Correction: Grapevine High School provided data for its concussion assessments, which have to be verified by a physician as a concussion.

As medical revelations shine a spotlight on the lasting effects traumatic brain injuries have had on professional athletes, the University Interscholastic League is implementing new rules for all Texas coaches to help reduce the effects of student concussions.

The UIL is an organization that creates rules for and administers almost all athletic, music and academic contests for public schools in Texas. Through a collaboration of the UIL and the Texas High School Coaches Association, every Texas high school and junior high school football coach is now required to become certified in teaching tackling as a part of the official UIL Coaches Certification Program. This rule will be implemented in the 2018-19 school year. A UIL statement said the decision is part of an effort to provide best practices in tackling training for all football coaches and to keep athletes who play the game safer from head injuries.

This announcement comes ahead of summer sports camps for students in Carroll and Grapevine-Colleyville ISDs and ahead of a concussion summit Southlake will host in July.

“We’ve made a lot of strides over the past 10 years [with concussions],” said Dr. Damond Blueitt, medical director for the Texas Health Sports Medicine Concussion Center in Fort Worth. “… There’s so much more education.”

The three-day Concussion Health Summit in Southlake will focus on some of the newest data and research to help doctors and athletic trainers better treat concussions. Dr. Shane Miller, associate professor of orthopaedics and pediatrics with Texas Scottish Rite Hospital Sports Medicine Center, will be one of the speakers at the Southlake concussion summit, and he said more data surrounding concussions is continually being uncovered.

“The more we learn, the more we realize how little we know,” he said. “The brain is so complex, and every one of these injuries is different.”

Concussion procedures

In 2013 the Centers for Disease Control and Prevention reported that a leading cause of brain injury-related emergency department visits, hospitalizations, and deaths for children and teens is sports and recreational activities. Those accounted for an estimated 325,000 emergency room visits among children and teens in 2012.

In 2016 GCISD implemented a new system to report injuries, and in this year reported a total of 50 concussions. With this data, Robert Carlson, athletic trainer at Grapevine High School, noticed a trend of a decrease of football athlete concussion assessments. In 2016 the school reported 21 football-related concussion assessments, which decreased to 10 in 2017. Colleyville Heritage High School did not include specific sports for its concussion reports.

Carlson said he was not sure what led to the decrease but said the football program at the school district has a neck exercise program in place specifically to help reduce the risk
of concussion.

“It strengthens your neck, and the hope is that if you get hit in the head you don’t get as much movement­—you’re able to decelerate appropriately and not get knocked as much,” he said.

If a concussion does occur, Miller said a full recovery means the student is no longer having symptoms and can tolerate school and physical activity well. Concussion centers and school districts are also able to provide a baseline test, called an impact test, to distinguish if a brain is showing any abnormal activity.

In 2012 a Texas law was passed mandating each district to form a concussion oversight committee and implement return-to-play protocol, and the UIL designs the framework for return-to-play, said Dr. Kenneth Locker, one of the moderators for the concussion summit.

When a concussion protocol is in place for a student, he or she has to be cleared to return to the classroom by his or her physician, Carlson said. Once the student has returned to the classroom, he or she has to be able to tolerate increasingly longer days in the classroom for a full week. If the student is unable to tolerate being in the classroom at any point, he or she has to begin the following Monday from square one.

Once a student can be in classes for a full week, then he or she can be cleared for return-to-play of gradual levels of physical activity before returning to full participation.

Carlson said GCISD also performs its impact test on any student-athlete and to any other student who desires to have one done.

He said all coaches are required to have concussion training at least once every two years to be able to recognize concussions, and that the district works closely with a student’s physician when a concussion is sustained.

In 2016 Michelle Houran’s daughter Lindsey received a concussion during a club volleyball game. It took seven weeks for the then-sixth grader to recover. Houran said the Grapevine-Colleyville school district, where her daughter attends, worked well with her family to help
Lindsey recover.

“She would go to school and she would say that while she was in class she was fine, but when she was in the hallway and everybody was talking, it was loud and chaotic and it was just overwhelming,” Michelle Houran said. “… So the school let her out five minutes early to pack for her next class when the hallways were not full of people. They were totally accommodating and absolutely wonderful about that. They gave her whatever she needed.”

The Grapevine Parks and Recreation Department holds sports leagues for adults and children, and Deputy Director Chris Smith said the department uses the North Texas Football League, which monitors club sports in North Texas, concussion policy as its standard procedure if a brain injury
is suspected.

“The thing about youth sports is it’s a lot of parents out there coaching,” he said. “They don’t have a lot of this information, so it’s us trying to provide them information that will get them the best protocol they can have in place.”

He said the department has a partnership with Baylor Scott & White Sports Care to provide workshops and training for the coaches, and many times during a tournament or game, a Baylor Scott & White trainer will be on-site and can provide a medical assessment if needed.

Jenni Lanier, city of Southlake community relations manager, said if a player receives a head injury, the game is stopped and first aid is rendered. The parent and/or coach would then decide if the player should re-enter the game, she said.

As of press time, no one was available to discuss Carroll ISD’s concussion policies with Community Impact Newspaper.

Effects of a concussion

Blueitt said because nearly everyone is at risk of a concussion, the safest measure is to have a plan in place and to continue improving safety measures, such as the UIL’s recent policy for tackling certification for football coaches.

It is not just football taking a look at safest practices. Two years ago, the international soccer association FIFA implemented a no heading rule for children under the age of 10. In volleyball, Houran said she has seen more and more teams take steps to avoid having the players turn their backs on the fast-moving ball.

Symptoms of a concussion include dizziness, headaches, nausea, balance and vision problems. Miller said these are what doctors call nonspecific symptoms, and because so many things can cause a headache or cause a person to feel tired, these signs can be easy to miss.

“It’s very common for parents to come in and say that it took them several days to put the pieces of the puzzle together,” Miller said.

He said until more questions are answered about concussions, drastic measures should not be taken.

“There’s a lot of benefits to sports, so it concerns me when parents are taking their children completely out of sports because of concern,” Miller said. “Finding sports that are possible safer alternatives, or making sports safer is what I would recommend as opposed to not participating
in sports.”

Blueitt emphasized the best way to prevent a concussion is through proper education.

“The only primary way [to prevent concussions] is to not participate in sports, not having an automobile accident, not have a fall. You can’t prevent this stuff, but you can make sure you are doing the right things and you recognize the symptoms and seek medical attention immediately.”