The Importance of Concussion Awareness and Education in the Campus Recreation setting
October 04, 2016
Assistant Director – Club Sports
University of Michigan
Concussions continue to be in the forefront of sports news. In January 2016, a federal judge approved a settlement in a class-action suit against the NCAA that created new mandates for response to head injury. Whether it is fair and accurate or not, the comparison between Club Sports and NCAA athletics is frequently drawn. The Risk Management Department or University Legal is unlikely to understand the difference – their ultimate concern being the potential insurance claims and lawsuits that could result from an activity. Despite the fact that there is typically a significant difference in the amount of resources (both human and financial) provided to an NCAA team vs. a Club Sport’s team, the risk of injury does not change, hence the need for education and response to head injuries also does not change.
In an ideal situation…
The courts have made it clear to the NCAA the type of education, response and resources athletes affiliated with their sports will receive. On many campuses, Club Sports provide an opportunity for a high level of competition in sports that may not be represented in the NCAA or for which the university is not able to provide scholarships. An example of this would be rugby; in an ideal world, rugby athletes participating in a Club would have access to the same level of screening and care for all injuries. This would include concussion pre-screenings (e.g. ImPACT® testing), physicals, and access to medical personnel for post-injury care.
While there are some Campus Recreation departments who have created partnerships with the Athletic Department or Health Services on their campus, the number of Campus Recreation and Club Sports programs that have these types of resources available for their students are few. While pre and post-screenings are more affordable than many think, it becomes an issue comes in when you don’t have a partner on campus to administer the tests and interpret the results. As recreation professionals, we do not have the knowledge or training required to do this alone, so partnerships are essential if implementation is desired.
What if I don’t have those resources?
If you are in the majority or programs, you may feel helpless when Risk Management calls and asks you what you’re doing in response to the risk of head injuries in sports. I’ve been on the receiving end of that type of phone call, and while it made us feel vulnerable, it was also one of the most beneficial conversations we’ve had.
We were very clear with Risk Management on our limitations: we have no money to contribute; we do require that each of our Clubs has a coach; where there are coaches they are often volunteers, most of whom we only see once per year, and many do not travel with our students; we have Safety Officers for each team, but they are students and their training and certification is on a very basic level; we have around 1,600 Sport Clubs participants each year who may come and go from their teams; we have little to no contact with these participants beyond the waiver they sign and the proof of medical insurance they provide.
These limitations were heard and understood by Risk Management, but did not excuse us from having to do something to respond to the seriousness of this potential risk. So rather than focus on a response to injuries, we chose a preemptive focus on education.
Knowledge is Power
There are a number of great resources available online (see end of this article) that can be used to educate students and coaches on the risk of concussions and set some expectations on how response occurs when these and other injuries happen. As we developed our plan to fulfill the request from Risk Management, I found that the American Academy of Neurology has great educational resources available.
The “AAN Position Statement on Sports Concussion” was one of the best resources I found and it provides a great structure that can be used by sports organizations of various levels can use. While this statement focuses on youth sports, it identifies model legislation and recommendations that can easily be applied to other levels. It discusses the need for concussion education and training, for removal from play protocols in the event of an injury, clearance by a qualified medical professional before returning to play, and a recommendation for a participant signed acknowledgement of the risk of concussion.
Additionally, the AAN website includes information on state concussion laws (which are in place in all 50 of the United States) info graphics for coaches, parents and participants and free online training options that are available.
At the University of Michigan, Risk Management asked Club Sports administrators what type of medical pre-screening we were doing before participation, and what type of medical clearance we were requiring after an injury. At many universities, Campus Recreation departments require injury records to be kept, but do not require any type of medical clearance for a participant, even in situations where emergency response is required. In talking with colleagues about the idea of medical clearance, both prior to participation as well as after injury, my question was ‘why would we provide a different standard or level of care for one group of our participants but not for another group? While 1,600 students participating in Club Sports may not be as difficult to manage as the many thousands we have participating in Intramural Sports, the risks are similar when it comes to like sports – so why would there be a different expectation re. medical clearance for one program (e.g. Sport Clubs) over another (e.g. Intramurals)?
Simply stated – Campus Recreation does not have the knowledge, skills or time to implement a medical clearance protocol for injuries (including concussions). If Risk Management thinks otherwise – push back, hard!
One of the most important things you can do in response to the attention that your programs may receive about risk of concussion is to make sure it is clear who is responsible and accountable for injury response and follow-up. It is vital, especially when students make the call, that you equip and empower them to stand up to peer pressure and remove someone from play if a head injury is sustained. If that is a shared role, it’s critical that both parties understand that if there is a disagreement on removal from play, the individual is to be removed.
Individuals should also have personal accountability for their participation and injury reporting. For our participants, we added a page to their electronic waivers about concussions and other injuries. We also use a short educational video which they have to confirm they’ve watched, and two statements of confirmed understanding: one that they are responsible for reporting their own injuries sustained during participation, and one that our department reserves the right to remove individuals from participation.
We began our concussion education measures two years ago. At the end of year one, we reviewed the process and added components to it. At the end of year two, we did the same. In both of those reviews, we found additional resources and new ways to more broadly use the measures we already had in place. While there are many things we wish we could do to help students participating in our programs, at the end of the day we want to be able to say that we are doing everything reasonable within our means to educate and make participants aware about all aspects of concussions.
Editors Note: Lexi has created an outstanding video titled ‘Concussion Education of a Shoestring Budget’.
For more information, go to https://www.sportrisk.com/sportriskwebinars/
For additional resources on concussions, see ‘Concussion Resources’.