Missouri considers youth concussion legislation

Tuesday, February 9, 2010 | 6:21 p.m. CST

JEFFERSON CITY — Young Missouri athletes who suffer concussions would not be allowed to return to practice or games without written medical clearance under legislation proposed in the state House.

Growing attention about the long-term risks of concussions for professional athletes has Missouri lawmakers joining those in at least a half-dozen states seeking to require the benching of injured younger players, for whom the dangers of a concussion are even greater.

Missouri's measure — aimed at high school athletes — would require players be kept out of practices and games until cleared by a licensed health care worker trained in evaluating and managing concussions. The Missouri State High School Activities Association also would be required to provide athletes and their families with information about concussions and head injuries.

A House health care committee was to consider concussion legislation Tuesday evening.

The measure is modeled after a Washington state law that applies to all youth sports. Washington's policy is named after teenager Zackery Lystedt, who suffered a debilitating brain injury in 2006 when he returned to a football game shortly after suffering a concussion.

Professional teams are paying more attention to concussions. The National Football League has implemented stricter return-to-play rules, and the National Hockey League is considering restrictions on hits to the head.

Stan Herring is a physician for the Seattle Seahawks and Mariners professional teams who assisted in passing Washington's law after treating Lystedt. He said media attention has made people more aware of concussions.

"How many times did you watch Tim Tebow get concussed?" Herring said. "That kind of exposure has raised everyone's awareness."

The Brain Injury Association of America estimates 1.6 to 3.8 million sports- and recreation-related concussions occur in the U.S. each year.

Concussions in young athletes generally take longer to heal than in adults. Teens or children who return to competition while still recovering from a concussion risk an even greater second injury, which can lead to serious disability or death.

Tom Martin, president of the Brain Injury Association of Missouri, said athletes and their families now recognize the seriousness of a brain injury. But there is pressure on athletes to downplay symptoms, he said.

"It is difficult for the person who had the injury to look at it unbiasedly, and for coaches, their goal is to win games, so it's difficult for them," said Martin, director of neuropsychology at MU.

The Missouri State High School Activities Association says players should not return the same day they suffer a concussion. The association also recommends athletes with three concussions in one season be benched for the rest of the season and kept out until after a thorough exam. Also, players who lose consciousness cannot return the same day as the injury without written medical permission.

"A win is nice," said Fred Binggeli, an assistant executive director for the association, which governs high school sports statewide, "but why take a chance on rushing them back?"

Binggeli said the medical community and schools must work together to develop policies to protect young athletes.

In Washington state, Herring said most coaches and athletic directors he has spoken with are relieved they no longer have to decide when an injured player returns. The mandatory benching requirement there has no penalty for violators, but he said most have erred toward keeping athletes out when there is doubt.

"Return-to-play after a concussion is a medical decision and simply stating that legally makes it so," Herring said. "It allows the coach to be relieved of that burden. It allows the athletic director to be relieved. It doesn't allow a parent who might be overly zealous to put their son or daughter back too quickly."

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