Sports medicine

John Doherty: Concussion law has more than one flaw

2013-01-07T17:45:00Z John Doherty: Concussion law has more than one flawBy John Doherty Times Correspondent
January 07, 2013 5:45 pm  • 

Since becoming effective in July of last year, the Concussion Law in Indiana has generated as many questions as answers.

It isn’t as if Indiana Department of Education officials have been trying to confuse anybody. They’re just interpreting the language from the law the best that they can.

The initial and clearest component of the law — as far as a school district is concerned — involves education. It reads, “Each year, before beginning practice for an interscholastic or intramural sport, a high school student-athlete and the student-athlete's parent: must be given (an) information sheet and form; and shall sign and return the form acknowledging the receipt of the information to the student athlete's coach.”

That provision would be straightforward if it weren’t for the inclusion of the word “intramural.” According to the IDOE, “An intramural contest occurs when all participants on both teams are members of one school." That could conceivably apply to a physical education class.

The IDOE has also defined as “intramural” any team where all the members are from the same school and the coach is paid or “recognized” by the school. Consequently, the law applies to cheerleading and dance squads.

The law applies only to grades 9-12. However, IDOE officials indicate a “standard of care” has been established by the law and any school district would be foolish not to comply at all grade levels.

The law also compels schools to educate coaches, but there is no provision regarding frequency.

As for when a concussion actually occurs, the law becomes murky. It reads, “A high school student-athlete who is suspected of sustaining a concussion … in a practice or game shall be removed from play at (that time); and may not return to play until (he/she) is evaluated by a licensed health care provider trained in the evaluation and management of concussions … and receives a written clearance to return to play from the health care provider who evaluated the student athlete.”

The law does not specify who is qualified to be suspicious. Referee, coach, athletic trainer, teammate, parent in the stands? The IHSAA does impart some responsibility to referees during games.

Nor does it prohibit return to play the same day as the injury — if a medical provider is foolish enough to grant it. On the other hand, it doesn't force a school to allow an athlete with such foolish clearance to play.

Finally it does not define the words “medical provider.” For better or worse, the words are defined elsewhere in Indiana Code. Therefore, a medical doctor (MD), doctor of osteopathy (DO), doctor of chiropractic (DC), dentist, nurse, occupational therapist, physical therapist, podiatrist, and psychologist are among those who are able to provide such written clearance.

Notably absent? Athletic trainers. They are medical “professionals” under Indiana Code, not “providers.”

Prior to the passage of the law, the IHSAA already had a rule in place allowing only MDs and DOs to provide written clearance. A higher and far better standard of care; one any school district is free to and would be wise to follow.

John Doherty is a certified athletic trainer and licensed physical therapist. This column reflects solely his opinion. Reach him at Follow him on Twitter @JDohertyATCPT.

Copyright 2014 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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