The concussion discussion has become more prevalent over the past decade since awareness of the prevention of traumatic brain injuries has gained attention.

The American Academy of Pediatrics reported that concussions rose 200 percent among teens ages 14 to 19 in the last decade. Concussions may be caused by the internal rattling of the brain against the skull, including from whiplash. Symptoms such as dizziness, headaches, nausea, forgetfulness, imbalance, mood changes, fatigue, auditory dysfunction, visual sensitivity and memory loss can last a lifetime, even though concussions normally diminish after about 10 days.

Boys’ lacrosse coach Tarik Ergin recalled his time spent in high school athletics in the 1980s when concern over helmet safety gained scrutiny from coaches and trainers. In the previous year of 1976, the National Collegiate Athletic Association and the National Federation of State High School Associations had altered high school football rules establishing butt blocking and face tackling as illegal in an effort to “reduce the incidence of” getting concussions and catastrophic cervical spine injuries from the “deliberate” use of helmet-contact.

With safer helmets, Ergin said athletes took advantage of their sturdiness by increasingly using head-butting on the field, gradually decreasing the importance of thick shoulder pads as less shoulder-butting was used.

“We were always taught as kids to hit with your shoulder, not your head. But, today, there is this evolution in football and lacrosse where everyone wants to wear the smallest shoulder pads possible,” Ergin said. “I was the kind of player in football and lacrosse where I loved to hit, but I also loved to not get injured, so I wore the pads. Nowadays, it’s more about the look than it is the effectiveness.”

However, Ergin said concussion safety isn’t necessarily about the right protective gear: it’s about the focus on pre-game awareness and preventative training ahead of time.

“I think that instead of buying the right gear, teaching people a way to avoid hitting in a dangerous manner and proper technique goes a long way toward protecting against serious injury,” Ergin said.

Sophomore and junior varsity lacrosse player Massimo Ridino said that he suffered a concussion while playing for the Los Angeles Mavericks in July 2017.

“During a game, I was carrying the ball down the field when another player got into my blind spot. He was much bigger than me, so he hit me and I landed straight on my back. When I landed I hit the back of my head. After the game, I knew I had a concussion,” Ridino said. “Things like nausea, dizziness and headaches were frequent for the next week, although they decreased in severity as the week went on.”

Ridino said he was affected going into the school year.

“[I got] headaches from looking at the smart board too long, any device [was] a small problem. It just made it a little hard to focus,” Ridino said.

Co-athletic director Ann Pettit said that players must be symptom-free for an entire week before they can get back on the field.

“During that time it’s important to rest, to not be active and to follow whatever the doctor tells you to do in terms of thinking and homework,” Pettit said.

Contact sports are known for increasing the risk of concussions. According to the Centers for Disease Control and Prevention, 33 percent of sports-related concussions occur during football practice.

“Most of our concussions happen during football practice where one player is going full speed and the other tends not to be going full speed,” head football Coach Casey Webb said.

California state legislature mandates that every high school and pro athlete team has to hire coaches with certification. To become certified, athletic coaches and trainers must study and pass a class on concussion protocols administered by the National Federation of State High School Associations. This class guides them through concussion diagnosis, symptoms, focused neurological examinations — including focused orientation exams that test short-term memory recall such as the event, score or last meal as well as long-term with a name or birth date –– and recognizing students approved by a health physician as symptom-free and ready to return to the playing field.

“The protocol for kids getting back to playing from concussions is a lot stricter. A concussion can happen and the most dangerous part is playing again and getting hit again before you’re fully healed, and in the past they didn’t understand how fully dangerous that was, and that can be deadly,” Pettit said.

High school football accounts for 47 percent of all sports-related concussions, the American Orthopaedic Society for Sports Medicine reported. Oak Park High School’s head athletic trainer Brenda Pasqua evaluates a student athlete’s neuropathological status in the event of concussion-inducing circumstances by pulling them out of the game and performing a “sideline” evaluation.

Boys’ soccer head coach Kevin Smith said that if a student presents even the slightest chance of a concussion, it becomes a matter of “When in doubt, sit them out,” which is a motto enforced by the NFHS.

“Anytime the player gets hit in the head at all, and they look dizzy, I just pull them out because it’s not worth it. If they show any symptoms at all, they’re done, they’re just done,” Smith said. “We are team, we have always been a team, so one player does not make or break that team.”

USA Today reported that more girl soccer players suffer concussions at 17.1 percent compared to 12.4 percent of boy soccer players. Girls’ soccer coach Mark Zeolla said he trains his players to be mindful of the risk of brain trauma.

“While concussions are frequent, most athletes have not shown signs of this trauma however, anytime an athlete gets hit in the head can have some effect to their health.  In soccer the 50/50 ball is the worst, two players battling for possession of a ball typically in the air and sometimes they collide heads or get struck by the ball when not prepared. This usually happens on corner kicks, goal kicks and balls that are being cleared by the defensive backs,” Zeolla said. “We train our athletes to use proper technique when heading to minimize trauma but accidents will always happen.”

Concussion awareness and scientific research has spiked interest over the past few years mostly due to incidences involving National Football League players and  chronic traumatic encephalopathy.

CNN reports CTE to be a neurodegenerative brain disease caused by repeated head trauma which include symptoms of memory loss, aggression, depression, anxiety, impaired judgement and impulse control. CTE cannot currently be diagnosed among living players and has only been discovered during autopsies of deceased players’ brains.

According to the National Public Radio, the NFL invested $100 million in 2016 “in support for independent medical research and engineering advancements in neuroscience related topics” after repeatedly denying claims of a connection between CTE and football.

“This is in addition to the $100 million that the NFL and its partners are already spending on medical and neuroscience research,” NPR reported.

Now in 2017, the New York Times reported that out of 111 NFL brains studied by a neuropathologist, 110 brains, or 99 percent, were found to have CTE.

Pettit said that, with the new knowledge of the effects of concussions in mind, being aware is the most important tactic in reducing risk of severe brain trauma.

“I’m hoping that the certification process of knowing what concussions are and how to treat them is widespread across all of our people dealing with athletes,” Pettit said. “Sports should be fun, but there’s always an element of risk.”