SPORTS SCIENCE (Quality Work, No Plagarism, A++)

74 Kappan March 2016

JulIe undeRWood (Julie. [email protected]) is a professor at the University of Wisconsin-Madison.

head or an indirect blow to the body . . . . Symptoms usually reflect a functional disturbance to the brain, and may include physical (e.g. headaches, nau- sea), cognitive (e.g. difficulty with concentration or memory), emotional (e.g. irritability, sad- ness), and ‘maintenance’ (e.g. sleep disturbances, changes in appetite or energy levels) symptoms. A concussion is con- sidered a brain injury. (www. concussiontreatment.com)

Concussions in youth sports are common, and the statistics are a bit surprising. Accord- ing to the Centers for Disease Control and Prevention:

• 33% of all sports con- cussions happen during practice, not competi- tion;

• 46% of all sports con- cussions occur during high school football;

• 20% of all high school athletes will sustain a concussion during a sea- son; and

• In soccer, the concus- sion rate for girls is 68% higher than for boys.

The reporting of concus- sions during high school sporting activity has increased dramatically. According to the National High School Sports- Related Injury Surveillance Study, in 2005, concussions represented 9.1% of reported injuries; in 2013, they repre- sented 23.1% of the injuries. During this timeframe, many

As states make new laws on sports-related head injuries, districts and schools must adapt and operate new protocols.

Sports-caused brain injuries have garnered quite a lot of public attention lately. Have you seen the Will Smith movie Concussion? In 2015, a federal judge approved a class-action settlement between the NFL and thousands of former play- ers regarding chronic traumat- ic encephalopathy, In Re NFL Players Concussion Injury Litiga- tion, 307 F.R.D. 351 (E.D. Pa. 2015). University of Wiscon- sin’s Chris Borland gave up his $3 million NFL contract with the San Francisco 49ers due to his concern about the potential for concussion brain damage. Reports of concussions caused during professional athletic play are common. But con- cussions can and do happen elsewhere — in everyday life and in school athletics.

The Sports Concussion In- stitute defines concussion as:

A complex pathophysiological process that affects the brain, typically induced by trauma to the brain. It can be caused either by a direct blow to the

protective requirements than others. (See National Confer- ence of State Legislatures, Traumatic Brain Injury Leg- islation, http://www.ncsl.org/ research/health/traumatic- brain-injury-legislation.aspx)

Unfortunately many of these statutes, like the first two, are named after in- jured children. Most statutes require school districts, state departments of education, local school districts, and/ or the state interscholastic athletic association to develop guidelines and protocols for recognizing sports-related concussions and returning young athletes safely back to sporting activities. Statutory requirements vary but most typically require:

• Educating coaches, par- ents, and athletes about concussions, symptoms, causes, and effects;

• Removing youth ath- letes from the playing field immediately when a concussion is sus- pected;

• Returning an athlete to play or practice only af- ter at least a 24-hour re- covery and after receiv- ing permission from a health care professional; and

• Ensuring that parents and the youth athletes have provided clear in- formed consent to play.

states, schools, and sports leagues created policies and response protocols on con- cussions in youth and high school sports, which may have increased the number of reports. See the report: http:// bit.ly/1VPPbfC

The first law

In 2009, the state of Wash- ington passed the Zackery Lystedt Law, the first law concerning concussions in K-12 schools (2009 Wa. ALS 475). The Lystedt law requires medical clearance of youth athletes suspected of sustaining a concussion before send- ing them back in the game, practice, or training. The law was named for Zackery, who was permanently disabled after sustaining a head injury while playing football at age 13. He was returned to play 15 min- utes after the first injury and sustained a second head injury. As a result of these successive concussions, he was in and out of a coma for three months, with years of disability and treatment ahead.

Shortly after this, Oregon passed Max’s Law (OAR 581- 022-0421), which requires school districts to imple- ment concussion manage- ment guidelines for student athletes. Now all states and the District of Columbia have statutes, usually referred to as return-to-play laws, regard- ing youth sports concus- sions. Some states have more

U N D E R T H E L AW

Schools should heed concerns over sports’ brain injuries

By JULIE UNDERWOOD

V97 N6 kappanmagazine.org 75 Photo: Thinkstock/iStock

on the federal front

Congress has considered — both in the Senate and House — measures similar to what states already have passed that would require local schools to create and implement formal concussion management plans, notify parents, and re- quire written medical releases before student athletes are returned to play or compete after suffering a concussion.

This issue has played out in litigation involving school- age athletes as well. When students (and parents) file a personal injury claim against a public school district, they most often run afoul of the state’s immunity to civil ac- tion. They can prevail if they show that the state created the danger through which they were injured, showing:

1. The harm caused was reasonably foreseeable;

2. The state actor acted with a degree of culpability that shocks the conscience;

3. The state actor and the plaintiff had a special protective relationship; and

4. The harm was caused through an affirmative act of the plaintiff, not merely a failure to act.

Two examples

On Nov. 1, 2014, Sheldon Mann was at his high school football team’s practice when he was hit on the head. He told the coaching staff he did not feel well. They sent him

back out to continue practice, did not perform a concussion assessment, did not send him to the trainer, and did not notify his parents of the injury. Later on, during the same practice, he was hit again on the head. This time, he exhibited physi- cal symptoms of a brain injury. From that time on, he suf- fered serious and permanent effects of brain injury, including headaches, hallucinations, poor short-term memory, seizure activity, and brain dysfunction. The district did not have clear policies on protecting a student athlete from injuries, nor did it have a return-to-play policy. In litigation against the coach and the district, the court allowed the case to go forward in spite of a motion to dismiss, finding that the alleged facts did state a possible claim of action against both the coach and the district. Mann v. Palmerton Area School District, 33 F.Supp.3d 530 (M.D. Pa 2014).

On Aug. 20, 2012, M.U. was playing in a preseason high school soccer scrimmage. During the game, she jumped to head the ball and collided with another player, causing a blow to her head. One of her teammates told her coach that she had been hit in the head, but the coach did not pull her from the game. M.U. played the remainder of the game, ex- perienced other collisions, and headed the ball in other plays. She developed a headache on the bus ride after the game. Two days later, her mother took her to the hospital where doctors confirmed a brain injury. M.U. continued to have anxiety, difficulty concentrat- ing, memory loss, and head- aches. She missed more than 80 days of school that academ- ic year due to her symptoms. In litigation against the coach and the district, the court

dismissed the case finding that the alleged facts did not state a possible claim of action. M.U. v. Downingtown High School, 2015 U.S. Dist. LEXIS 54765 (E.D. Pa. 2015).

The differences

The difference in the two cases is that the court in M.U. found that the coach’s and district’s actions were not so severe as to “shock the conscience.” The M.U. court considered the claims in light of the Pennsylvania Safety in Youth Sports Act and still found there were no affirma- tive steps taken by the coach and district; they failed to act but did not affirmatively take steps that caused M.U. ’s injuries. In Mann, the coach observed physical symptoms of

a possible brain injury and still affirmatively sent the athlete back into play. In M.U., the coach failed to remove the student from play but did not return the student to play in

spite of observing symptoms of a possible brain injury. The difference between an affirma- tive step and failure to act may appear slight, but it is critical.

Considering the possibility of severe injury to students, districts and employees should carefully reconsider their policies and practices on children’s accidental brain injury. Consistent with the return-to-play requirements in the statutes, when an injury occurs that may have caused brain trauma, schools should exercise caution. K

The reporting of concussions during high school sporting activity has increased dramatically.

Copyright of Phi Delta Kappan is the property of Sage Publications, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.