“Prep football coaches get an education on concussions” was the title of today’s excellent “Varsity Letter” high school sports column by Preston Williams. High school football coaches were exposed to current theory and practice with concussions at Redskins Park. Secondary school coaches from Virginia, Maryland and the District filed into a tent at Redskins Park on a recent Saturday morning for a seminar on concussions. The coaches watched a presentation, questioned Dr. Peter Gonzalez, an assistant professor of sports medicine at Eastern Virginia Medical School in Norfolk and watched a Redskins practice.

There are an estimated 43,000-67,000 concussions — really just a fancy word for injured brains — per year in high school football. About 50 percent of concussions are suspected of going unreported by young athletes. Football coaches, particularly those at schools without full-time certified athletic trainers — which in the Washington area includes Montgomery, Prince George’s and Anne Arundel counties — are the first responders to injured players. So these coaches often either make, or help make, the decision about whether a player, including one who is possibly concussed, is fit to remain in a game or continue to practice. The Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, determined that more than 40 percent of high school athletes who sustain concussions return to action too quickly. Two high school football players in North Carolina died in 2008 from concussion-related injuries.

One coach wondered if players would be better served by being subjected to more hard hits in practice, because they would perhaps build up a tolerance and resistance to the shots that result in their brains colliding with their skulls. No, Gonzalez said tactfully. The fewer hits to the head, the better. Other coaches had never heard of the ImPACT program, in which athletes take a 30-minute computer test that gauges their neurocognitive functions. That provides a baseline of information. The athletes are re-tested after a suspected head injury. Howard, Fairfax and D.C. schools, among others in the area, use ImPACT. Other coaches were unaware that athletes who sustain a concussion are two to four times more likely to sustain another, with 80 percent of those repeat concussions occurring within 10 days of the first one. A Time magazine article from 2009 cited a study that found from 2005 to 2008, 41 percent of concussed athletes, at 100 high schools nationwide, returned to play too soon, based on American Academy of Neurology guidelines. “We can’t prevent this first concussion,” Gonzalez told the coaches. “What we can prevent is the sequella of that concussion, the second-impact issues, worsening or delaying recovery.”