being high school students.  The organization has been very active in concussion education for several years and has incorporated concussion awareness into coaching education courses and seminars that have reached more than 70,000 youth football coaches since 2010.   USA Football urges every youth football league to adopt the USA Football football concussion awareness plan.  Produced in conjunction with the CDC, the "Put Pride Aside for Player Safety" video and management initiative focuses on removing any player who is suspected of having sustained a concussion from play, and not allowing any athlete to return to play without written medical authorization.  Additional information can be found at usafootball.com.

Pop Warner Little Scholars, Inc.:

With 425,000 members ages 5-16, Pop Warner, part of USA Football, is the largest and oldest youth football, cheerleading, and dance organization in the world.  Their newly adopted concussion policy requires any athlete suspected of having sustained a concussion be removed from play and not allowed to return to activity without written medical authorization.  

Pop Warner league concussion policy 9/30/2010

Baseball

Pro/MLB

Major League Baseball's first concussion policy was implemented in 2007 and updated March 29, 2011.  Immediately after a suspected injury, a player is evaluated on the field by a certified athletic trainer.  A 7-day disabled-list (DL) was recently implemented, designed for concussed players who have recovered before the traditional 15-day DL designation.  A team physician as well as the medical director at the commissioner's office must clear players.  Baseline testing is now mandatory for players and umpires during Spring Training.

Youth/USA Baseball

USA Baseball governs more than 12 million amateur baseball players across the country.  The Medical/Safety Advisory Committee outlines the recommended course of action for treating a player suspected of having sustained a concussion as supplied by the Centers for Disease Control and Prevention (CDC) and provides information on the medically-designed graduated return-to-play protocol.  In December 2010 the USA Baseball Bat Advisory Committee was formed and new guidelines were issued for NCAA and high school sports regarding the composition regulations for bats.  These new bat rules are designed to decrease the speed of the ball after it is hit, thereby increasing the safety of pitchers and others.

Soccer

Pro/MLS

Major League Soccer's first concussion policy was implemented in 2011 and requires players be evaluated by the team's medical staff, who has the authority to return the athlete to play.  A neuropsychologist conducts post-concussion evaluations.  Baseline testing has been used within the league since 2003.  A committee including players, team trainers, doctors and representatives from both the league and players’ union will work on implementing the measures. Among them: Every club will have an independent neuropsychologist available to assist team doctors and trainers; more comprehensive testing methods; closer monitoring of concussed players returning to action; enhanced education including presentations to clubs and referees; notices and posters at club facilities; and multi-lingual initiatives.

Youth/US Youth Soccer

US Youth Soccer adopted a concussion policy at its recent board meeting in Phoenix, Arizona in March 2011. The policy follows the CDC’s “Heads up” concussion guidelines that have now been adopted by 16 youth sports organizations in the USA.

US Youth Soccer is the largest youth sports organization in the United States with more than 3 million players, and thus realized that the impact they have is far reaching. They are committed to the education of players, coaches, administrators, referees, and parents as well as others.

The number of concussions that occur in youth soccer, at all levels of play, was a critical factor in addressing and adopting the standards on concussions throughout its 55 state associations.  US Youth Soccer has joined the National Coalition on Youth Sports Concussions organization.  The league believes that concussions are a major health issue and progress must be made in its prevention, recognition, and response.

US Youth Soccer now commits to educate and mobilize its members at the national and state levels about the dangers of concussions in youth soccer, and will advocate for sports concussions laws in every state that does not have a substantive law in place.

Washington Youth Soccer

Doug Andreassen, President of Washington Youth Soccer, is a co-author of the Lystedt Law, Washington state's concussion law.  As such, he has been a prominent advocate for the adoption of concussion policies within WA Youth Soccer and nationally.  WA Youth Soccer is a leader in youth soccer concussion management as a result of Mr. Andreassen's efforts.  WA Youth Soccer concussion compliance information

Hockey

Pro/NHL

The National Hockey League was the first professional sports organization to implement a concussion policy, which has been in place since 1997,  the same year the league first utilized baseline testing.  The current policy was updated in March 2011 and requires a team physician to perform a 15-minute neuropsychological evaluation on a player in a quiet setting to determine if the athlete has suffered a concussion.  A team doctor is able to clear the athlete after a week (minimum) if he is asymptomatic during a graduated return-to-play protocol and passes a neuropsychological exam.

Youth/USA Hockey

The USA Hockey Annual Congress will vote in June 2011 on clarification of head-contact rules and rule changes regarding increasing the age at which body checking is allowed.  A Canadian study found a 50percent decrease in injuries, including concussions, for pee wee age players who are not allowed to check.  USA Hockey has also modified the 2011-2012 annual coaching certification program to include additional information on concussion safety and prevention.   A concussion resource page is available at USA Hockey.    The organization has more than more than 585,000 members.

Basketball

Pro/NBA

The National Basketball Association currently does not have a concussion policy.

Youth Basketball

Concussion policies for youth basketball are determined on an individual team basis.

Cheerleading

The American Association of Cheerleading Coaches and Administrators was founded in 1987 to address cheerleading safety rules and coaches education. The AACCA has over 15,000 members from youth cheerleading through the college level and works with the NFHS, NCAA and the US All Star Federation. The association convened an expert panel in early 2010 to address cheerleading concussions and provide a standard protocol including a cheerleading-specific return to play guide.  For more information visit AACCA Concussion Policies