Limitations do not create exceptions – concussion education can be the answer

February 16, 2017

Lexi Chaput

Assistant Director – Club Sports

University of Michigan

Within every Campus Recreation department, different types of risks are managed differently based on the resources dedicated to the program, but with more and more discussion taking place about head injuries in sports participation, resource limitations are no longer a valid reason for a department saying they ‘can’t’ when it comes to response and management. Regardless of your size, structure, or resources, education is always a viable option, and can be a valid response when Risk Management calls and wants to know what you are doing to keep participants safe.

A Future of Uncertainty for Club Sports

For those whose Club Sports are insured by the University, it’s important to know that the future of that coverage has the potential to change dramatically, and could result in higher costs or added requirements. In a recent conversation with our Risk Management Office, they are anticipating changes to our liability coverage. While our insurance providers have so far not mentioned “no coverage” for head injuries sustained during activity, limitations on coverage could be implemented, especially surrounding timelines – specifically around when the injury was reported, and if the injury was the first of its kind sustained.

Risk Management is expecting similarities to the changes in liability coverage that were experienced for child molestation in the wake of Penn State and other similar incidents.  In advance of those notable incidents, schools had liability coverage in place as part of their general policy. After those incidents occurred, coverage for child molestation switched to a separate policy that organization had to purchase as additional coverage.  The other shifts that occurred surrounding molestation included the closing of some loopholes in coverage specifically that a claim had to be a for a specific event that occurred and that if the molestation was a series of events over time, only the “last event” could be claimed. Head injuries could follow this trend and increased limitation on coverage and claims are likely to occur.

How do I approach a call from our Risk Management Office on this topic?

You may feel helpless when risk management calls and asks you what you’re doing in response to the risk of head injuries in sports. Often times, Club Sports is the first to be examined, and while we felt very vulnerable when we got this question from Risk Management, it also led to an incredibly valuable conversation.

We started by being very clear with Risk Management on our limitations: we have no money to put toward this; we do require that each of our Clubs has a coach; coaches are volunteers and most of them we see only once per year; many coaches do not travel with our students; while we have Safety Officers for each team, they are students and their training and certification is at a very basic level; we have around 1,600 participants each year who may come and go from their teams, and we have little to no contact with them beyond the waiver they sign and the proof of medical insurance they provide.

These limitations were heard and understood by Risk Management, but did not excuse us from having to do something to respond to the seriousness of this potential risk. So rather than focus on a response to injuries, we chose a preemptive focus on education.

Knowledge is Power

There are a number of great resources available online that can be used to educate students and coaches on the risk of concussions, and set some expectations on how response occurs when these and other injuries happen. As we developed our plan to fulfill the request from Risk Management, I found that the American Academy of Neurology has great educational resources available.

The “AAN Position Statement on Sports Concussion” was one of the best resources I found and it provides a great structure that can be used by sports organizations of various levels can use. While the position statement focuses on youth sports, it identifies model legislation and recommendations that can easily be applied to other levels. It discusses the need for education and training, for removal from play in the event of an injury, clearance by a qualified medical professional before returning to play, and a recommendation for a signed acknowledgement of the risk of concussion by participants.

Additionally, their website includes information on state concussion laws, which are in place in all 50 of the United States, info graphics for coaches, parents and participants, and online training options that are available for free.

Injury Response

Most campuses have a required means for reporting injuries that occur in their recreation facilities and programs. For many, it’s a record of the injury that occurred as well as the care that was provided. This is certainly a good practice should there later be a claim of negligence or a need to provide information to others on campus about the procedures followed. What is done with those reports could vary based on the program in which the injury occurred, however it is never a bad idea to recommend to the injured person that they seek medical attention before resuming activity.

Creating accountability

One of the most important things you can do in response to the attention that your programs may attract about risk of concussion is to make sure it is clear who is responsible and accountable for injury response and follow-up. It is vital, especially with students making the call to remove someone from play if a head injury is sustained, that you equip and empower them to stand up to peer pressure. If that is a shared role, it’s critical that both parties understand that if there is a disagreement on removal from play, the individual is to be removed.

Individuals should also have personal accountability for their participation and injury reporting. For our participants, we added a page to their electronic waivers that is about concussions and other injuries. There is a short educational video that they have to confirm they watched and two statements of confirmed understanding: one that they are responsible for reporting injuries sustained during participation and one that our department reserves the right to remove individuals from participation.

Continue improving

We began our concussion education measures two years ago. At the end of year one, we reviewed the process and added components to it. At the end of year two, we did the same. In both of those reviews, we found additional resources and new ways to more broadly use the measures we already had in place. While there are many things we wish we could do to provide for the students participating in the program, we want to be able to say that we are doing everything within our means, with a hope that a demand for more response would also come with the support and resources it would require.