For the past several years, the topic of sports concussions has had front-row seating in the national media. From coverage about the pending NFL lawsuit to startling new evidence linking early-age concussions to diseases such as ALS and Parkinson’s, it seems every day we are faced with another statistic in the news. The response across the country has been a gradual, state-by-state adoption of concussion policy primarily focused on secondary school athletics, in most cases mandating “return to play” protocol. Concussion education and training for coaches at the youth level has become fairly commonplace with national youth sports organizations such as USA Hockey and U.S. Lacrosse, but the dissemination of information and policy mandates from park and recreation agencies has been slow to gain traction at the community level.
Since park and recreation agencies often support youth sports activities differently across the country, there may be some disagreement about who follows through with implementation of training or policy. In some agency models, there may be full-time staff and administrative support, collection of fees, and oversight of leagues, coaches and volunteers, but on the other end of the spectrum, agencies may have parent-run boards that assume total responsibility for youth sports. In general, however, there is usually at least a philosophical level of endorsement and collaboration from the park and recreation agency to support the ideology of health and wellness and use of public facilities to that end. And whether it is through partnership with sports leagues or the creation of policies that mandate concussion training, concussion education should be one of the standard best practice models applied in all agencies.
Through the work of people like Chris Nowinski and Dr. Robert Cantu of the Sports Legacy Institute and researchers Dr. Ann McKee and Dr. Robert Stern of Boston University Medical School, the importance of concussion detection and treatment has transcended the world of pro sports and become the hot topic at the dinner table as well. But while there are a lot of people talking about concussions, do they really think it’s important as it pertains to their life, their kids and their activities? Are parents of athletes equipped with the information to make the appropriate decisions if faced with a concussed child? Should park and recreation agencies be in the business of providing concussion education and training? Given the wealth of knowledge and information available, there is a very significant and important role that park and recreation agencies can have as leaders in expanding the campaign to educate families and communities about sports- and recreation-related concussions.
Educating parents when their children are young can play a vital role in the campaign for concussion awareness. Teaching parents early on when their children are involved in youth recreational sports allows for maximum exposure about the risk of concussion during play. Awareness of the risk then becomes standard practice as children get older and more competitive. “Making concussion education a routine requirement for youth sports players, parents and coaches in the park and recreation setting can accomplish a great deal,” says Dr. Neal McGrath, a nationally recognized neuropsychologist and the clinical director and founder of Sports Concussion New England. “Though the incidence of concussions in youth sports is fortunately not as great as in high school because younger athletes are smaller and slower, it is invaluable for children to have a foundation of concussion awareness from an earlier age for their own safety. Park and recreation programs have the opportunity to begin the concussion education process for younger athletes as a routine part of their sports participation. That education therefore begins at an earlier point for their parents as well.”
In addition to providing education and training for coaches at the recreational level, it is important for park and recreation agencies to address the need for broad-based community awareness as well. Although youth sports concussions are generally associated with high-impact sports such as football and hockey, the statistics tell a different story. Third only to bicycling and football, concussions on public playgrounds are a little-known but common occurrence. Between 2001 and 2007, there were 16,706 reported emergency department visits for nonfatal traumatic brain injuries occurring on playgrounds in the United States.
Creating and implementing policy can be a straightforward, simple process. In Brookline, Massachusetts, a three-pronged approach to concussion education has been implemented, including promoting a marketing campaign called “Heads Up Brookline” and a service offering free baseline concussion screening to all student athletes in the community. Last spring, the agency created a concussion policy mandating Centers for Disease Control (CDC) training for all sideline coaches and volunteers of organizations seeking facility permits. To receive a field or facility permit, the sports organization must verify that all coaches have completed the 20-minute online concussion training course offered by the CDC. The agency had very little debate on the implementation of the mandate and reports a 100 percent compliance record. Taking an approach similar to the roll out of “zero tolerance” and “code of conduct” policies, a concussion policy review committee was formed with youth sports organization representatives, which ensured buy-in from stakeholders from creation to implementation and compliance.
Al Davis, president of the Brookline Youth Soccer Organization, says, “It was such an easy thing to implement — we just tied receiving the annual coaching card renewal to taking the easy and quick online training. With a few gentle reminders, we achieved 100 percent compliance.” When asked how the education and training affected the organization’s process, he said, “It was a sense of relief, actually. Assessing an injury and pulling a player who doesn’t want to come off is the most difficult thing there is for a coach. By clearly setting parameters and training coaches, they now have the tool set to act decisively. I had a coach thank me last week because a kid suffered a concussion, and he knew exactly what to do.”
As promoters of health, wellness and physical fitness, and as the gatekeepers of the public space accessed for that purpose, there is an inherent responsibility for park and recreation agencies to provide information and resources to the public to deal with the issue of concussion prevention, assessment and treatment. “We depend on our recreation department for field permits and authorization to play in our town. They set the standard for licensing, and we complied. Simple. Everybody wins,” says Davis. There is an abundance of both resources and information available to create and implement policy and provide education to communities. By capitalizing on that knowledge base, park and recreation agencies have the ability to become leaders in expanding education and awareness about one of the most important and compelling health issues of our time.
Lisa Paradis is the Director of Recreation in Brookline, Massachusetts.