For two seasons, three Purdue professors tracked every practice and game hit sustained by 21 football players at Lafayette Jefferson High School in Indiana. "That's when we started to see that about half of the kids had some level of easily measurable neurophysiological change without any concussion whatsoever," says Purdue's Eric Nauman.
"What we think is probably happening is that since these kids don't have any symptoms, nobody ever takes them out of the game or makes them sit. They probably keep racking up more and more hits, and it tends to affect more and more of the brain."
Nauman and his colleagues are looking for funding so they can study soccer players, wrestlers and participants in activities that aren't usually thought of as dangerous. "Anecdotally, the cheerleaders at Purdue had almost as many concussions as the football players," Nauman says.
Florida is one of the few states to balk at concussion legislation for youth athletes, a nationwide trend that started in 2009 when Washington gave a thumbs-up to the Zackery Lystedt Law. A prototype for dozens to come, that legislation requires that any athlete younger than 18 who suffers a suspected concussion receive written consent from a medical professional before returning to play. (There is no similar federal law.)
In Texas, Natasha's Law, named after a soccer player who suffered brain damage, was signed by Gov. Rick Perry in June after the Senate passed the bill by a 31-0 margin. And, beginning Jan. 1, 2012, Colorado's Jake Snakenberg Act will take the Lystedt Law one step further by requiring every coach in youth athletics to complete an online concussion-recognition course.
Florida, however, recoiled from its own version of concussion safety because state Sen. Dennis Jones (R-Seminole), a chiropractor, was miffed that the language did not include the back-cracking set among "medical professionals." Jones' view is that, "As chiropractors, we've been treating head injuries since 1931. The symptoms of a concussion are not that difficult to diagnose."
California's concussion legislation has been in the works for the past two years but, due to financial constraints, has not made it out of committee.
As more and more states enact concussion laws, medical professionals, athletic trainers and school administrators are wondering if these laws actually will help prevent a condition that's inherently difficult to detect.
St. Louis University's head athletic trainer, Anthony Breitbach, says the concussion law in Missouri "comes up a little short because a lot of these symptoms are subtle and can be easily concealed by the athlete if he or she wants to play."
Additionally, Breitbach estimates that since only half of the state's schools can afford to employ an athletic trainer (which follows a nationwide trend), a lot of concussions will continue to go undiagnosed, even with the new law in place.
In Arizona, on the strength of Gov. Jan Brewer's signature on House Bill 1521, the Mayo Clinic is offering free, online-based concussion tests to more than 100,000 high school athletes.
In June, the Mayo Clinic issued a press release stating that the Arizona Interscholastic Association had endorsed the baseline test, which was not true; that caused an AIA attorney to threaten legal action. The two since have made up and are partnering to test all Arizona contact athletes during the 2011-12 school year, starting with football.
Steve Hogen, athletic director of Mesa Public Schools, had concerns with Arizona's law even before it passed. "It put the burden on us that we had to make sure that all Pop Warner football kids were tested," Hogen says. "That's impossible. What if an out-of-state group had come in and they didn't have this concussion testing? We wouldn't have had the resources to check."
Because a legal precedent has yet to be established on these new laws, attorneys are divided on how potential lawsuits will play out in a courtroom.
Steven Pachman is a Philadelphia-based lawyer who has advised numerous academic institutions and athletic entities about concussion litigation. Though Pachman declined to comment about specific clients, a records search shows that he defended La Salle University in a lawsuit filed by the family of a former player. Preston Plevretes claimed that he had suffered severe brain damage because the school's nurse and a team trainer inserted him back into play too soon following a concussion. (La Salle settled out of court for $7.5 million.)
Pachman explains that he receives a call each week from advice-seeking youth and high school sports organizations, and "what I'm hearing from the defense perspective frightens me." He says sports organizations say they don't have a plan and that "an athletic trainer is too expensive."
Randall Scarlett of the San Francisco–based Scarlett Law Group admits it's a "dismal state out there in terms of concussion protocols that coaches and others are to follow." However, Scarlett doesn't think there will be a deluge of lawsuits if and when the state's bill is approved.
"In California, you're not going to get litigation unless you get some pretty egregious facts, because of the burden of proof and the lack of standards for non-physicians," he says.
Before concussion laws came into vogue, the mother of Illinois high school football player Demond Hunt Jr. took her son's coach and the local school district to task in a lawsuit.
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