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Heading off concussions
August 08, 2012, 01:00 AM Julio Lara, Daily Journal Staff
As the national spotlight shines with greater fervor on head injuries in sports, California legislation will require all high school coaches to receive training in concussions that could affect the way local schools handle this type of injury.

On Monday, Assembly Bill 1452 passed through the state assembly 65-0 on its way to the Gov. Jerry Brown’s desk.

The bill would require high school coaches to receive training every two years on recognizing the signs of concussions and responding to them appropriately.

"If you’re an athletic coach, especially at this level, it is not only a job, it’s a responsibility of you and it should be a mandate to be so safety conscious,” said Phillip De Rosa, head girls’ soccer coach at Burlingame High School. "You have to remember, we’re dealing with kids. Parents entrust the kids to us and we want to make we have all the knowledge that we possibly can to keep those kids safe.”

"I’m not surprised,” said Steve Sell, head football coach at Aragon. "I think history shows, once something like this gets proposed, it becomes law faster than anything. Nobody is going to oppose it. Right now, it’s a hot issue.”

Hot indeed, especially after a study published in the Journal of Athletic Training found that the two highest rates of concussions in high schools in the United States per 100,000 player games or practices occur in football (47) and girls soccer (36).

The California Interscholastic Federation has bylaws in place to deal with concussions.

On May 7, 2010, the State CIF Federated Council passed Bylaw 313 that requires a signed medical release before a student-athlete who is suspected to have sustained a concussion can return to play.

The bylaw states: "A student-athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time for the remainder of the day. A student-athlete who has been removed from play may not return to play until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and receives written clearance to return to play from that health care provider.”

Currently, the CIF bylaws do not require a high school coach to have formal education on concussions. The CIF says schools should ensure that all coaches (paid or volunteer) are educated in the nature and risk of concussion or head injury prior to the first practice and/or competition. The education shall include signs and symptoms of concussion and/or brain injury.

There are those medical professionals that believe that preventative and proactive measures should go a step further.

"I think that’s great,” said Jo Silken, the former head athletic trainer at Skyline College for 33 years, and current trainer for the Pac-West, a subdivision of the Pac-12. "Of course as an athletic trainer, and if you talk to others in my profession, they’ll tell you the same thing. While we think that’s a good step to take, we would prefer that they hire an athletic trainer at every school that is going to access the athletes and not leave it up to coaches.”

The proposed California legislation would require coaches to take a two-hour online course. Silken believes that simply isn’t enough. Currently, a voluntary 20-minute course exists on the CIF website.

"A lot of times, there’s just one thing wrong with the athlete and it might be something that you can visually see is wrong with them,” Silken said. "The reality is, most schools have a nurse there during the day, when the risk of serious injury is far less than when sports are going on. So, why would you provide care for P.E. class injuries and daytime injuries with a nurse and not provide any care after school?”

Schools like Burlingame’s have a head trainer who is very visible and accesible throughout the athletic year.

"It’s extremely helpful to have him at our games,” De Rosa said of Matt Smith, Burlingame’s athletic trainer. "We’re so involved with coaching in the games, sometimes we don’t see those things. And it’s peace of mind knowing I have a trained professional going out there to deal with this injury. It just takes a lot of pressure out of coaching.”

"The athletic trainers, we work with [sports medicine doctors] all the time. We’re doing the same medical tests they’re doing, and that’s the thing,” Silken said. "These athletes need to be monitored and re-tested every day and coaches just don’t have time to do that.”

According to Sell, the San Mateo Unified High School District recently allocated funds for every school in their district to hire a part-time athletic trainer (20 hours a week). On top of that, the education all high school coaches would receive might help the actual athletes be more careful with their bodies, especially when dealing with something as serious as a head injury.

"I think generally the awareness is up,” Sell said. "I think the referees are more in tune, coaches are more in tune, parents are more in tune, the players are more in tune. The question is: is it going to successfully change behavior? Maybe. If it helps one kid, it’s worth it.”

"Now, given all that’s going on, concussions are at the forefront of all sports, especially at the youth level,” De Rosa said. "Having said that, we educate the kids on it and will continue to do so. If you have an injury, if you feel like you’ve banged your head, we need to made aware of it. There’s a certain responsibility on their part.

"Anytime a teacher, a coach, has additional training, becomes more cognizant and aware of injuries, how to deal with them, how to be aware of symptoms, that is extremely important.”

Brown, after receiving AB 1451, will have 12 days to decide whether to sign or veto it. If he does neither, the measure would become law automatically and take effect next January.

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