Youth Sports Concussion Safety Laws: New Mexico

New Mexico Governor Bill Richardson signed the country'stoughest youth sports concussion safety law on June 1, 2010.

Key provisions of the New Mexico law:

• No same day return to play. A coach shall not allow a middle school or high school student-athlete to participate in a school athletic activity on the same day the athlete: 
  • exhibits signs, symptoms, or behaviors consistent with a brain injury (e.g. physical trauma to brain, skull, or neck caused by blunt or penetrating force, concussion, hypoxia-anoxia or electrical charge) after a coach, school official or a student athlete reports, observes or suspects that a student athlete exhibiting these signs, symptoms or behaviors has sustained a brain injury.
  • has been diagnosed with a brain injury. 
• One week minimum before return to play: After a player has been removed from a game or practice with a suspected brain injury, he must sit out at least one week before returning to play AND return to play only: 
  • when he no longer exhibits any sign, symptom or behavior consistent with a brain injury; and
  • when he receives a medical release from a licensed health care professional (e.g. doctors, physician's assistants, nurse practitioners, psychologists, and athletic trainers)

• Coaches training. Coaches must receive training to:
  
  • understand the nature and risk of brain injury associated with sports;
  • recognize signs, symptoms or behaviors consistent with a brain injury when the coach suspects or observes that a student athlete has received a brain injury;
  • understand the need to alert appropriate medical professionals for emergency diagnosis or treatment; and
  • understand the need to follow medical direction for proper medical protocols.

• Yearly student-athlete and parent consent form required. Before a student-athlete is allowed to participate in school sports for that year, both he and his parents are required to sign a written brain injury information form.

Toughest law

The New Mexico law is the toughest of the new youth sports concussion safety laws enacted by states in several respects:

• Completely bans same day return to play. The New Mexico law adopts the conservative approach to MTBI in youth athletes recommended by the most recent international consensus statement on sports concussions, which states that it is "not appropriate" for athletes under the age of 18 to return to play on the day of injury regardless of the level of athletic performance and even if the resources (e.g. access to neuropsychologists, consultants, neuroimaging) are the same as for an older, professional athlete. 
• Imposes 7-day waiting period before return to play. Two 2003 studies suggest that a 7-day waiting period may minimize the risk of another concussion. Not only does the evidence show that athletes take, on average, 7 days to fully recover after a concussion, but same-season repeat injuries typically take place 7 to 10 days after the first, which supports the idea that the developing brain of young athletes may more vulnerable to injury during the first 7 days after injury.¹ The minimum 7-day waiting period also recognizes that a 7 to 10 day recovery period is typical of the vast majority (80-90%) of concussions. 
• Uses brain injury, not concussion, label. The New Mexico law refers to "brain injury" not "concussion," terminology consistent with a recent Canadian study that found that labeling a child's head injury as a "concussion" conveyed the wrong message to parents, athletes and athletic trainers about its seriousness, and arguing that to encourage full reporting of head injuries in sports and to allow adequate management and recovery time the term mild traumatic brain injury (MTBI) be used in its place. The negative consequences of the use of the concussion label, the study noted, may be especially pronounced in the context of sports-related concussion, perhaps explaining the underreporting of head injuries by young athletes and their trainers as being due in part to the still-common belief that a concussion does not need to be treated seriously.
• Addresses "code of silence." The law encourages reporting of suspected brain injury, not only by the athletes themselves, but by teammates. It is thus meant to address the problem of the "code of silence" in which athletes confide in teammates they are suffering symptoms of a brain injury but neither the athlete nor his teammates tell the coach, athletic trainer or team doctor, sometimes with tragic consequences. A recent HBO's Real Sports on high school sports concussions, for instance, featured the tragic story of Ryne Dougherty, a Montclair, New Jersey football player who died in 2009, likely from second impact syndrome, when he suffered a blow to the head when he returned to play, despite having confided in teammates that he was still experiencing headaches from an earlier concussion. Asked if, knowing what they knew now about the dangers of playing with concussion symptoms, they would still hide their concussion symptoms in order to play, they all answered without equivocation, "Yes."