At the University of Virginia, reports of concussions have tripled but doctors say more hits may not be to blame. Increased education and awareness paired with return-to-play laws have players, coaches, and parents thinking twice. 

A concussion is a brain injury characterized by impairment of cognitive and/or physical functioning, and is caused by a blow that causes a jarring of the head (i.e., a helmet to the head, being knocked to the ground, etc.) According to the American Journal of Sports Medicine, concussion rates have more than doubled in the past 10 years. It's a trend that is holding true in central Virginia. 

Doctor Kristen Heinan, a pediatric neurologist at UVA has seen concussions surge in greater Charlottesville. In 2014, her team diagnosed people 22 years old and under with a total of 647 concussions. That's up more than a 300 percent from just 5 years ago.

Fourteen-year-old Rachel Taylor took a hard hit to the head playing soccer for Charlottesville High School in early April. A corner kick collision left her with a concussion. “I didn't know when the day was, or the date or my phone number. It was hard and I went to the doctor and had to say the months backwards and oh my goodness I could not do that!" She stated.

Luke Reilly suffered a concussion playing lacrosse for Western Albemarle High School. One play set him back four weeks. “It was really frustrating. It's kind of like being bedridden because you can't really do anything at all. You're just kind of sitting there. You can't play sports, you can't watch TV, you can't do schoolwork,” he said. 

The concussion sidelined Reilly for so long because of return-to-play laws, adopted in Virginia in January 2011, which establish specific guidelines for the treatment of concussions.  The guidelines ensure that student athletes who get concussions are properly diagnosed, given ample time to heal, and are supported until they are symptom free. Student athletes cannot return to play until several conditions have been met.  Click here to read more on the Virginia Board of Education guidelines for policies on concussions in student-athletes. 

One of the purposes of return-to-play laws is to prevent second-impact syndrome, when the brain swells catastrophically from a second concussion before the first is fully healed. “The biggest thing that people worry about is second-impact syndrome. That's actually very rare, but that is the deadly thing that you would worry about," stated Dr. Heinan.

Dr. Heinan believes high profile cases of second-impact syndrome and heightened awareness could be causing the increase in the number of reported concussions, not necessarily more hits.  "People are becoming almost hyperacute about it," she stated.

Charlottesville High School football coach Eric Sherry agrees. “Just because of today's culture and information is, the automatic trend is you get hit and ‘oh my goodness, that's gotta be a concussion,'" he said.

He remembers a different game, one of more hits and less diagnosed concussions.

"Growing up, when I was younger, concussions you know were dismissed a lot of the time as ‘you got your bell rung' or ‘you got something this or that' and you went about your business. And that was just the way things were conducted. Nowadays that's certainly not the case, nowadays you treat everything with a little bit more caution,” he said.

Coach Sherry says he figures football is actually getting safer. “If anything, I would say kids are getting hit far less than what it used to be. And I can guarantee that, especially with us, the way rules have changed and the way you go out in the waters and educate yourself.”

More education and rules are exactly what the Virginia High School League (VHSL) wants. The VHSL governs high school sports in Virginia.

“Whether it's coaches, parents, or players, things that used to slide through are not happening so much anymore with players and concussions, even the thought of a potential concussion,” said VHSL Assistant Director Tom Dolan.

To combat concussions, the VHSL limited live contact time for football practice to less than 90 minutes a week. And now it's taking a second look at how helmets are worn, making sure they fit just right. Football helmets have an air bladder that needs to be properly inflated and it's important lacrosse helmets sit right and aren't too loose. 

"The proper fit of a helmet is one of the most important things to do in helping not eliminate but lessen the hits and the injury that can occur," Dolan stated.

Another right-to-play guideline is that coaches must complete an online concussion education and prevention course each year.  “There's a sign off that they do within their school and then the school keeps the records and if there's ever a question we would ask the school, ‘let's see your record on so-and-so coach,'" Dolan said.

VHSL says its next move might be imposing live contact limits on lacrosse, the sport that left Reilly benched and behind in school. According to the Center for Disease Control, his age group, 15- to 19-year-olds, has the highest risk for concussions. 

"I had a lot of trouble concentrating, and I had a lot of trouble for about a month after until it finally went back to normal,” Reilly said.  

Dr. Heinan says missing class can cause other serious concerns. "Feeling isolated and anxious because they're falling behind and so that anxiety makes them feel bad and contributes to their headaches and then they get depressed because they're isolated, they haven't seen their friends," she said.

Dr. Heinan says the emotional reaction can be explained by science, "the physical part, with disruption of the neurotransmitters and the brain chemicals, that in and of itself can contribute to mood lability, grumpiness, tired." 

Taylor remembers feeling confused and frustrated.  "It hurts really bad and you need someone to help you or you get over emotional, which I did. I just cried about everything, even stupid things. I just cried and cried and cried.”

Now she is ready to leave that concussion behind, finally cleared by the doctor to play. “It should be great. And I'm confident I'm gonna score," she stated.

Symptoms for a concussion can vary from severe headaches to memory loss and you do not have to be knocked unconscious.  Dr. Heinan says concussions are not just high school sports related. She has seen children under two years old with concussions. The safest bet if you think you or your child suffered a concussion is to see your doctor.