Author: Katherine Snedaker

Baseline testing your players is very important for all youth sports teams for players over the age of 11. Even the impartial CDC is now on board and has printed an education flyer for teams to use to support of baseline testing for all youth athletes. But at the same time, there is also new emphasis on training all coaches with concussion awareness and sideline management of possible head injuries. While teams who fall under their state concussion laws must follow certain requirements, most non-school, volunteer-run teams have choice and most cannot accomplish both in one season. As the Concussion Advisor for our State Lacrosse League for the last few years, I have often asked which one should a team focus on first. After working in this field for several years, testing kids as a coach and as part of a concussion clinic, I have a clear answer based on my experience.

Always spend your time, money and effort on Coaches Training first.  Baseline testing is important; however, it is a second step after coach, player and parent education. Here is why…

While baseline testing is valuable, I have seen teams use testing to address concussions in their sport in place of educating coaches, parents and players. Ideally both testing and education should be put in place at the same time. As a concussion social worker and a former youth coach, I started out of my personal frustration when I keep receiving the same type of phone calls from upset parents who had ImPACT tested their kids. The following is a true story and is not unique at all. I can pick really any sport – boys or girls’ teams – and recount a similar story.

A hockey team signed up for ImPACT testing instead of both testing and concussion education for their coaches. Like most leagues, this team did not think they had the time for their coaches to be trained and so they only offered ImPACT testing to their players. A fraction of the players who signed up for testing were kids who already had already had a concussion.  Their parents already knew about value of ImPACT testing with their experience with ImPACT in the past. Despite growing awareness in sports about concussion, I have found that parents who have not had any previous concussion education tend to not sign up their kids for testing if testing is offered as optional by the team.

So the hockey season started and a few games into the season, a boy took a hard hit to his head as he was slammed into the boards. Coming off the ice, the hockey player told his coach that he had no headache, but his vision was so blurry so he could not read the numbers on the back of the other players’ jerseys. The coach who had no concussion training thought the kid was joking and so sent this player back into the game. The coach did not know blurry vision was a sign of a concussion and that any player with a hard hit to the head should sit out for 24 hours, even with no immediate sign of a headache. The player also did not know this was a sign of a possible concussion.

After two minutes of skating without any additional hits, this player collapsed on to the ice and hit his head again. At this point, his worried parents rushed down the stands to their son now unconscious on the ice. The parents had doubts after their son’s first hit, but trusted the coach to make the “right call.”

While having an baseline ImPACT test helped this player’s doctors after the injury, training for this coach could have prevented the second blow to this player’s head and may have reduced the long recovery this player might suffer to heal from this concussion. But everyone thought they had done the best they could – The youth hockey player took his ImPACT test, his parents felt reassured they had protected their son, and the team felt confident they had taken steps towards a safer season, but the key piece education for coaches, parents and players was missing. What if the coach had known the signs? Or the player himself said, “Coach, I think I have the signs of a concussion?” Or the parents had insisted on speaking to their son after such a hard hit and knew to pull him when he complained of blurry vision?

I receive several calls a month from families with very similar stories. I hear regret from parents over and over when they wish they had checked on their child after a blow to the head, but they trusted the coach to make a call.  Being a coach for a number of years, I do appreciate when parents let me do my job; however, when it comes to head injuries, I use my cellphone and call the parents to the bench to see their child, and make them an active part of the process. If I believe a child should not return play, I do not let a parent talk me out of my decision. But a parent has doubts about a child who I think could return to the game, I go with the parents’ gut and remove the child from play.

A player with a second blow to the head in a game or practice risks longer recovery times and in very rare cases, even death. I am afraid that in “only offering ImPACT testing,” sports teams are feeling secure that they have addressed the safe issues around concussions. Coaches’ training is put off until next year. Since the management in these sports teams haven’t been educated why the coaches and parents and players all need concussion education, they are missed the point of protecting the kids before a second injury. With simple, quick educational programs, coaches can remove players from play as soon as there is a suspected head injury, players can raise their hands and say, “take me out,” and parents can feel confident when to say, “you are done for the day.”

With education for coaches, parents and youth athletes, it is easy to live by CDC’s motto is ”When in doubt, sit it out. Better to miss one game than a whole season.”

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