Mo. considers requiring medical clearance for young athletes to return after concussions

Mo. mulls bill restricting youths with concussions

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

Growing attention to 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 concussion dangers 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. Athletes and their families also would need to be provided information about concussions and head injuries.

Sponsoring Rep. Don Calloway, D-St. Louis, told a House health care committee Tuesday that he’s considering expanding the legislation to cover all youth sports.

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.

Dr. Stan Herring, a physician for the Seattle Seahawks and Mariners teams, lobbied for the Washington legislation 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 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 adult neuropsychology at the University of Missouri-Columbia.

The Missouri State High School Activities Association, which governs high school sports statewide, 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.

Kerwin Urhahn, the association’s executive director, told lawmakers the organization has been studying concussion policies and will provide further guidance to coaches and schools. Urhahn also said that starting in the 2010-2011 school year, players will be barred from returning the same day they show signs of concussions — regardless of whether they lose consciousness.

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.

“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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Missouri House concussions measure: HB1548

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On the Net:

Legislature: www.moga.mo.gov

Brain Injury Association of Missouri: www.biamo.org