High school coaches are not only charged with leading their sports programs, they are now also tasked with being first responders in emergency situations involving their players.
Janet’s Law, a state law implemented in 2014, requires at least one team coach, licensed athletic trainer or designated staff member to be trained in cardiopulmonary resuscitation [CPR] and the use of an automated external defibrillator.
Parents may feel more at ease this school year when they drop off a child at practice, as regulations now require better understanding of the effects of heat and hydration, limits on contact during football practice to help prevent concussions, and training in defibrillator use.
“In many schools in the Shore Conference, there is only one athletic trainer and we have to prioritize when it comes to games,” said John Desimini, the athletic trainer at Ocean Township High School.
“The coaches will be the first line of defense in recognizing the situation quickly, calling for backup and treating (the player) until we get there,” he said.
Janet’s Law is named after Janet Zilinski, an 11-year old from Warren who died in 2006 from sudden cardiac arrest after cheerleading practice.
The law requires schools to establish and implement an emergency action plan to respond to sudden cardiac events, which includes a list of five school employees, coaches or trainers to hold CPR and defibrillator certification, and a detailed procedure for responding to sudden cardiac events.
Desimini said he has trained Ocean Township coaches in CPR and the use of the defibrillator in-house since he became the Spartans’ athletic trainer 12 years ago. He also said he is hopeful more progress is made in addressing and identifying students at risk for sudden cardiac arrest, much like the progress that has been made in regard to concussions.
“The thing that scares me the most now is the sudden cardiac arrest,” Desimini said. “I think eventually they are going to start doing more with it like they started doing more with concussions.
“I think we are starting to notice that more kids are at risk at a young age, and that scares me the most.”
Better training for coaches is especially important in lower-risk sports, according to Desimini, because trainers are often forced to prioritize which games or practices to attend.
He said all coaches in Ocean Township schools have radio contact with the trainer in case there is an incident and he is not currently at the specific field.
“I have walkie talkies at every field, so if there is a soccer game, coaches will have walkie talkie,” Desimini said. “Soccer has just as many concussions as football, so when there are games, you just prioritize the higher-risk game.”
While Desimini is struggling with balancing multiple sports, South Amboy High School Athletic Director Ken Blekeski said the problem at his school is the district does not currently employ an athletic trainer; something he hopes is eventually addressed.
“Our coaches really have to be that first line of defense, and if it is something that they can’t really assess, they are going to make a call to the local first aid squad,” Blekeski said. “It is very inefficient and it is something we are trying to correct.”
While Janet’s Law is in its second year, the New Jersey State Interscholastic Athletic Association (NJSIAA), which oversees public, private and non-public high school sports in New Jersey, has made a concerted effort in recent years to reduce the risk of both concussions and heat stroke.
Cory Davies, the head coach of the Freehold Township High School football team, said the state has made great strides and it has led to an overall improvement for high school athletes.
“I think we’ve come a long, long way with just the whole awareness to it and the awareness to the concussions and the hydration from where we were back in the old days,” Davies said. “We think about sometimes there were a lot less concussions back years ago, but there probably were because no one ever knew what a concussion was.
“The awareness is so much different and so much better for the protection of the game.”
Steven Timko, NJSIAA executive director, said one of the new requirements in 2015 is that football teams are only permitted 90 minutes of contact a day once the first game of the season is played in an effort to limit concussions and other injuries.
Davies said the new policy would help players stay healthy throughout the season.
“The first thing that has been changed is how many contact days we actually can have,” he said. “There is less contact in practice, and we are able to keep players healthy from the standpoint of not having concussions during practice.”
Although Davies said he never coached a lot of contact practices even in his early days as a head coach, he said a lot of coaches years ago made contact in practice an emphasis.
“When I first started coaching, a lot of guys wanted to find out how physically tough the players were and had a lot of contact drills,” Davies said.
According to Timko, all coaches are also required to take both a concussion and heat acclimatization course in the offseason to better understand the risks to the players and better equip themselves to possible emergency situations.
Desimini said as recently as six years ago players who suffered concussions were able to return to play after headache symptoms subsided.
However, he said the district requires all athletes to submit to an impact concussion test, which is a cognitive baseline test that can be used as a comparison when a player has a concussion.
“When they start to get close to the baseline, we can start progressing them,” Desimini said. “After we feel that they’ve been cognitively in good shape, we start to do a return to play protocol.”
According to Desimini, the return to play protocol is a five- to six-day process where the player progresses from riding a stationary bike to light aerobic work to weight training to individual sport drills to light contact before the player may return to practice.
Desimini also said it has become policy in Ocean Township to relax the strenuous academic requirements of students suffering from concussions.
“We started giving them academic (guidelines) because we start to notice that any type of brain stimulation does not help the healing process,” he said.
“There are guidelines that give the student extra time in class. They are allowed to wear sunglasses in class if they are still sensitive to the light, and allow them to do homework when they feel ready.”
Blekeski said a lot of the improvements to player safety could be attributed to continued research on concussions and a better understanding of the risk.
“A lot of it is really common sense,” Blekeski said. “I think a lot of things have changed in the last 15, 20 years where it used to be just get out and go and suck it up.
“A lot of that has changed, coaches are very conscious now of a lot of different things.”
Blekeski said the problems that persisted in the past have been largely addressed by policy changes within both the individual districts and the NJSIAA.
“It absolutely has been addressed, there is a tremendous amount of training that coaches have to go through just to recognize it,” Blekeski said. “I have no doubt that as far as concussions are concerned that really has been addressed here in New Jersey.
“I think that the coaches who work here all treat it the same, whether it is a game, whether it is a practice or any kind of activity. They really are vigilant when it comes to things like that.”
According to Blekeski, a lot of the focus on concussions on the high school level can be attributed to high-profile cases like Hall of Fame linebacker Junior Seau, who committed suicide in 2012 after 20 years in the NFL with the San Diego Chargers, Miami Dolphins and New England Patriots.
“I think the state has really been pretty proactive when it comes to concussions,” he said. “I think a lot of that trickles down, you see a lot of big profile guys in the NFL.”
While football gets the lion’s share of attention regarding concussions, the Sports Concussion Institute, a California-based research organization studying concussions for middle school and high school athletes, has concluded that there is a 50-percent risk of concussion for female soccer players.
Courtney Bonura, the head coach of the Howell Township School girls soccer team, said to limit concussions during practice her teams do not often practice “headers.”
She said the majority of the concussions that occur during soccer games are either by players heading the ball or two players colliding, both which she seeks to avoid during practice.
Another issue that has received attention by the NJSIAA and high schools throughout the state is the risk of heat stroke to players as practices primarily begin in August in preparation for the season.
Timko said one of the recent guideline changes is football players gradually work toward full pads once practices start in August, meaning practices begin with only helmets for a period of time before adding pads due to the heat.
Davies said an emphasis on hydration throughout the day is a focus for players in Freehold.
“We’re at the point now where we have all kinds of water jugs out there, we have guys walking around squirting water bottles and we have water stations,” he said. “We preach to our guys that they have to be drinking water over a period of time and not just when they get to practice.”
Davies said how coaches view water breaks is a far cry from the days of the “Junction Boys” where water breaks from Hall of Fame head coach Bear Bryant were few and far between.
“Years ago that wasn’t even a thought,” Davies said. “I know when I played, once a practice we’d walk over to a hose and the coach would yell at you if you stayed at the hose too long.”
Blekeski said South Amboy coaches have also focused on the risk of heat stroke for players and have cancelled more summer practices in 2015 due to heat than in years past.
“This summer felt like it was particularly hot and humid here,” he said. “For the first time in a while, I actually have seen coaches not even go to the point of having practices for teams.
“It was cancelled for heat maybe once or twice a week.”