Photo by Tim Mossholder on Unsplash

The consequences of undiagnosed and untreated concussions can be severe; we need athletic trainers at every game.

Teach Plus
Nov 13 · 4 min read

By Yvonne Morgan

Each week as I sit in the stands watching my three sons play football, I am constantly on edge. I know how dangerous the game can be, but I also know how much they love to play. As a nurse and a health science technology educator who teaches a course in sports medicine, I am always practicing what I teach my students: to be observant during every play and notice the “odd” behavior of the student athletes.

A month ago, my 8th grader made a big tackle that made me cheer with joy. But my cheering was cut short when I noticed that he ended up at the bottom of a pile of players and then proceeded to line up on the wrong side of the nose tackle. I started to recognize the symptoms of a concussion and headed down to the field. I was shocked when I realized there was not an athletic trainer available to evaluate him, which unfortunately is the norm. The coaches did not recognize his symptoms either. Fortunately, I was able to advocate for my son and get him the help he needed. A month later, even after getting immediate treatment, he is still dealing with the lingering symptoms from his concussion. This makes me wonder how many student athletes have experienced the effects of concussions and never knew it because there they were unaware or not diagnosed early enough.

My son’s experience highlights the need for additional training for middle school coaches on recognizing the symptoms of and the need for immediate treatment of concussions. Parents entrust the care of their children to the coaches and rely on their expertise. In Texas, Natasha’s Law mandates that all coaches should have no less than two hours of training on concussions. Although two hours is a great starting point, most training consist of online webinars. I know from experience that this is not enough. Concussions are varied and each athlete could present with different symptoms that hinder recognition and the onset of treatment. Districts should require all coaches to attend an in-person training that includes various simulations and the dispelling of common myths to fully understand concussions.

Most high schools in the state of Texas have one athletic trainer on their campus who is typically responsible for their high school and all the middle schools that feed into it. This means that for larger districts, one athletic trainer could oversee the athletes at three to four schools. This caseload makes it impossible for an athletic trainer to be present at all middle school games. Although having a certified athletic trainer at all sporting events does not protect a student from sustaining a concussion, it at least ensures that a student is diagnosed at the first signs of it and gets immediate treatment. A certified athletic trainer should be on site at all middle school high impact sporting events.

Realistically however, coaches and trainers can only do so much. Parents must also become aware of concussion symptoms. My son was adamant that he did not hit his head and was unaware that a concussion can occur from any sudden jolt to the head as well as a direct blow. Both cause the brain to “jiggle” in the skull which can damage its parts. Concussions can result in physical, cognitive, and behavioral symptoms. Based on the force and location of impact, the symptoms may differ. The most common symptoms are confusion, headache, dizziness, fatigue, nausea, vomiting, extreme emotional outbursts, and loss of memory. The consequences of undiagnosed and untreated concussions can be severe and although most are resolved in about two weeks, some can linger on for months causing permanent damage to the brain and leading to depression, anxiety, and in some cases suicide.

Parents, you must be your child’s advocate and you must be aware of the symptoms. School districts should ensure that all student athletes, including in middle school, are well taken care of. This means providing the necessary training to coaches and ensuring that an athletic trainer is at every game where high compact is involved. Our children’s health depends on it.


Yvonne Morgan teaches upper level practicum in health science technology courses specializing in therapeutic careers and sports medicine at the School of Health Professions at the Yvonne A. Ewell Townview Magnet Center in Dallas. She is a 2019–20 Teach Plus Texas DFW Policy Fellow.

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