Archive for the ‘Concussion’ Category

12 Critical Steps to Protect Youth Football Players

A common-sense approach to reducing liability

1.  Buy high-limit, high-quality team/league insurance

 At a minimum, purchase the following policies to assure a funding source for player injuries:

  • Excess Accident: $100,000 medical limit; $5,000 AD&D limit, deductible no greater than $500
  • General Liability: $1,000,000 each occurrence limit; $1,000,000 participant liability limit; includes custom coverage enhancements for sex abuse/molestation and non-owned and hired auto liability and does not include exclusion for brain injury.

See our-endorsed AYF insurance program for an example of an affordable, high quality insurance program that almost any league can access.

2.  Train coaches in the fundamentals of tackle football

A comprehensive online training program is essential in educating coaches on the basic needs of youth and the fundamentals of tackle football.  It makes sense that the better programs that invest in comprehensive coach training will be more safety conscious. The Datalys study by Kerr draws the conclusion that comprehensive coach education combined with practice contact restrictions may help lower injury rates.

3.  Provide basic concussion education training for coaches 

All coaches should be required to complete a basic concussion education course every two years. Completion documents should be retained at the team/league/association level. The National Alliance for Youth Sports has an excellent basic education program available free of charge. I like the NAYS program better than the similar program offered by the CDC. I think it’s organized more intelligently. 

4.  Limit full contact at practices

Intelligently-designed practices have always emphasized non-contact drills and skill development over full contact. An analysis of the above-mentioned Datalys Study indicates that limitation of full contact at practice is perhaps the most effective way to reduce brain injury exposure in youth tackle football. Governing bodies suggest limiting of full-speed head-on tackling or blocking drills to a starting distance of three yards or less. In addition, full contact as defined by “thud” and “live action” should be limited to 60 or 90 minutes per week. 

5.  Follow the concussion protocols recommended by governing bodies and mandated by certain state legislatures that key in on the following elements:

  • Coach education on concussion basics and tackling techniques. 
  • Parent concussion education through CDC handouts.

 Written policies on procedures on how to:

  • identify suspected cases of concussions
  • mandatory removal from play if concussion is suspected
  • return-to-play protocols

See our Football/Cheer Brain Injury Risk Management Program for a sample brain injury risk management awareness program with links to important sources.

6.   Train coaches in Hawks tackling technique and instill a no-tolerance policy for bad hits

Governing bodies strongly recommend the Hawks tackling technique, which quietly replaced the awkward “heads up” technique originally endorsed by USA Football. See our Hawks Tackling Resource page for more information on the Hawks technique.

Instill a no-tolerance policy for illegal and head-first hits. Coaches should not look the other way when this occurs and should bench players to let them know this will not be tolerated.
Football helmets and concussions

7.  Proper fitting of helmets

Helmets should be fitted strictly according to the manufacturer’s instructions. A improperly fitted helmet will not provide the same protection as a properly fitted helmet. 

8.  Follow manufacturer specifications for maintaining and retiring helmets

Liability risk can be reduced by following manufacturer instructions regarding helmet modification, reconditioning, and replacement. Detailed information can be found under our AYF/AYC Sample Risk Management Program in the equipment section.

9.  Baseline neurocognitive and post-event testing

In the past, baseline and post-event neurocognitive testing was expensive and difficult to administer. It took about 30 minutes and required a classroom setting with PCs. A new entrant into the market, HitCheck, introduced affordable sideline testing, which can be completed on a smart phone or tablet in about 10 minutes.

10.  Implement mandatory heat illness protocols 

Heat illness is one of the leading killers of youth football players. It is preventable in most cases if coaches are properly educated and recommended guidelines are followed. 

11.  Implement sex abuse / molestation controls

Mandatory criminal background checks on all staff with access to youth is a critical requirement, but just a starting point. We provide educational resources on types of criminal background checks and background check vendors. However, it’s estimated that less than 10% of sexual predators have discoverable backgrounds. You need to ask yourself what you’re doing to protect your kids against the other 90%. We provide a comprehensive educational program on creating a hostile environment. It includes policies and procedures to make an incident less likely to occur and a requirement to notify law enforcement if an incident is suspected. 

12.  Document all of the above in writing with risk management awareness programs

Here are our most popular free risk management programs for youth tackle football and cheer: 

  • Concussion/Brain Injury Risk Management Program: This sample program incorporates the proven techniques to reduce brain injury exposure as well as common requirements by state legislatures.
  • Sample AYF/AYC Risk Management Program includes Sex Abuse/Molestation: This general risk management program keys in on reducing risk in terms of facilities, equipment, supervision, instruction, sports injury care, and use of autos. It also includes a section on sex abuse/molestation education and risk management.
  • Lightning 30/30 Safety Rule: This is possibly the most abused safety rule in sports. Administrators and officials must make the unpopular call to postpone and evacuate when the rule is triggered. 
  • Before You Sign the Facility Lease Agreement: Agreements with facility owners are subject to negotiation. Don’t let them impose heavy-handed requirements that make you and your insurance carrier responsible when they are negligent. Learn how to recognize pitfalls and tips for negotiation. 
  • Collecting Certificates of Insurance From VendorsAll vendors, including security, officials associations, janitorial, field maintenance, concessions, etc., expose your association to liability due to their negligence. Require them to carry their own insurance so yours does not take the hit when they are negligent.  
  • 12- and 15-Passenger VansDon’t use these types of vehicles to transport participants due to their tip-over propensity.

 If you have any questions about how to protect your youth football and cheer participants or how to get an instant insurance quote, please call us at 800-622-7370 or visit us at www.sadlersports.com/ayf.

New Device Shows Promise in Preventing Concussions

Unlike helmets, Q-Collar enhances brain’s existing protection from inside

At Sadler Sports and Recreation we keep our eye out for concussion-related news. We’re very careful to share well-researched information and not fan the flames of concussion hysteria. Our focus is reducing concussions during the course of play, not instilling fear of concussions.

That being said, I recently learned of an innovative product currently being tested as a concussion prevention device. Dr. Gregory Myer of the Cincinnati Children’s Hospital Division of Sports Medicine is conducting tests on the Q-Collar, which controls blood flow to the athlete’s head.

The Q-Collar approaches concussion prevention differently than helmets.  A helmet can help reduce the force of impact. However, it can’t keep the brain from moving around within the skull, which the Q-collar appears to do.

How it works

The c-shaped Q-Collar fits around the athlete’s neck, which exerts slight pressure on the jugular veins. These veins are the blood’s main pathway from the head back to the heart. The collar mildly increases blood volume in the cranium so the brain fits more snugly, reducing its ability to slosh about. In other words, the increased blood volume acts as an airbag for the brain.

The most recent test participants are high school football players and female soccer players. Earlier tests included high school hockey players. The study results show a potential approach to protecting the brain from changes sustained during participants’ competitive seasons, according to Myer. He is continuing his research  and data analyzation, but is optimistic that the device could be a game-changer in concussion prevention.


Source: Elise Jesse. “New ‘collar’ being tested in Cincinnati could prevent concussions.” www.wlwt.com. 17 Aug.2017.

2017 Insurance Program Released For American Youth Football

AYFThe gold standard that is the envy of the competition

The American Youth Football and American Youth Cheer endorsed insurance provider, Sadler Sports Insurance, has released the new 2017 insurance program for teams /associations /conferences.

Detailed 2017 coverage, rate information, and online enrollment are available now on our website!

Get Quote Now

The 2017 offering is, once again, the gold standard in youth football and cheer insurance with an unbeatable combination of low rates, broad custom coverages, and best-in-industry automation that allows instant online enrollment and issuance of proof of coverage documents and certificates for field owners. But that’s not all: the program also provides best-in-industry risk management resources to prevent injuries before they become claims and groundbreaking studies on safety in youth football and cheer.

Apply, pay, and print proof of coverage documents and certificates in as little as 10 minutes

Our advanced automation is so simple and fast that you can complete the entire insurance purchase transaction and print all your documents in as little as 10 minutes. Many competitors require the completion of forms and days of waiting just to get a quote. Then, once the quote is bound, it can take several days to get the proof of coverage documents and certificates for field owners. Or, they could charge $100 extra for next day rush delivery.

After the purchase, we provide our clients access to our website so that they can self-issue certificates for new field owners 24/7. It’s so easy and our clients love this benefit.

Beware of competing programs that seem too good to be true

We often hear stories about a competitor offering cut-rate policies with a per team rate that is too low to be believable. Whenever this happens, something ends up being defective with the offering, which illustrates that if something is too good to be true, it usually is. We’ve seen cases where the quoted price did not include the cost of both the Accident and General Liability policies, where the organization never reported the transaction to the insurance carrier and no insurance was in force, and where a big corporation was going to foot the bill for the insurance (dream on), etc. Just this year we found a competitor that was bragging about their great insurance program but had grossly misrepresented its limits and coverages to the public. We brought this to the attention of their insurance carrier and corrections were made. After a little bit of digging, these schemes fall apart.

What is being done to combat the risk of concussion/brain injury and related litigation?

Sadler Sports Insurance provides a sample Football/Cheer Concussion Awareness Risk Management Program (short form) that is strongly recommended for all teams/associations/conferences. This free program can be found under the risk management section of our AYF Insurance page. This program consolidates accepted risk management practices into a three-page document for easy board adoption and implementation. We recommend coaches complete the AYF coaching education program. Certification is required of head football and cheer coaches participating in AYF national championships. We also encourage coaches, volunteers and players view our Seahawks’ tackle resources page. which demonstrates their tackling methods. AYF has provided a certification test to take in conjunction with this video on myafy.com. It is important for all teams/association/conferences to thicken their shields by adopting and fully implementing a comprehensive concussion/brain injury risk management program. The future of our sports depends on this action and it’s the right thing to do to protect the kids.

Check Out Our New, Improved AYF Webpage And Video And Our 98% Staff Awesome Rating

Our AYF/AYC webpage has been totally redesigned for an enhanced user experience where our prospect and clients can access all of our services (ex: applying, renewing, issuing certificates, add/delete teams, claims, etc.) without ever having to speak to a staff member at Sadler. However, should you have a question or need assistance, you can contact our staff by email, chat, or phone. We are very proud that surveys indicate that our staff is graded as 98% “Awesome” by those who have contacted us.

Also, all the football and cheer specific risk management content and related blogs are now available directly from the webpage.

In addition, we created a new video that can be viewed individually or by a small group to explain how to access our insurance and risk management services.

Best-in-industry risk management resources (free)

We have an incredible line up of free risk management resources including articles, legal forms, risk management program templates for your easy adoption and customization, and training videos for administrators and staff. This includes the newly created document entitled Sample AYF/AYC Advanced Plan, which is a comprehensive risk management program customized for AYF/AYC organizations.

Be a part of groundbreaking injury studies

If you purchase your insurance through the endorsed insurance program, all Accident claims automatically become part of the database where our custom software analyzes the information to produce meaningful injury reports. This has led to groundbreaking studies on the comparison of injuries in age only vs age/weight categories and the incidence of concussions within AYF/AYC.

Get Quote Now

Please visit our webpage at www.sadlersports.com/ayf or call us at 800-622-7370 if you have any questions.

 

California Youth Sports Concussion Law Ramped Up

State aspires to greater concussion education and caution

A California youth sports concussion law that broadens the current return-to-play law went into effect January 1, 2017.

The previous return-to-play legislation only applied to scholastic sports, as is the case in many jurisdictions across the country. The new law applies to all youth sports organizations that are defined as camps, competitions or clubs in which participants are under the age of 18.

The changes involved

The additional law surrounding youth sports concussions and head injuries could result in significant changes in operations for many organizations. Specific stipulations in the law include:

  • Concussion and head injury information must be distributed to and signed by athletes and parents/guardians every year prior to play. The material must include information regarding head injuries, potential consequences of such injuries, concussion signs and symptoms, best practices for athlete removal from play upon suspicion of a concussion, and return to play.
  • Every organization’s coaches and administrators must be offered concussions/head injury education and/or materials every year. Education materials must include the same information as that distributed to parents and athletes.
  • Immediate removal of any athlete suspected of suffering a head injury. Athletes can only resume play upon submission of written clearance from a licensed healthcare professional trained in concussion management. Athletes diagnosed with a concussion or head injury will only resume participation on a gradual return-to-play protocol for no fewer than seven days under the supervision of a licensed healthcare provider.
  • Parents/guardians of athletes suspected of suffering a head injury or concussion must be notified of the date/time the injury occurred, the symptoms displayed and the treatment received.
  • Youth sports organizations must identify the procedures that were adopted or adapted to comply with the new law.

Liability fallout

The new law could spark interesting legal scenarios:

  • The new higher standards of care and increased obligations could be the basis for an injured athlete suing for negligence.  An organization’s procedures and implementation will have to comply fully with the law’s requirements to meet the duty of care owed under the law of negligence.
  • Any youth sports organization that doesn’t provide the mandated information and education to athletes, parents and coaches prior to play will likely have more difficulty in relying on assumption of risk defense and waiver/release for protection.
  • The youth sports organization’s obligation to to provide greater education for and oversight of all coaches means they will have a duty of general supervision to make sure that coaches receive the proper training and make the right decisions.
  • Sports equipment manufacturers and distributors may be able to avoid liability based on an alleged equipment defect if they can show the sports organization failed to comply with the law.

New California Law Likely To Be Adopted By Other States

It’s likely that California’s broader concussion law will spur similar changes in other states. All 50 states and the District of Columbia already have concussion laws on the books, and there is both a need and demand for more comprehensive concussion education efforts for coaches, players and parents – particularly in the areas of removing suspected injured players from play and returning injured players.

The CDC’s National Center for Injury Prevention and Control offers sports organizations resources on complying with the law. We invite you to peruse our extensive library of articles on concussions and brain injuries on our blog and check out our free concussion risk management material.


Source: Anne Marie Ellis and Paul A. Alarcon. “New California Law Will Change Youth Sports Concussion Cases.” www.lexicology.com. 23 March, 2017.

Refuting Reports of Increased Concussion Rates in Youth Sports

Looking at the facts

Reckless reporting and alarmist headlines about rising concussion rates in youth sports are a pet peeve of mine. Parents, athletes, coaches and league administrators deserve to have the facts presented responsibly on such a serious topic.

The headline on a recent article by a doctor screamed “Concussion rates are rising among U.S. youth.” What the doctor didn’t say in the article is that concussion rates are NOT rising; concussion reporting is rising.

Our internal Accident insurance claim statistics reveal the following increases in the reporting of concussion claims as a percentage of total claims reported:

Sport

Youth baseball

Youth football

Concussion rates prior to 2012

2.96%

7.89%

Concussion rates 2012-16

8.01%

15.88%

The significant increases in concussion claims reported over these time periods have nothing to do with change in the risk factors in these two sports over this time period. These increases have everything to do with educational awareness.

We have concussion education efforts and concussion laws on the books in all 50 states and the District of Columbia to thank for that. These efforts have brought about a heightened awareness of concussion recognition, initial diagnosis and treatment, and return to play monitoring. The increase in the number of reported concussions only reflects how many youth athletes were walking around with undiagnosed concussions in the past.

Promoting educational awareness and risk management

Over a year ago, I wrote about the need for increased efforts in concussion education, stating, “Fear of concussion among many parents is affecting their decision to permit their children to participate in contact sports.” And nearly two years ago, I said in an article addressing the media’s concussion hype,  “The best outcome is the awareness being brought to the general puConcussion risk managementblic about diagnosis, second-impact syndrome, removal, and return-to-play policies.“

I’m pleased to see that all this awareness resulting in more athletes getting the medical care necessary, which enables them to return to playing after treatment and full recovery. The Center for Disease Control’s HEADS UP offers many resources to help parents, coaches, administrators, and healthcare providers recognize, respond to, and minimize the risk of concussions or other serious brain injuries.

We’re proud to continually provide up-to-date and credible information on sports concussions and a variety of sports injury and risk management-related topics on our blog.


Source: Brad C. Gollinger. “Concussion rates are rising among U.S. youth.” www.recordonline.com. 07 Mar., 2017.

Youth Athletes and Concussion Recovery

Too many parents following outdated medical advice

Starve a cold, feed a fever. Swimming within 30 minutes of eating causes cramps. Cracking your knuckles causes arthritis. Tilt the head back to stop a nosebleed. All outdated but once heavily relied upon advice from the medical community. Sadly, these and similarly unsubstantiated notions continue to circulate. And apparently so are incorrect ideas about concussion recovery.

Despite ongoing media attention and education efforts surrounding concussions, research shows that many parents still rely on outdated advice when monitoring their concussed children. Where once the impact of concussions was downplayed, apparently now parents are going to the opposite extreme and impeding recovery.

A national survey conducted by UCLA Health asked 569 parents how they would care for a child with concussion symptoms that persisted a week following the head injury. More than 75% said they would wake their child to check on them throughout the night and 84% said they would not permit the child to participate in any physical activity. About 65% said they prohibit use of electronic devices.

Making a healthy recovery

Frequent disruption or lack of sleep can affect memory, moods and energy levels, which are exactly what doctors use to measure concussion recovery. Once the child has been examined by a medical professional and determined to be at no further risk, sleep will help the brain recover more quickly, according to Christopher Giza, a UCLA paediatric neurologist.

And while contact sports are to be avoided until the child is fully recovered and cleared by a medical professional, mild exercise and aerobic activities such as walking and bike riding promote the healing process and overall good health.

As for electronic devices, it’s a good idea to keep kids off them during the early days of the injury. But easing them into their normal social, intellectual and physical activity is what’s best.

Most concussion patients make a full recovery, though dizziness and headaches can persist for weeks. Parents should always heed the advice of the physician monitoring the child and remember that rest and pain relievers for headaches are the best treatments in most cases.


Source: “Parents following outdated concussion tips,” www.sbs.com.au. 08 Sept. 2016.

Heads Up Football’s False Concussion Claims Exposed by New York Times

A recent article in the New York Times entitled “N.F.L.-Backed Youth Program Says It Reduced Concussions. The Data Disagrees” has exposed USA Football / Heads Up Football for publicizing misleading data and conclusions about the findings in the Datalys study. In their blogs, USAFB crowed about the effectiveness of the Heads Up Football program in reducing concussions; however, the actual data from the study do not support this.

Sadler Sports Insurance realized that misleading statements were being made several months ago after an independent review of the Datalys Study and mentioned this in our blog entitled AYF Study: 2005-15 Concussion Trends in Youth Tackle Football. We are in favor of getting the head out of the tackle, but have serious concerns about any program that publishes misleading conclusions in its blogs, especially when making the claim that their program is the standard in youth tackle football.

USAFB hired Datalys to study effectiveness of HUF and  practice contact restrictions

USAB hired and funded Datalys Center, an independent research firm specializing in sports injury research and prevention, to study player safety in youth football on a national level. They did so in an effort to promote safer playing standards and lessen injury risk, including concussions. Datalys completed a study in 2014 entitled Comprehensive Coach Education and Practice Contact Restriction Guidelines Result in Lower Injury Rates in Youth American Football.  The study compared overall injury rates, lost time injury rates, and concussion rates between three groups:

  1. Heads Up Football Leagues with Practice Restrictions (Combined HUF | Practice restriction)
  2. Heads Up Football Leagues without Practice Restrictions (HUF Only)
  3. Non Heads Up Football Leagues (Non HUF)

The study has been widely cited by USAFB and the NFL as evidence that Heads Up Football  leagues have significantly fewer injuries and fewer concussions than Non HUF leagues.

The unstated reason for the study was to prove that the HUF Only group significantly reduced concussion rates vs the Non HUF group.

It’s my opinion that the primary reason for the study was to find out if the HUF initiative reduces concussion rates in youth tackle football. Youth tackle football is under attack by the media and various researchers and activists, not because there are too many overall injuries, but instead because there are too many concussions and subconcussive impacts.

However, the statistics generated from the study were not favorable for the HUF Only leagues as regards to reduction of concussion rates. The concussion rates for the Non HUF leagues were actually a little lower than the HUF Only group, as will be explained.

USAFB made misleading claims about Datalys study

In various online publications such as its blog, USAFB made the following statement as regards the Datalys study (but recently taken down):

“Compared to non-Heads Up Football leagues, leagues that adopted Heads Up Football had a 34 percent reduction in concussions in practices and a 29 percent reduction of concussions in games.”

To the extent this statement appears to compare HUF Only leagues vs. Non HUF leagues, this is just not true according to Table 2 in the 2014 Datalys study.

What the math really says about concussion rates in HUF Only leagues vs Non HUF leagues

Table 2 of the Datalys study indicated the following about concussion rates in Combined HUF | Practice restriction leagues vs. HUF Only leagues vs. Non HUF leagues:

 

Practice concussion rate

Game concussion rate

Combined HUF|Practice restriction

.19

 

.68

HUF Only

.65

 

1.50

Non HUF

.58

 

1.46

Concussion rate is the rate per 1000 “athlete-exposures,” defined as one athlete’s participation in one practice or one competition.

It’s clear that the concussion rates are actually slightly greater for the HUF Only leagues as compared to the Non HUF leagues in both practices and in games, although these slight differences were statistically insignificant.

Practice restrictions drove the reduction in concussion rates in the study

The Combined HUF | Practice Restriction Group produced significantly lower concussion rates as compared to both the HUF Only leagues and the Non HUF leagues. Why is this the case? Is it the combined synergistic effect of HUF + practice restrictions or is it primarily due to practice restrictions?

The researchers lamented not having a group of leagues to study that consisted of leagues with practice restrictions, but not HUF. That is the only true way to isolate the practice restriction variable. Regardless, instituting HUF without practice restrictions did not reduce concussions.

Was a new group formed after the fact to rescue HUF?

It is possible that the misleading statistics referenced in the USAFB blogs differ from the Datalys study due to an attempt to rehabilitate the poor HUF Only performance?  A new group may have been formed, called “Leagues that implemented Heads Up Football,” consisting of all leagues that used HUF, regardless of whether or not they also used practice restrictions. Data from this new group is consistent with the statistics that were referenced in the USAFB blogs, which USAFB has since taken down. Because the injury rates were much lower in HUF leagues that used practice restrictions, the Datalys report separated out these groups to show the difference, whereas the USAFB blogs may have combined these groups to hide these differences. The statistics that were created in the blogs were misleading because they implied that HUF was the driving force behind lower injury rates and don’t give the practice restrictions the proper credit.

Our conclusions and what this means for brain injury / concussion risk management

We still believe that removing the head from the tackle is an important element of a youth tackle football brain injury / concussion risk management program.  However, it is clearly not the primary solution as touted by USAFB and the NFL. USAFB has hurt its credibility with this misleading marketing campaign.

AYF Study: 2005-15 Concussion Trends in Youth Tackle Football

Provides perspective for impact of education, getting head out of tackle, and practice restrictions

The latest American Youth Football (AYF) study on concussion trends reveals that education of administrators, coaches, parents, and players is having a positive impact on the identification of and more aggressive response to concussions. On the other hand, popular initiatives to remove the head from the tackle and practice contact restrictions may have a more limited role than portrayed by various groups due to the high percentage of concussions that would not be impacted by these measures. Nevertheless, these initiatives are important components of a broad based brain injury/concussion risk management program.

Updated statistics based on Accident insurance claims for 2005-15 seasons

AYF is the largest youth football organization in the U.S. and represents a wide cross section of players aged five to 15.  The data in this study is based on Accident insurance claims filed with the endorsed AYF insurance program through Sadler Sports & Recreation Insurance. An injury questionnaire consisting of some 20 questions is completed by the authorized team official as a part of the claims filing process and the answers are input into a database. A variety of reports can be produced to drill down to answer specific questions about concussions. The study includes 3,855 injuries reported from 2005 through 2015 of which 434 are concussions. This study is a representative sample of concussion trends occurring not only in AYF, but in youth tackle football as a whole.

Concussions as a percentage of total injuries

What this tells us about the positive impact of concussion education

201514.48%
201416.18%
201316.41%
201215.99%
201111.55%
20107.73%
20098.20%
20086.36%
20075.88%
20063.80%
20056.72%
Total All Years11.26%

Notice the spike in concussions reported in 2011 and continuing through 2015. This coincides with the media reports of the NFL class action lawsuit, other concussion related lawsuits, autopsies indicating CTE in deceased pro football players, and anecdotal stories of disabled pro athletes. This also coincides with the beginning of widespread and heavily publicized educational efforts on behalf of the Center for Disease Control and various football-sanctioning and governing bodies on concussion recognition, removal-from-play, medical response, and return-to-play protocols.

It appears that the media attention and educational efforts to train administrators, coaches, parents, and players are having a positive impact in that concussions are taken more seriously and reported more frequently than in past years. Suspected concussions are resulting in increased rates of emergency room and doctor office visits, and diagnosed concussions are resulting in more follow up care as pertains to return-to-play protocols. Overall, Accident insurance carriers are experiencing increased claims payouts for concussion care.

Concussion by situation (physical cause at point of contact)

What this tells us about initiatives to remove the head from the tackle and to limit contact at practice

Tackled by player23%
Contact with ground23%
Collision with opponent18%
Tackling player7%
Blocked by player7%
Collision with teammate6%
Blocking player5%
Other3%
Total100%

The initiative to take the head out of contact as detailed by the Seahawks Tackling video or Heads Up Football (HUF) is very important, but not the magic silver bullet to solve the concussion problem in youth tackle football.

For argument’s sake, assuming that the initiative to remove the head from the tackle is 100% effective in reducing concussions (Datalys study by Kerr on HUF refutes this – see paragraph below), this would result in a reduction of concussions by 30% (sum of tackled by player 23% plus tackling player 7%). If heads-up blocking is added to this equation, that would result in a total reduction of 42% (add blocked by player 7% plus blocking player 5%). The other 58% of concussion claims that occur due to contact with ground, collision with opponent, collision with teammate, and other would not be touched by this initiative.

The above analysis assumes that HUF is 100% effective in reducing concussion claims arising from tackling and blocking. To the contrary, the Datalys study by Kerr in Table 2 indicates that HUF-only leagues have slightly higher concussion rates that non-HUF leagues. Let’s hope that future concussion studies with more participants reach a different conclusion.

On the other hand, the initiative to limit contact at practice would likely have a larger impact in reducing concussions among more categories of physical causes of loss, including contact with ground, collision with opponent, and collision with teammate.

Concussion by activity being performed

 

Tackling33%
Running with ball30%
Blocking15%
Running w/out ball6%
Shedding blocker5%
Passing3%
Catching ball2%
Recovering fumble1%
Other5%
Total100%

Concussion by event type (practice or game)

What this tells us about initiatives to remove the head from the tackle and to limit contact at practice

Practice32%
Game65%
Other3%
Total100%

Since most concussions occur during games and not practices, the initiative to limit contact at practice would only impact those 32% of concussions that occur during practice. With regard to the initiative to remove the head from the tackle, it’s easier to get the head out of the tackle in controlled practice drills as opposed to live action during games, and as a result, its effectiveness should be expected to be diminished as well.

Concussion by position played

 

Running back20%
Linebacker16%
Defensive line16%
Quarterback10%
Offensive line8%
Secondary7%
Receiver4%
Practice drills4%
Kickoff returner2%
Kickoff blocker2%
Kickoff tackler2%
Punt tackler1%
Punt return blocker1%
Other7%
Total100%

 

Concussion by type of play from perspective of injured participant

 

Offense42%
Defense42%
Receiving kickoff4%
Other practice3%
Kicking off2%
Punting1%
Kicking field goal/extra point1%
Other5%
Total100%

The kickoff accounts for 6% of total concussion injuries: 4% when receiving kickoffs plus 2% when kicking off. That statistic does not seem to be out of proportion with the total percentage of plays in a typical game that are kickoffs. Pop Warner recently banned kickoffs for ages 10 and under starting with the 2016 season due to perceived risks.  Based on our statistics, banning kickoffs would not appear to reduce concussion rates.

Concussion and absence from play

 

2011-20152005-2010
1 to 3 Weeks44%46%
3+ Weeks27%15%
1 to 7 Days11%18%
None2%7%
Unknown/Not Answered16%15%
Total100%100%

The period from 2011 to 2015 shows increased absence from play, i.e. later return-to-play times, presumably due to following suggested return-to-play protocols. The 3+ weeks category shows a significant increase with significant decreases in the “1 to 7 Days” and “None” categories. This is further evidence that increased educational initiatives are having a positive impact on concussion treatment.

Concussion and weight of injured player compared to other players

 

About-average weight78%
Below-average weight10%
Above-average weight6%
Significantly below-average weight1%
Significantly above-average weight1%
Other4%
Total100%

It appears that players of below-average weight are only slightly more susceptible to concussions than players in the other weight categories. Players classified as significantly below-average weight have the same percentage of concussions as players of significantly-above average weight.

Conclusions about concussions from the study of Accident insurance claims

The higher rates of concussion reporting and more aggressive medical care and return-to-play protocols seem to validate that concussion education is having a positive impact. Initiatives to get the head out of the tackle and to limit contact at practice, while not game changers in themselves, are important components of a broad based concussion/brain injury risk management program as they have the potential to reduce a significant percentage of concussions and subconcussive impacts. Our statistics indicate that practice restrictions may play a larger role than removing the head from the tackle. Additional studies with more participants are required before firm conclusions can be drawn on these concussion reducing initiatives.

The Truth About Concussion Risk Management in Youth Football

How to Plan a Youth Football Brain Injury Risk Management Program

Local associations must adopt and implement a concussion/brain injury management program to battle looming liability crisis.

For the past three years, Sadler Sports & Recreation Insurance has been urging our youth tackle football clients to implement comprehensive brain injury risk management programs to help to prevent injuries and resulting lawsuits from becoming insurance claims. In the event that a lawsuit is filed by an injured participant, whether from a single concussion, multiple concussions, or cumulative traumatic encephalopathy (CTE), it is crucial for a local association to show that it has complied with the national standard of care for brain injury protection. Doing so not only protects the players against injuries and the association and staff against lawsuits, but also protects the General Liability insurance carrier, which makes it more likely that brain injury coverage will be available in the future.

Standard of care owed is determined by state legislation, case law, sanctioning and governing bodies, risk management resources, and expert witnesses

In a negligence-based lawsuit, the claimant filing the lawsuit must prove that a duty was owed, the duty was breached, and that the breach was the cause of the damages. The duty that is owed is also known as the standard of care. The standard of care to protect against brain injury for youth football players will be determined by state legislation, case law, sanctioning and governing bodies, risk management resources, and expert witnesses.

Depending on the source, some standards are mandated and others are recommended or are just guidelines. However, understand that the claimant’s attorney will argue that even recommended standards and guidelines should be implemented by a reasonable and prudent youth football association.

9 Elements of a solid written risk management program for youth football associations

The following elements should be considered by local tackle football associations when developing their concussion/brain injury risk management program.

  1. Written program

A written risk management program should be adopted by board action and communicated to all administrators, staff, players, and parents. A written program that builds in accountability is much more likely to be implemented than a program that is not in writing.

  1. Educational awareness through online training and information handouts

Coaches should receive training and certification in both 1) concussion basics for youth sports through the CDC Concussion Training CourseNAYS Concussion Training Course, or a similar online course, and 2) a tackle training program on how to remove the head from the tackle such as through Seahawks Tackling.

Players and Parents should receive and be required to sign off and return to the association a concussion fact sheet handout from the CDC or a similar source at the beginning of every season.

  1. Document retention

The local association should maintain documentation of coach training certificates and player/parent fact sheets for 15 years. Note that a 5-year-old child may wait until age 20 in many states before filing a lawsuit for a past injury.

  1. Baseline and post injury neurocognitive testing

This is a rapidly changing area with the emergence of new, lower-cost technologies where baseline and post-injury testing can be delivered on the sidelines through smart phones and tablets. So far, baseline neurocognitive testing is considered to be a voluntary measure in most instances.

  1. Identify suspected cases of concussions

The highest medical authority (M.D., D.O.,  athletic trainer, or person with EMT or Red Cross certification) at a practice or game should make the call in terms of signs observed by parents, guardians, or sports staff and symptoms reported by player. The highest authority must be aware of danger signs that would result in an immediate trip to the emergency room and in questions to ask and exertional maneuvers to perform to identify a potential concussion. Identification of potential concussions is a rapidly evolving area with a number of new tools that have recently hit the market or that will soon be available, such as helmet impact indicators, smart phone/tablet apps for sideline testing of memory and fine motor coordination to compare to baseline results, tablet eye-tracking devices, telemedicine with doctors via smart phones, etc.

  1. Actions to take if a concussion is suspected

Remove the athlete from play, make sure the athlete is evaluated by an M.D. or D.O., inform parents through the CDC fact sheet, and keep the athlete out of play until written return-to-play medical clearance is received from a qualified medical provider. Some state concussion laws allow return-to-play medical clearance by a “health care provider” which may also encompass professionals such as physicians’ assistants and nurse practitioners.

  1. Reduce full contact during practices

The Datalys Study by Kerr indicates that limiting contact at practice may reduce concussions in youth tackle football. Governing and sanctioning bodies have started to adopt contact limitation guidelines.

  1. Proper fitting and care of helmets

This has always been and continues to be of critical importance in protecting youth football players from head and neck injuries. A number of online guides and videos are available from helmet manufacturers to assist coaches and equipment managers in this area. A list of these sources can be found on the risk management section of our website.

  1. Compliance with state concussion laws and governing body and sanctioning body requirements or recommendations

Any risk management program should comply with the standards as prescribed by state concussion legislation (this only applies to schools in some states) and governing body (USAFB) and sanctioning body (AYF, Pop Warner) requirements and recommendations.

Based on my 30 years of experience in the sports insurance niche and the potential for brain injury litigation, I would not want to be a board member or staff member involved with a youth tackle football organization that did not have an effective, formally-adopted and fully-implemented written concussion/brain injury risk management program.

Sadler Sports & Recreation Insurance has developed a sample concussion/brain injury risk management program for our youth football clients that incorporates the elements listed above and that can be downloaded from our website in WORD document format.

Fear of Concussions in Youth Sports

More effort in awareness and education needed

The anxiety level among Americans regarding concussions was found to be quite high according to a recent online survey. The University of Pittsburgh Medical Center conducted the survey among 2012 Americans over the age of 18. The results highlight the myths and misunderstanding about concussions.

Nearly 90% of those surveyed consider concussions to be a moderate to severe health concern. Nearly one-third of parents said they fear their child will suffer a concussion, and 25% do not allow their children to play contact sports because they fear they’ll suffer a concussion.

Ironically, 26% of the parents surveyed did not seek medical treatment when someone in their family suffered a concussion. Worse, 81% of those surveyed said they would not know the steps to take in treating a concussion if they sustained one.

More statistics from the survey:

  • 87% did not know the definition of a concussion, and 37% admit to being confused as to what a concussion actually is.
  • 58% could not identify headache or dizziness as immediate symptoms of a concussion.
  • Only 34% understand that fatigue is also a symptom and just 13% know that mood changes can also be the result of a concussion.
  • 79% of adults incorrectly think concussions are incurable and that the symptoms can only be managed.

Decreasing the level of fear

Fear of concussion among many parents is affecting their decision to permit their children to participate in contact sports. While there has been much progress in educating coaches, trainers, parents and players about concussion risk management and treatment, there’s much work to be done.

Sports are a healthy physical and social activity for children and teens, and fear of injury should not prevent them from participating. Concussions are treatable and when properly managed, athletes can return to play. “With careful evaluation and treatment by a well-trained specialist, even the most complex injuries are manageable,” says Erin Reynolds, fellowship director of UPMC Sports Medicine Concussion Program.

Click here for the full survey results. We have more articles on concussions on our blog and offer free concussion risk management material in our risk management library.


Source: Susan Manko, “Are American Parents Too Afraid of Concussions?” futurity.org. 05 Oct, 2015.