It is safe to say that the issue of concussions is now a mainstream topic. The New York Times published an article of a recent concussion study on the front page. Full-length films (one titled “Concussion”) cover the subject. Professional sports leagues, and even youth leagues, have come under legal fire for how they handle concussion risks for their athletes, professional and amateur alike.
Despite the incredible attention around concussions, we find there is still a significant gap in resources to help private organizations to form an appropriate response to the risk of head trauma according to state laws. In a study by the CDC on new adopters of concussion protocol, researchers cited this gap in knowledge and awareness of return to play laws as a major barrier to proper policy implementation. Tailored, digestible information is difficult to find, which is why we decided to take the plunge in this article.
Below you will find a the result of our research on the legal landscape of youth sports. We scoured the laws in each state and boiled the information down into visuals to provide a resource for those involved with amateur sports outside of schools. Keep in mind that our interpretation may be different from yours, so use the links to your state’s legislature in our citations below to check our work. We will continue to provide more tailored resources and updates to this article as the landscape continues to evolve.
When it comes to concussion law, we found the three common components in concussion law after reviewing the legislature in each state. The common themes are education, removal from play, and return to play.
1. Education – By boosting awareness about concussion symptoms and risks, legislators seek to reduce risks of concussions in amateur sports. Lack of informed consent is one of the key points of contention in major concussion lawsuits, and several states now require organizations actively educate their membership, train coaches, provide resources, and obtain signed ‘informed consent’ forms.
Even if your state doesn’t have a legal requirement, it is best-practice to include a concussion education component to programming and resources on your website. Not only is it best for the players, but it shows your organization is proactively responding to concussion risks and on top of your game.
2. Removal from Play – No amount of education, equipment, or preparation will completely remove the risk of concussions out of sports, and legislators acknowledge that. Based on the consensus of researchers at a 2012 concussion conference in Zurich, laws now reflect best-practice protocol to respond to concussions.
That’s where removal from play becomes critical. When a suspected head trauma occurs, athletes should be removed from play for assessment. However, different states have different regulations on what comes next; some say that the player must stay off the field for at least 24 hours, and others leave this open to be discerned by coaches/parents. California and Nebraska even require organizations to report incident data (symptoms, time of incident, etc.) to parents and guardians.
3. Return to Play – One of the top risk with concussions isn’t the concussion itself, but avoiding secondary concussion before full recovery. Research shows that repeated concussions increases the risk of lasting damage, and concussions can take over two weeks to heal completely. Thus, legislation also governs how and when players can return to play.
Medical practitioners typically break up return to play into a step by step process. As recovery progresses, athletes can slowly re-engage with their sport from light athletic activity to full-contact participation. However, from a legal standpoint, organizations often have to collect a signed medical release form before an athlete can return to regular participation. States differ on the exact credentials required for the signing party (usually a medical practitioner of varying degree), and some don’t specify a written release form, but legislature around return-to-play is pretty uniform in the way concussion protocol is regulated: there should be documented proof that an athlete is clear to play, for both the protection of the player and the organization.
Now that’s all well and good, but states also vary on whether concussion legislature applies to only school sports or to private sports clubs. The infographic below shows which states have concussion legislature that directly affects private sports, in red. All 50 states have concussion laws that affect school sports, and a few states have regulation for organizations that use school fields and property to conduct operations.
Legal Landscape for Youth Sports: Which states does concussion law extend into private club sports?
If your state is highlighted, don’t get overwhelmed! We have prepared a more detailed checklist of what requirements need to be met to be compliant for your specific state.
Requirement Breakdown by States with Concussion Mandates in Youth Sports
|Information Sheet||Coach Training||Removal from Play||Return to Play [written clearance]|
|Alabama||Signed||Annually||Yes – no same day return||Yes|
|California||Signed||Annually||Yes – Notify date, time, symptoms, and treatment||Yes|
|Michigan [effective 2018]||Signed by guardians and athlete||Not specified||Yes||Yes, retain files until athlete stops participation with organization or turns 18|
|Minnesota||Yes||Every 3 years||Yes||Yes|
|Montana||Signed by guardians and athletes, annually||Annually, and ‘officials’||No, not required||No, not required|
|Nebraska||Yes||Available||Yes – Notify date, time, symptoms, and treatment||Yes|
|Ohio||Yes||Every 3 years||Yes – no same day return||Yes|
|Oregon||Yes, receipt acknowledged by guardians and athletes 12 and older||Annually, and referees||Yes – no same day return unless cleared by athletic trainer||Yes|
|Tennessee||Signed, coaches and guardians, maintain records for three years||Yes||Yes||Yes|
|Utah||Signed by guardians||Not specified||Yes||Yes|
|Wisconsin||Signed by guardians/athlete||Yes||Yes||Yes
Regardless of your state’s specific concussion laws, organizations can still be found liable for injuries, even with the protection of a waiver. The best way to manage this risk is to take the time to implement best-practice concussion protocol and monitor it.
State Legislature Sources
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Little League Baseball and Softball has overviews of concussion law in each state, as well as links to other resources. You can find this page at http://www.littleleague.org/learn/programs/childprotection/concussions.htm
- Ward, Joe; Williams, Josh; Manchester, Sam. “110 NFL Brains”. New York Times, July 25, 2017. https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html?rref=collection%2Ftimestopic%2FHead%20Injuries%20in%20Football&action=click&contentCollection=sports®ion=stream&module=stream_unit&version=latest&contentPlacement=12&pgtype=collection
- Caplan, Arthur L.; Igel, Lee H. “Pop Warner CTE Lawsuit Reveals A Hidden Risk About Youth Football”. Forbes, SportsMoney section, October 27, 2017. https://www.forbes.com/sites/leeigel/2017/10/27/pop-warner-cte-lawsuit-reveals-a-hidden-risk-about-youth-football/#18ae03bd7f1f
- “Implementing Return to Play: Learning from the Experiences of Early Implementers”. Center for Disease Control National Center for Injury Prevention and Control. https://www.cdc.gov/headsup/pdfs/policy/rtp_implementation-a.pdf
- McCrory, Paul et. al.”Consensus Statement on Concussion in Sport: The 4th International Conference on Concussion in Sport, Zurich, November 2012″. J Athl Train. 2013 Jul-Aug; 48(4): 554–575. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715021/