Indiana high school soccer coach Cruz Gallegos knew something was wrong when one of his players seemed to fade in and out of consciousness on the bench. The junior had been pulled from the field after getting slammed into midair during a match against a hometown rival.
Gallegos, who did his master's thesis on head injuries in athletics, had an idea of what he was dealing with: a concussion. "That kid was sitting there like he was on a whole other level, a whole other planet," said Gallegos, who coaches at Adams High School in South Bend.
Gallegos has coached soccer for more than a decade, but many of his peers may overlook signs of potential concussions if they're not aware of the symptoms — or how long it can take for them to show up. A new Indiana law, one of the most extensive training requirements in the nation, will look to close that knowledge gap.
Starting in July 2017, all coaches for every public school sport offered to students in grades five through 12 must complete a course on how to spot symptoms, such as dizziness and temporary loss of consciousness, and the potential consequences of concussions. The law, recently signed by Gov. Mike Pence, also gives civil immunity to coaches who complete the course from being sued for student injuries.
"The kids we're talking about, middle school, high school, they're more vulnerable than the pros," Dr. Henry Feuer, a neurosurgeon and member of the National Football League's Head, Neck and Spine Medical subcommittee, said at a state Senate hearing earlier this year.
Concussions are at the forefront of leagues' minds these days, as the NFL and NCAA face numerous lawsuits from players who say they weren't properly informed of the risk of concussions. Studies of the brains of several former NFL players who have died have shown they suffered from chronic traumatic encephalopathy, which is linked to repeat head injuries.
Indiana joined more than 40 states four years ago in a national blitz to require coaches to pull student-athletes with any signs of a concussion from games and practices until a doctor signs off. Indiana took it a step further in 2014, becoming the first state in the U.S. to mandate high school football coaches to get concussion-recognition training and require a 24-hour waiting period before a player can return to a sport after an incident.
"I think in general that has made a significant difference," said Dr. Terry Horner, a neurosurgical consultant for the Indianapolis Colts and Indiana University. "Parents are really more aware of what a concussion is."
During the 2014-15 school year, the Indiana High School Athletics Association received nearly 2,200 reports of concussive events for athletes — nearly half from football and the majority of the others from wrestling and soccer. But the reports don't show the entire scope of incidences because reporting is voluntary for schools and do not confirm whether each case was a concussion or just an incident that showed signs of a concussion.
The IHSAA already requires all public high school head and assistant coaches in any sport to get some concussion training, but the new law would mandate that they retake the course every two years. The additional training will be more beneficial, said IHSAA assistant commissioner Robert Faulkens.
"I think it's more helpful and it gets the parents more aware of what to look for and how to protect against damage at well," he said.
One of the lawsuits filed against the NFL is by the family of Dave Duerson, a two-time Super Bowl champion who committed suicide in 2011 and was found to have CTE. His brother, Michael Duerson, has been leading the recent efforts to bolster concussion legislation in Indiana schools through his organization, the Dave Duerson Athletic Safety Fund, which provides testing for concussions and advocates for safety awareness.
Michael Duerson also lives with the effects of a concussion he got 39 years ago playing college basketball; it paralyzed half of his body for nearly six months and to this day, he has to take handfuls of pills in order to sleep and get out of bed.
"I think we have a good start and we're further down the road than we were," he said. "I think Indiana has made the right move to put in place a protocol for the youngest of students."
The new law isn't expected to cost taxpayers much because coaches can take a 30-minute course through the federal Centers for Disease Control and Prevention for free.
Gallegos said his student who got a concussion didn't rejoin the team this year despite being a long-time player. And though it was the worst case Gallegos had seen, he has noticed more cases recently, which he said could be due to increased awareness — something he thinks will increase come next July.
"I think it's going to make other coaches maybe open their eyes more maybe about the severity of a concussion," Gallegos said. "It's one of the biggest things that we watch out."