GOSHEN — As the second phase of a new law dealing with concussions in high school sports takes effect today, local athletic administrators and coaches are adjusting to the new law’s changes in who is authorized to clear players to return to action.

The law requires coaches to document suspected concussions, and also mandates that school officials do more to inform parents about the dangers of concussions.

According to a fact sheet on the new law distributed by the Indiana Department of Education, athletic trainers can do an initial assessment of a player with a suspected concussion. But trainers are not recognized under the new law as a “licensed health care provider,” and thus are barred from clearing athletes to return from a concussion.

A “licensed health care provider” must meet three specific criteria under the new law:

• They must have a license given by a governmental agency that regulates a specific profession;

• They must be listed under the Indiana Code as a health care provider;

• They must have training in the evaluation and management of concussions and head injuries.

Goshen High School Athletic Director Larry Kissinger said he is in the process of communicating with his coaches on the new law and what it means for them.

But Kissinger said school officials have always had a stringent set of guidelines in place to deal with athletes with concussions.

It’s a three-step process, Kissinger said: A day is set up for an anthlete to come in and do some conditioning under supervision; they then proceed to light practices and drills, with no contact; and if all that goes well, they are gradually eased back into full participation.

“The safety of our student-athletes is always a top priority for us,” Kissinger said. “We’re always going to err on the side of safety.”



A valuable purpose

According to IU-Health Goshen neurologist Dr. Jody Neer, the new law will serve a valuable purpose.

Neer, a 1990 Goshen High School graduate and former Redskin football player, will be part of a working group at the high school helping to develop guidelines for implementing the new law’s mandates at Goshen.

“This law moves Indiana toward the head of the pack with regard to protecting young athletes, but we still have a long way to go,” Neer said.  

“There are considerable inconsistencies as to how injured players are evaluated and cleared following a head injury, more specifically concussions. The next step is to adopt one standard protocol which is clear to the players, families and coaches in order to avoid confusion and liability.”

Neer said the Goshen High School concussion team will strive to have that protocol in place at Goshen by the beginning of fall sports practices at the end of July. The first day of football practice is July 30.



A big adjustment

Kissinger said between now and the start of fall sports, he and the other members of the Goshen concussion working group will be trying to get some questions answered.

“We want to know what ‘cleared to return to play’ means specifically,” Kissinger said.

The new law may also have the unintended consequence of increasing health care expenses for student-athletes and their parents, Kissinger said: The kind of higher-level testing that comes with suspected concussions — and the new mandate to be even more vigilant in identifying them — will come with a cost that may not be covered under the supplemental sports insurance plans purchased by some parents.   

Kissinger expects to be answering questions about the new law at the fall sports meeting for Goshen student-athletes and parents, tentatively set for Aug. 9.

One of the Redskins’ two certified athletic trainers sees no ambiguity in the way the law treats her profession.

“If an athlete is thought to have suffered a concussion by an athletic trainer, a coach, an official or a doctor, they can’t return to action until they are cleared by a health care provider,” head trainer at Goshen High School Catherine Wohlford said.

According to IHSAA suggested guidelines for management of concussions, a health care provider is described as an Indiana licensed health care provider who has been trained in evaluation and management of concussions and head injuries, and includes a medical doctor or doctor of osteopathic medicine who holds an unlimited license to practice medicine in Indiana, but may also include any Indiana health care provider who is licensed by the state.

“I’m not sure why athletic trainers were excluded. We are certified and licensed by the state,” Wohlford said. “This has not happened at Goshen, but there may have been schools where a coach has put pressure on a trainer to release a kid. That should not happen anymore if a doctor has to clear them.

“I don’t think the law is going to change too many of the things we do at Goshen. We have already been working closely with doctors when it comes to a concussion or a head injury. In the past our process, depending on the severity of the concussion, an athlete would not be able to return until all of the symptoms of the concussion were gone. That includes things like headaches, nausea or memory problems. It was a minimum process of three days.”



Tools already in place

One of the tools Goshen and some other schools are already using is baseline testing.

“It’s a computer program that gives you an athlete’s reaction time, their memory ability and how their brain processes things,” Wohlford said. “Then if they do have a head injury we have something to measure them against.”

The upcoming fall sports season is a busy one for athletic trainers.

“We see an average of about two head injuries a week,” Wohlford said. “Statistics show the two worst sports are football and girls soccer.”

Despite the fact the law takes away the ability of athletic trainers to clear players returning from concussions, Wohlford feels the law has positive aspects.

“It’s good for awareness, but it makes it more difficult for an athlete to return since they have to see a doctor before returning,” she said. “That takes away some of our abilities as an athletic trainer.

“In the past concussions have probably been taken lightly. Over the five years I’ve been at Goshen things have gotten a lot better.”



Changing times

The old days of a football coach telling a player to tough it out after an injury, especially a concussion, are gone.

“It’s different from when I was growing up. Coaches would just tell players to get back out on the field,” Northridge High School football coach Jonathan Kirkton said. “You can’t do that anymore, especially with a concussion. Coaches are going to have be more aware and we are probably going to have to error on the side of caution.

“We’ve had a rule at Northridge that a player has to stay out a full seven days if they have a concussion. Our trainer Michelle Lamb has always done a good job of evaluating kids, but my understanding of the new rule is that she might not be able to make those decisions anymore. We may have to have a doctor on the sidelines.

“There are a lot of things that we don’t know yet. The rule given to us has about 80 pages. The state is the one pushing it. I don’t think it is going to change the way we coach. One thing we are probably going to have to do is watch kids leading with their head. It’s a natural tendency for a player to lead with his head and we may have to work with kids when we see it happening.”

Another area coach, meanwhile, sees the issue from several different perspectives.

“Any time you are dealing with something that affects players as coaches we have to put on our parent’s hat,” Concord football coach Tim Dawson said. “I’ve told our coaches when it comes to concussions were are going to look at it as if the player was our son. Parents want their sons to be safe. We are going to have to err on the side of safety.”

According to Dawson one of the keys to preventing concussions has to do with the helmet.

“Today’s helmets are phenomenal,” the coach said. “But they have to be inflated properly. Because of the new law you are going to see a lot more coaches checking helmets. I’ve joked with my coaches that I’m going to buy them air pumps to replace their whistles.

“Helmets are going to have to be checked before each game. The coaches are going to have to be responsible for that. Kids will not do it. You hand a helmet to a kid when practice begins in August and most will not think about checking it during the season. You can make a helmet too tight. The helmets of today are much better than the ones we used in the past, but it takes time to check them.”

Players will now be required to come to the sidelines if the player, a coach or an official suspects that player to have received a head injury. Dawson feels there could be some confusion between this and a rule that goes into effect this season by the National Federation of State High School Association.

The new rule states: high school football players must sit out one play if their helmet comes off while the ball is live.

“Under the new law a player that has a concussion can’t return to play until they have been cleared by a doctor,” Dawson said. “With the new Federation rule there may be some people who get confused if a player gets his helmet knocked off and has to come out for one play. Their first thought is probably going to be that player has a concussion. When he goes back in people might wonder why?”

Dawson has also been on the side of a parent when his son Tim played football at Concord.

“We’ve made progress in the area of concussions,” the coach said. “My son suffered a concussion in a game against Goshen and he went back in the game when he probably should not have.”



Officials in the spotlight

Kirkton feels the new law puts more pressure on officials.

“It’s going to put a lot of pressure on officials,” Kirkton said. “They are going to be required to send a player to the sidelines if they see a player take a hard hit and they think he might have a problem. Like the coaches there are probably have to error on the side of caution.

“There has already been an emphasis placed on the officials to make more calls for spearing. That is a hard call for officials to make at full speed.

“With everything that has been coming out about concussions the new law is probably a good thing. But with technology the way it is our sport may be threatened some day. Still I think it’s good people are being made aware of the problems concussions can cause.”

Concussions and other injuries have changed the way football practices are conducted, Kirkton said.

“We used to do a lot more hitting,” Kirkton said. “Now you have to pick and choose the times you hit. You can still accomplish a lot with players in helmets and shoulder pads, but to teach kids how to tackle you need to be in full pads. The coaches have to make the judgment as to when to use full contact in tackling drills.”