Thousands of children playing recreational sports will be required to be removed from games and practices should they sustain head injuries, under a bill approved by the Ohio legislature this week.
But the law wouldn't apply to most Ohio high schools, which will be allowed to follow their own Ohio High School Athletic Association rules that provide a way for athletes to reenter games and practices if a medical professional determines the athlete hasn't sustained a concussion.
The concussion rules, found in HB 147, require coaches and referees to remove players showing "signs, symptoms, or behaviors consistent with having sustained a concussion or head injury." Referees and coaches also are required to undergo training to identify those symptoms. The bill was unanimously approved by the senate on Tuesday and overwhelmingly approved by the house on Wednesday.
Dr. Thomas Pommering, chief of sports medicine at Nationwide Children's Hospital said the law will help the thousands of children playing in youth sports outside the OHSAA's realm, which have had no real rules when it comes to handling head injuries.
Licking County Youth Football League commissioner Chris Weber said his league mostly uses high school officials who do the games on Friday nights, and are trained to recognize concussions and what to do about them.
"They have the experience and the familiarity," Weber said. "But as a coach at practice, you don't have that luxury. Limiting contact at practice may be a step. We only practice three nights a week and maybe we could have like an hour's worth of contact at one of them."
The LCYL has been proactive in dealing with concussions, offering baseline testing through Nationwide Children's Hospital at Watkins Memorial before the season started for fifth and sixth graders. Players were tested for reaction time, processing speed and memory to establish data in case they suffer future concussions. They hope to do it for younger players next year as well, but hope for a better turnout. "Less than 10 percent of those eligible took advantage of this," Weber said.
Weber said the new law forces everyone to adjust and get better at dealing with concussions.
"The spirit of it is spot on," he said of the law. "It's a good thing to protect our children. We encourage coaches to confer with parents and medical professionals, to pay more close attention.
"We need to make a greater effort on our part as administrators to educate, police and enforce these rules. We're glad to be aligned with Children's Hospital, because they're the experts."
Licking County Youth Wrestling League commissioner Seamus Mulligan of Northridge said mostly concussion-trained high school officials are used in their matches as well.
"The ref. has control of the match. If he has any questions at all (about a concussion), the match is forfeited," Mulligan said. "Like in football, however, practices could be another matter.
"We have to address this (the new law) at our league meeting, and I'm going to email all of our coaches," he said. "If there's any indication of a concussion at all, they should be removed from practice and be put in the hands of their parents."
Dr. Pommering said he was pleased with the legislature's quick action on the law, especially because the state was lagging so many others.
"I think it's time for Ohio to step up and help kids with concussions," he said.
Pommering said the focus of the law to sit out children who have concussions is vital. He said if a child still recovering from a concussion suffers another hit to the head, even a moderate one, there is a possibility they will suffer from immediate brain swelling. He said this swelling carries a 50 percent fatality rate for kids.
Even if such swelling doesn't occur, frequent hits will increase the severity of the concussion, he said.
Rep. Michael Stinziano, D-25, authored the bill to eliminate what he saw as a patchwork of rules on the subject across the state.
"The intention is to provide education and protect an athlete's safety," he said.
Under the state law there is no exception to allow a child removed for concussion symptoms to return to the game or practice. The OHSAA, however, has rules that allow a medical doctor, doctor of osteopathy or athletic trainer to give an athlete clearance to return, providing they do not believe an actual concussion has occurred.
The state law allows sports organizations with rules "substantially similar" to the law to be able to follow their own rules instead of the new law.
Tim Stried, OHSAA spokesman, said the organization believes its rules permit it to be exempt from the law. The association is in its third year of its concussion rules, which he said are similar or more stringent than the state law. The association also requires its coaches and officials to be regularly trained on concussion injuries, for example.
During this year's fall sports season, 269 student athletes were removed for concussion-like symptoms, according to Stried. More than 65 percent of those happened in football. Stried did not have data showing how many of those athletes were allowed to return after being removed.
Stinziano agreed that the OHSAA's rules could be used instead of the law, and noted there was discussion in the house over finding the appropriate balance on the issue.
"It's not our intent to be punishing anyone," he said.
Stried said his organization represents most, if not all, public high schools and many private schools. He said some smaller private schools and many junior high schools are not members and therefore wouldn't be required to follow its rules.
Pommering, with Nationwide Children's, said he sees no real difference in the state law and OHSAA regulations. The association's rules simply allow a medical professional to allow an athlete to return to action if they have been removed for something other than a concussion. For example if a player is vomiting and removed for possible head trauma, the professional could allow the player to return if it was caused by being hit in the stomach.
"I don't think there's a controversy there," he said.
The OHSAA's rules are clear on allowing children to return after sustaining a concussion: "Under no circumstance can that athlete return to play that day."
Stinziano said Gov. John Kasich has been "very supportive" of the bill.