Confronting the Youth Sports Concussion Crisis : A Central Role for Responsible Local Enforcement of Playing Rules

The sports world faces an epidemic of concussions, particularly in contact and collision sports. National attention once focused on concussions suffered by professional athletes, but we now know that concussions can happen in almost any sport and at any age. This article concerns the effect of playing rules on efforts to prevent concussions in youth sports. We can significantly reduce rates of sports-related concussions by periodically reviewing safety-based playing rules in light of medical learning, and then by assuring their enforcement by coaches, officials and parents who remain committed to sportsmanship and mutual respect in local games. Primary responsibility for rulemaking rests with national youth sports governing bodies (USA Soccer, USA Hockey and others), and with state high school activities associations that oversee the interscholastic sports programs conducted by their member secondary schools. National and state rulemaking, however, does not end the story because youth games are played on fields and other local venues largely beyond the direct supervision of national and state bodies. The rules stand the best chance of protecting players when coaches, administrators, game officials and parents enforce the rules responsibly. Legal constraints play only a limited role in producing greater safety from concussions in youth sports. Most states have taken a giant step forward by enacting concussion legislation that, while not displacing safety-based review and enforcement of playing rules, holds potential to make life better for the nation's youngest athletes. Tort litigation, however, has played comparatively little direct role in preventing youth league concussions. The specter of tort suits by injured players might accelerate safety initiatives by jeopardizing the availability of insurance at favorable rates, or by leaving individual parents reluctant to enroll their children. Any such potential longer-term influence on prevention efforts, however, has only residual effect on a player injured today