As high school athletes start practicing again, coaches are drilling them on the basics.
Football and soccer players are the most likely to be injured, so they’re being taught how to recognize signs of concussions.
New laws in New Hampshire and Vermont require teams to get medical opinions about when it’s safe for players with head injuries to return to the game.
The sun is blazing on the Hanover High School running track as football players run in formation, chanting about "causing physical harm." The lyrics are a reminder that it’s pretty hard to play a contact sport without risking injury. So Hanover High School Athletic Director Mike Jackson is looking into ways to improve the schools’ response to sports-related concussions.
Until now, Jackson says, it’s been hard for a layperson to tell when a head injury is serious enough to take a player off the field.
"But in general I’m feeling better," he says. "Not great yet because the training is still in need in all the schools and all the coaches and that kind of thing. But the high school coaches in New Hampshire now are required to take that course and that’s certainly better than when we had no training."
Actually, New Hampshire’s new concussion law, which took effect August 17, encourages but doesn’t mandate specific training.
It does say that athletes with a suspected concussion must be removed from play immediately, and cannot return to play without clearance from a medical care provider.
Vermont has a similar law. Doctor Kristine Karlson monitors injuries for Hanover High and other schools. While the definition of "medical provider" may be a little vague, Doctor Karlson says the real value of this law is that it’s raising awareness.
"The folks who really didn’t think that a concussion was a big deal are realizing that it’s a big deal. And that’s coming down from the pros," she says.
Karlson gives talks about concussion to parents at workshops hosted by Dartmouth-Hitchcock Medical Center in Lebanon. Their teenagers can take baseline cognition tests that would help diagnose a concussion, if necessary.
For Peter Murdza, whose fifteen-year-old son Robby plays soccer, the test is a practical precaution.
"You hear in the last two or three years all about the effects of concussions on NFL football players and NHL hockey players. And they can really do damage. So it’s important that we know about these things, both me and Robby," Murdza says, as his son goes into another room to take the test.
With other kids, he answers online brain teaser questions that test short term memory.
If they should get a possible concussion, those results, compiled by a company called ImPACT, will be compared to post-injury testing, and analyzed, most likely, by a Dartmouth-Hitchcock neuropsychologist named Art Maerlender. He advises parents and coaches how long to keep the students out of sport
"The problem is when a brain is recovering from a concussion, if it gets hit again there are potentially lethal-it’s rare – but there can be lethal consequences. But it also makes the brain take a lot longer to heal and makes things worse and makes it easier to get hit again. And there is evidence that the more concussions you get the worse it is," Maerlender says.
While mild concussions may not even present symptoms right away, doctors caution that serious red flags-like dilated pupils, seizures or changes in mental status-should trigger a trip to the hospital.