Across Ohio, thousands of young student-athletes are involved in team sports. Too often, however, players receive traumatic blows to the head known as concussions.

“The word concussion is a Latin term that means to shake violently so it’s any injury where the brain, which is really a jelly-like consistency, is shaken violently and frequently ends up abutting the skull, which is, of course, rigid,” says Dr. Anthony Ewald.

Ewald is a physician with Max Sports Medicine. He’s also team physician for Otterbein University and Westerville North High School. Though he cannot give exact figures, Ewald says concussions are extremely common, particularly in high impact and collision sports such as football, ice hockey and soccer.

“It’s a hard question to answer because a lot of athletes may underreport or maybe misrepresent their symptoms with the goal of staying on the field,” Ewald says. “In my own experience per a varsity football game which is four 12-minute quarters there’s going to be at least one if not two or three in that given game.”

Last week a colleague of Ewald’s, Doctor Thomas Hospel, took part in a presentation about concussions at the Dublin Public Library. Doctor Hospel says student athletes try to evade the concussion question because they want to stay in the game.

“Their first thought is, ‘I can play through this. I want to play through this. I want to do it for my teammates. I want to impress my coach. I don’t want to let down some of my friends who are here cheering me on. I want to be though. I want to have the reputation of somebody who’s tough who can play through it,’” Hospel says.

But Ohio’s new law mandates that coaches and other personnel such as athletic trainers keep a sharper eye out for signs of concussion in their players. That’s something that Dr. Ewald already does.

“We’re looking for people that get up slowly, that look groggy, that are kind of slow getting back to the huddle, or off to the sidelines. So, yes, we are absolutely looking for clues as to whether or not someone may have incurred one of these injuries,” Ewald says.

The new law does not require that a physician attend every sporting event. But it does require that a player suspected of having a concussion be taken out of the game or out of practice. That player cannot return until he or she has been evaluated and cleared by a physician.

House Bill 143 also requires that coaching personnel take training to recognize brain injuries. That training will be implemented by the state department of health. This is the health department’s Cameron McNamee.

“The training is really an overview of the signs and symptoms of concussions; how to recognize them and what to do when you suspect a player of sustaining a concussion during practice or play,” says McNamee.

The law also requires the health department to produce a concussion fact sheet that parents must return with their signatures before a student is eligible to play.

Scott Kasun oversees the football program at Saint Brigid Catholic School in Dublin. Kasun himself experienced concussions as a young football player.

“It’s safe to say that I’ve had at least ten concussions if not more in my playing career,” Kasun says. “And the days of getting a big slobber knocker and the coach coming over and looking you in the eye and asking you what day of the week it is, I have found out now how incredibly unsafe that really is.”

It’s unsafe because concussions take time to heal. Returning a player to sports too quickly can have disastrous results. Dr. Steven Simensky, a neurologist at Grant Medical Center, gives this analogy.

“How do you know that you’ve suffered a knee injury? Well, you know, it swells, it pops, it locks and you limp on it, it hurts. Would you then allow the athlete the next day to go run on it? Well, no; that would only create more damage. The same is true about concussions. Why would you allow an athlete whose brain has been injured back into an environment where you’re only going to cause more problems,” Simensky asks.

Here again is Doctor Anthony Ewald:

“The average concussion takes maybe seven to ten days to heal. If we get another hit to the head too soon, we may have just turned another seven day problem into a seven week problem or a seven month problem. And that we do see frequently,” Ewald says.

House Bill 143 takes effect in late April.

The Yoga exercise program on the Wii instructs users how to complete different poses. You have to stand on one leg,  stretch out your arms and hold that pose for several seconds. It’s good exercise, and it could help doctors spot the lingering effects of a concussion.

OSU’s Sports Medicine Concussion Program director of research Tamerah Hunt says balance is an important part in analyzing recovery from a head injury.

“We took those stances that are commonly used, the single leg, the double leg, the tandem stance and we looked at what the Wii yoga poses look like and they look very similar and so, we’ve been using those on the Wii fit,” says Hunt.

Hunt and her counterparts at the University of Maryland are doing baseline Wii testing for concussion management in college athletes and will soon do the same tests for high school athletes.

Hunt says because the Wii is inexpensive and portable it could be a valuable tool for athletic trainers.

“Something is better than nothing and right now a lot of clinicians aren’t using balance equipment, because it’s limited in what we have,” says Hunt.

Hunt says studies show between 5 percent and 15 percent of athletes will sustain a concussion each year, and more than half will go unreported.

New Albany High School athlete Anthony Flowers knows what a concussion feels like.

“During Freshman year of fall soccer I went sliding out to make a play and ended up getting kicked in the head, and basically we went to the hospital and after that I don’t remember too much,” Flowers explains.

Flowers suffered from headaches for a couple weeks and slowly returned to the field. He recently took part in a demonstration of the Wii Yoga balance testing.

“It draws the competitive side of wanting to get a higher score as possible with the balance board,” explains Flowers.

While Flowers still needed other tests, his high score in Wii yoga seemed to indicate he had recovered.

New Albany High School head athletic trainer Tim Mathews says using the Wii can be a more objective tool to determine whether an athlete still suffers from a concussion.

“When I test someone for their balance, I have to give my opinion of do I think they’ve lost their balance, or do they go out of position. With something like the Wii, it’s kind of a standardized measure, it takes the human element out of it,” Mathews says.

However, the Wii has its limits. OSU researcher Tamerah Hunt cautions the game is limited in measuring other movements.

“It doesn’t tell you how they’re swaying forward and backward really heavily, are they swaying from right to left, it just gives you this one number. And we always have to remind everybody that the Wii wasn’t intended for medical use,” explains Hunt.

Hunt wants to test OSU athletes on the Wii. She hopes it’s just another  tool to keep athletes safe from serious brain injuries.

“We’re starting to see some long-term effects of concussion and we’re also starting to see the deaths of young high school athletes following concussion. And so we always joke, but you only have one brain.”

The measure would require coaches or referees to remove a player from a game or practice if the athlete shows signs of or is suspected of having a concussion. School authorities and youth sports organizations would be banned from allowing people to coach unless they were trained to recognize concussions and head injuries.

The legislation contains some immunity provisions for coaches. But Beth Tsvetkoff of the Ohio Alliance of YMCAs says they are inadequate. She says record-keeping and paperwork requirements in the bill would increase liability.

The measure is pending before an Ohio House panel.

Columbus Representative Michael Stinzino, a co-sponsor of the measure, says the bill is designed to raise the awareness of young athletes, parents and coaches about the long term effected of repeated brain injuries. Stinziano says it’s important for coaches to recognize the symptoms of concussions and to know when to take a player out of the game. He says this is not a helmet law.

The National Football League is encouraging states to adopt such legislation in an effort to reduce the long term brain damage that can occur when athletes suffer a series of hits to the head.

The Brain Injury Asociation of Ohio also supports the bill. Executive Director Suzanne Minnick says head injuries can have serious consequences for younger athletes. She hopes the measure will raise the awareness of parents and coaches about the symptoms of concussion and the importance of a full recovery.