Is the NJ Concussion Law Working?

Is the NJ Concussion Law Working?

Yes, according to one of the Bill’s sponsors, but…

“So far, we’ve had nothing but positive comments from coaches, kids, and parents,” said Assemblyman Patrick J. Diegnan, a sponsor of the bill from District 18 in Middlesex County.

Medical Field Sees Policy as Positive, But Has a Warning

Dr. Robert Monaco, the director of the sports medicine fellowship program at UMDNJ-Robert Wood Johnson Medical School and the director of sports medicine at Rutgers University, said that the new concussion policy is a good one.

“I think it helps to protect athletes in general; I think it’s very good at high school and younger levels,” he said. “They’re guidelines. They’re not definitive things, but they do help serve as a reference to remind doctors, particularly those that don’t have experience with it, what should be done in most situations.”

Many schools have been incorporating ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) into their athletics programs in order to help protect student-athletes. Depending on how many students are tested, ImPACT costs between $500 and $1,000 per year.

According to the ImPACT website, “ImPACT an be administered by an athletic trainer, school nurse, athletic director, team coach, teach doctor, or anyone trained to administer baseline testing.”

But according to Monaco, ImPACT, which relies on comparing how an athlete responds to various tests and questions after a potential concussion to how the athlete responded to those same tests and questions when not concussed, should not be the only thing considered when evaluating concussions.

“It’s a tool in your toolbox for evaluating,” he said. “The problem with ImPACT is you need to get good baseline information before the injury … this can be problematic in getting if students don’t take it seriously and if the test is not proctored properly … looking at the test after a concussion is not as accurate if good information is not obtained up front.”

Director of neurosurgery at Morristown Medical Center and co-medical director of the Concussion Center at Overlook Medical Center Dr. Jack Knightly also feels that ImPACT is only one part of evaluating concussions.

“Having a base line is better than having nothing,” he said. “Part of the problem is that everyone says, ‘my imPACT test is normal and I’m good to go.’ That’s only part of the problem … doesn’t matter whether in sixth grade or a six year veteran of the NFL.”

Knightly, who has been the director of the concussion center at Overlook since approximately seven years ago, says that how he treats concussions “is completely different than six years ago.”

He does believe, like Monaco, that the new concussion policy will have a positive effect.

“It fortuitously takes the onus of saying when the athlete can return to sports away from coaches, who may not be experts, and puts it in the hands of someone familiar with it; an independent party, so the kid is safe to return to the sport,” said Knightly.

Concussions, according to Knightly, can have surprising side effects like not doing well in school or not coping well with families. If a concussion goes untreated and an athlete sustains another concussion, the athlete can suffer from Second Impact Syndrome, which Knightly called “the nightmare effect of not treating it correctly.”

According to the Centers for Disease Control and Prevention, playing sports with a concussion can be fatal, one potential result, according to Monaco, of Second Impact Syndrome.

“The biggest treatment is recognition and removal,” Monaco said. “The biggest thing is recognition with coaches and parents. … The CDC [Center for Disease Control], just the other day started a new program to help coaches and parents understand … the biggest thing is early detection, and removal is really the key in treating these things.”

Guidelines Being Embraced, Similar to Other Athletic Guidelines

Kathy Kickish, the head athletic trainer at Sacred Heart High School, a private high school in Vineland, previously worked in Virginia and had to develop a concussion protocol to match New Jersey’s guidelines this school year.

“For the most part, I found the [state guidelines] to be clear,” she said, but she emphasized the importance of educating athletes, parents, and coaches, who may not be as familiar with the medical aspects of dealing with concussions. The CDC also calls for increased education of athletes and parents.

So far this year, Kickish has only seen three possible concussions, which all turned out to be false alarms, but still she tests athletes the day of the possible concussion and the day after. If found to have a concussion, the athlete will be out for a minimum of one week, depending on when the athlete can get clearance from a physician—specifically from a physician trained to test for concussions, which Kickish says is a vital part of the new guidelines from New Jersey’s concussion law.

At Fairleigh Dickinson University, head athletic trainer Tom Wilkinson has been incorporating a similar concussion policy for his college athletes for the past three years.

The NCAA policy, he said, is “really not a whole lot different with the state law they did with the high schools.”

Wilkinson has had athletes kept out for up to one month due to concussion, and not just out of games, but also all practices and training. Once an athlete is cleared, Wilkinson gives them three days of reorientation to activity, which, he says begins with simple work outs and is increased day to day, until the athlete can return completely to a normal practice and game schedule.

[This terrific article via Teaneck Patch]

 

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