Strengthening Concussion Safeguard Through Community Education

A young athlete is knocked to the ground. The spectators let out an audible gasp. The referee jogs over to the scene while the coach holds their breath. But then, the athlete pauses and slowly staggers to their feet -- the crowd goes wild!

This is a shared memory for many high school athletes, regardless of whether they are caught in a powerful tackle during the homecoming football game or struck in the head by a ball during the championship soccer match. Those few seconds may not last in the spectators’ memory, but they can be life-changing for the athletes, especially if they have suffered a concussion. As we approach major sporting events such as the National Football League’s Super Bowl LVI in early February of 2022, I think back to head injury protocols in my home state of California. While the California state government has established policies for identifying and treating sports-related concussions, the reality is that the diagnosis and recovery journey is still convoluted for many young athletes. However, implementing community education programs at the individual school level is a crucial component of navigating the concussion epidemic.

Specifically, a concussion is a form of traumatic brain injury that occurs when a person experiences a bump, blow, or jolt to the head. Youth often experience concussions during high-impact sports due to falling, colliding with other players, or crashing with obstacles. The Centers for Disease Control (CDC) estimates that approximately five to ten percent of youth athletes experience a concussion each season; football, hockey, soccer, basketball, and cheerleading athletes are especially at risk. Symptoms of concussion include nausea, balance issues, dizziness, headaches, visual disturbances, and fatigue. During the intense adrenaline rush of a game, however, athletes may not realize they have experienced a concussion and continue to play on. In other cases, athletes may avoid reporting symptoms for fear of letting their team or coach down, losing out on playing time, or believing the injury is not serious enough for medical attention. According to a study published in the Journal of Athletic Training, this has led to high school athletes underreporting concussions in up to 55 percent of incidences.

Many individuals carry the mainstream “shake-it-off” attitude when it comes to concussions, but this is harmful to young athletes’ perception of the condition. In addition to causing short-term memory, sleep, mood, and concentration issues, delayed concussion diagnosis can pose risks for developing serious conditions such as depression and dementia. Considering the teenage years are a critical period for brain development, it is important to strengthen concussion safeguards in the present to ensure athletes’ brain health in the long run.

On a broader level, California has the second-highest number of high school athletes (800,000 individuals) in the United States, yet regional disparities play a large role. Access to trained sports medicine professionals is an equity issue, considering schools in more rural, lower-income communities are less likely to have the funding bandwidth for hiring additional staff. In a 2019 study, approximately 55 percent of 1,270 sampled California high schools reported having no athletic trainers present at practices or games.

While this gap is alarming, community education programs can open up ways for coaches, peers, and other school members to support athletes at risk of concussion. Partnerships with local hospital networks can catalyze building more accessible online training, allowing individuals to understand the signs of concussion. This is especially important in cases where the athlete is unable to self-report a potential concussion due to personal or social pressures. The launch of the Dignity Health Concussion Network in 2016 is a prime example of a community-centered movement within California that is bolstering concussion support for youth at five Bay Area high schools, impacting thousands of athletes.

Building a school-wide concussion management plan is another essential component that involves bringing administrators, teachers, and parents into the conversation. For instance, Saratoga High School and Menlo School implemented protocols that outline clear next steps for community members, ensuring no one is caught off guard. Additionally, easily understandable infographics such as those released by the Brain Injury Association of America can quickly be referenced during athletic activities on the spot. During this process, one hurdle community members face is the fear of missing important signs or inaccurately reporting suspicions, which could negatively affect athletes’ performance. It can certainly be intimidating to make a confident judgment, especially if an individual is not a trained healthcare professional. However, taking the initial steps in the concussion management plan outweighs the costs by ensuring that young athletes can receive adequate, time-sensitive support. In turn, having a strong community support network can encourage young athletes to feel more confident in voicing concerns about symptoms.

The time for concussion awareness is now -- as a community, we are the key in bridging the gap between state-wide policies and school concussion protocols at the ground level. Recognizing concussions among high school athletes allows us to promote brain health now and into the future.