High school sports: A change in attitude

North Dakota politicians are in the final stages of putting into law regulations that deal with concussions in school sports.

State lawmakers approved a new set of rules Tuesday to give a bill final approval that says athletes that show signs of a concussion can't resume playing until they've been cleared by a medical professional. That bill now goes to Gov. Jack Dalrymple.

In Grand Forks, meanwhile, athletic trainers have been trying to educate and change attitudes toward concussions for several years.

"The big message sent to us by the (athletic director) and athletic trainers is that the old way can't be done anymore," Red River football coach Vyrn Muir said. "That message has definitely been sent out. If it's a possible concussion -- you might be disappointed if he's an integral piece of the team -- but we don't question that at all. It's for the betterment of the kid and legally you also don't want to get stuck in a corner."

Some coaches, athletes and parents aren't as cooperative as Muir.

"There are some people who aren't used to having athletic trainers telling them no," said Sara Bjerke, an Altru athletic trainer at Grand Forks Red River.

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ImPACT tests

For the first time this year, Grand Forks high school athletes are using a process known as ImPACT to handle concussions. Athletes in collision, contact and limited contact sports are tested. The tested sports are football, soccer, volleyball, wrestling, gymnastics, basketball, hockey, pole vault, baseball, softball and cheerleading.

ImPACT is a computer program which originated out of the University of Pittsburgh Medical Center. The ImPACT testing, administered to athletes at the beginning of each sports season, lasts 20 minutes and gauges reaction time and memory (visual and verbal).

The results of the ImPACT testing give the students baseline numbers. If a potential concussion occurs during the season, these athletes retake the ImPACT test 48 to 72 hours after the concussion.

These new numbers are compared to the original numbers. The comparisons are placed on a symptoms scale. "This way we're not just going on what they're telling us," Bjerke said. "The kids aren't returning to play until they're symptom-free."

The numbers allow athletic trainers to gauge the impact of a concussion without relying solely on what the athlete divulges.

There are other benefits, as well. "It's nice to have something to show parents as to 'here is why your kid isn't playing,' " Bjerke said.

Grand Forks athletes are required to do the ImPACT testing every two years. Typically, freshmen and juniors go through the process.

Changing the culture

Prior to each season, Bjerke said she gives a presentation to all Grand Forks coaches on ImPACT and other concussion-related issues.

"We're given pretty extensive training in the preseason," Central wrestling coach Matt Berglund said. "The biggest thing they're telling us is that what we've believed before is wrong. There are lots of myths out there."

Muir said the key phrase is to "err on the side of caution.

"In the past, we've had kids with mild concussions allowed to play," said Muir, who added that he'd experienced three concussions as a player himself. "But there's new literature out there. In the old days, when the kids saw stars but it appeared they were OK and they said they were fine, they would go back in. Now if you see stars, as coaches, we know they're done. The awareness has really increased."

Bjerke said the number of concussions diagnosed is rising because of the ability to pinpoint concussions that aren't caused by "the big hit."

The ImPACT program claims 10 percent of all student-athletes in contact sports suffer a concussion during their season.

And according to a study in the journal "pediatrics," the number of children visiting emergency rooms for concussions doubled between 1997 and 2005.

Bjerke said Grand Forks athletic trainers haven't kept specific numbers for concussion reports. However, she said she hopes to start doing so next season.

A boost from the public eye

Bjerke said public awareness of high-profile concussion cases has helped coaches, athletes and parents understand the dangers of returning to play too soon.

n UND hockey player Chay Genoway didn't play for 10 months when he suffered a concussion to close out his 2010-11 season.

n Minnesota Twins slugger Justin Morneau was sidelined for eight months when he suffered a concussion sliding into second base last year.

n Even the popular video game "Madden" has taken a tougher stance on concussions. EA Sports President Peter Moore recently released a statement saying that it was "wrong" when the company's Madden game would allow concussed players to return to the field in the following quarter. That is no longer the case, Moore told the Associated Press. "We have an obligation in our industry to recognize that brain injuries are one the biggest on-field issues facing football at all levels right now," he said.

n Major League Baseball also hopped on the bandwagon, instituting a 7-day disabled list for concussions, in addition to the 15- and 60-day DLs. MLB and its players union announced in late March a new set of protocols for dealing with concussions, including the creation of protocol for mandatory baseline testing for all players and umpires and new steps for evaluating players that may have suffered the injury and for having them return to action.

"When the kids see some of these superstars struggling and the stories in the news, the light bulbs go off," Bjerke said. "That has helped."

To each his own

On the other hand, though, Bjerke said concussions are individualistic.

"We do tell kids they can't look at what's happening in the NHL or the NFL," she said. "Those are adults. You're not 30, you're 15. When you're 18 and younger, your brain is still growing and developing.

"There are differences between an 18-year-old and a 15-year-old and there are differences between a male and a female."

Bjerke said schools have also progressed as far as understanding what a concussion in sports means to a student in the classroom.

Athletic trainers speak to counselors, who then relay the limitations to teachers. Concussed athletes are also instructed to stop texting and playing video games.

"For the most part -- not all -- coaches and parents are pretty understanding and up to date," Bjerke said. "It has started to get better with some of this education."

Miller reports on sports. Reach him at (701) 780-1121; (800) 477-6572, ext. 121; or send e-mail to tmiller@gfherald.com .