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hen it comes to player safety, photos (and film clips) speak a thousand words.

A video montage created for a session at a recent NASO Sports Officiating Summit featured players being slammed, rammed, speared, elbowed, forearmed, run over, stomped on and pummeled. The audience, consisting of officiating leaders, reacted to each fresh collision with gasps, oohs and aahs.

Although hits to the head and the resultant concussions have been a particular point of emphasis in football recently, the video wasn’t confined to the gridiron. Athletes of all ages at all levels and several sports were depicted. And that means all officials need to be more diligent in keeping player safety JOB ONE.

Discussing the issue at that Summit were Bob Colgate, NFHS director of sports and sports medicine; Dr. Brian Hainline, chief medical officer of the NCAA and the former chief medical officer of the United States Tennis Association; Steve Shaw, Southeastern Conference coordinator of football officials; and Tom Minter, former risk manager for the Michigan High School Athletic Association and member of the NFHS Sports Medicine Advisory Committee.

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Jeff Triplette, NFL referee and CEO of ArbiterSports, served as moderator.

Because Colgate is also the liaison to the NFHS football and wrestling rules committees, he sees the issue of player safety from multiple angles.

“The game has changed,” Colgate acknowledged. “These athletes are getting bigger, faster, stronger. From the perspective of officiating, it’s got to change also. I think we’re behind on some things that we need to do. We can only do so much on the rules standpoint.”

Shaw pointed out that the NCAA recently put more teeth into its rules regarding contact at or above the shoulders of an opponent — a foul called targeting — by adding automatic ejection to the penalty.

“That has created conversation like there has never been before about (player safety), and that’s really good because football is a great game,” Shaw said. “We need to keep it great, but we have certain hits that we need to take out of the game. As officials, we must have the courage to enforce the rules as they’re written. As coordinators, not only do we have to teach our officials how to enforce it, but we have to stand behind them when they do put their marker on the ground and support it.”

Not a One Sport Problem

“Right behind football, we’ve got high incidence of injuries in soccer, wrestling, ice hockey, the list can go on and on,” he said. “Each one brings a different perspective from a safety or risk issue element that comes into play. From our National Sports Medicine Advisory Committee, we’re looking at all 17 sports we write playing rules on to address that.”

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Even when the rules of a sport allow violent contact, there are issues. Hainline noted that he is also a former ringside physician for the New York State Athletic Commission, which regulates boxing.

“I had to stop,” Hainline said, “because I got so queasy sometimes when I saw an athlete’s head getting concussed. It was difficult to actually witness that. The rules of boxing are very clear. The goal is to create neurological injury. A knockout means that you are so concussed that you can’t even pick yourself up from the floor. And a technical knockout means that you’re so concussed that you no longer have the neuromuscular control to protect yourself. But in none of the sports in the NCAA and none of the sports that we’re talking about is the goal to create a concussion, and I think that’s what we have to make very clear.”

Basic skills and executing plays in the games have been replaced by a desire to win through attrition — being more physical than the opponent to the point of knocking him or her out of the game.

“There’s been this understanding that if you really want to create a fumble, if you want to make certain that you’re safe at home plate, if you want to make certain that you disable someone else so that you make the play, the most effective way to do that actually is to cause a concussion, to target the other player,” Hainline said. “We as a society understand that that’s no longer acceptable. There’s been a movement that I think has been spearheaded by the NFL. The media has picked up on it. A lot of other places have been a little slow to accept that there’s a serious problem when you create a head injury.”

Minter, a longtime multi-sport official as well as an administrator, agreed that player safety rules are worthless if officials don’t enforce them. “Change has occurred. What we have to do as officials is to manage that change,” he said.

What’s the Rule?

Colgate pointed out that NFHS rules committees take into account several factors when considering rule changes. “The first priority of our rulesmaking process at the NFHS is safety — risk minimization,” he said. “When that is going to be tied into any rule that is approved by the committee is, can it be officiated? Can it be administered? We’ve got to look at the officials out there, that may put them into a position (in which a call is) subjective. Is it a clear-cut call? Where is this going to come into play?

“The educational process is something I think we’ve stepped up,” he declared. “I think our state associations have stepped up, and I think the local officiating chapters have stepped up also, because it’s all about education right now.”

Shaw noted that the Appendix C in the NCAA football rulebook addresses concussions. The reason that section is in the book — and the reason it’s important for officials to know it — is that their job in the area of injuries doesn’t begin and end with stopping the clock and waving the medical staff onto the field to attend to a stricken player.

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“I’m going to say in this world we’re in today, that’s not the end of our role,” Shaw declared. “In fact, the rulebook says … in this process officials and coaches — not just coaches and medical personnel — shall give special attention to player safety and players who exhibit signs of a concussion.

“Now (as a referee) I need to be looking over there into his eyes and say, ‘Is this guy woozy?’ If he’s demonstrating any signs of a concussion, I need to stop the game and put him out,” Shaw said. “The coach may not like it, but we need to get him to the right people on the sideline, the medical personnel, who now can make an assessment (and decide if) we let this guy play.”

While injury recognition is important, officials aren’t expected to be amateur physicians.

While injury recognition is important, officials aren’t expected to be amateur physicians.

“Absolutely not,” Hainline said. More important, he said, is management. “That’s really the key word. The officials aren’t asked to be medical doctors, they aren’t asked to treat, but they’re the group of people on the field or wherever they are on the court, they can manage the situation appropriately. They have guidelines to manage the situation, and I think that in this day and age if there was any sort of doubt, to err on the side of caution, no one is going to fault you for that.”

Offering information can be very valuable. “With 20,000 plus high schools across the country in the rural setting, we don’t have an appropriate health-care professional on the sidelines that’s coming out to tend to this individual that’s down on the court or on the ice,” Colgate said. “Maybe only one coach. If they’re tending to something else on the sidelines, they may not have seen what happened (to the injured player). Any information that (officials) may be able to let (the coach) know. Was this person conscious before they went down and collapsed? That could be a difference, life or death, right there. A little bit of information may do more good than harm. I think we’ve got to be proactive with this.”

Hainline agreed and suggested more education for officials. “You don’t have to be medically qualified to ask the question. You just have to have a sense of what you’re looking for. But for the official to ask, get a sense of what’s going on and to err on the side of caution, I think that’s really the way that things must go.”

Triplette related a situation from one of his games. Chicago Bears quarterback Jay Cutler took a hit that resulted in an injury. “He’s holding his wrist as the medical personnel come out. They treat that wrist, and lo and behold they sent him back in the next series,” Triplette recalled. “The next day they discover he has a serious concussion. He’s out for the next week.

“You come to find out that the trainers are administering to an injured player on the sideline (and) no one on the sideline — none of the trainers, none of the doctors — had seen the hit that took place on the field.”

Officials can and should offer any information that might assist the medical team, Minter said. “If you see a person get cut down and their leg buckles underneath where you know it’s a knee injury, and the trainer comes out and immediately starts looking around the player’s head or something like that, you have positive information that something is not right,” he said.

Warning! Don’t Warn

At one time, it was acceptable and in some cases mandated that players were warned but not penalized for what were thought to be minor infractions. Those days, Minter said, are long gone.

“I think for officials in managing player safety, we are going to need to rethink those incidents where we traditionally have passed on (penalizing),” he said. “We’ve seen the rather rough play off the ball, 15 yards behind the play, or at the other end of the court on the low post or something like that, and what have we traditionally done? We’ve gone up to those players and said, ‘Hey, I saw that. Can’t let that happen again.’ The old talk-to, right? We’ve all engaged in talk-tos. What we need to now look at and determine is, is a talk-to a viable defense when we talk to our insurance carriers? Because now plaintiffs are definitely going to raise that as an issue. … Maybe we’re going to need to rethink that. We’re going to step in on the first whistle when the puck is dropped in the first period, the minute we see something, we’re going to nail people, if for no other reason than self-defense.”

It Starts at the Top

While officials do bear a great responsibility in the area of player safety, Shaw believes they are not alone. “Coaches have to change the way they coach,” he said. “No longer can we say, ‘It’s just a good football play.’ You have to change the way you coach. If it’s tackling, heads up, see what you hit, lower your target. And then the player has got to execute that.”

In addition to the competitive edge that can be created by “taking out” an opponent, players are trying to make hits that will get them on TV highlight shows. Shaw says there is a way to accomplish that legally.

“In (players’) words, they can still blow (opponents) up, but stay off their head,” he said. “That’s the behavior that if we change we keep it a great game and a tough, physical game, but a more safe game. We as officials have to do our part to not hesitate to put the marker on the ground.”

While most great athletes are considered to have a certain “tough-guy” mentality, Hainline said taking that attitude to an extreme is problematic in the treatment of injured players.

“It’s not only that players shouldn’t try to hurt someone else by way of deliberately concussing them, but players who are concussed, they actually hide it,” he said. “We’re publishing a study (that reveals) 50 percent of players from an Ivy League football school — you’d think they’re educated — hide their concussions because they’re afraid they’re going to lose their position, someone is going to take it from them.”

Hainline said the NCAA has an opportunity to add to the body of knowledge by creating a video devoted to player safety, injury recognition and prevention. “A video package that has a lot of educational pieces in it,” Hainline said, one that “really just takes you from A to Z about the different points, not only of concussion, but other potentially serious issues that happen on the field. The NCAA has a role, I think has a duty, to do the education.”

The last piece of the puzzle, Hainline said, is buy-in from parents of players and fans.

Repercussions Coming?

In some ways, the injury problem is nothing new. Triplette recalled that President Theodore Roosevelt threatened to ban college football after a spate of catastrophic injuries, including deaths, were occurring during games. Roosevelt conducted a meeting with influential coaches and ordered them to get things under control. Those efforts mollified the president and the game continued.

Could history be preparing to repeat itself?

“That’s a good question,” Colgate responded. “If we don’t take a close look at all parties involved with the management of sport, there’s going to be issues. And if it’s not going to be addressed by those that are overseeing it, I’ve got a feeling Washington, D.C., is going to step into the fold.”

Congress has made noise about mandating concussion legislation. Hainline said the NFL and the NCAA were made aware of a bill that would have prescribed exactly how to manage a concussion. “That’s the worst thing that Congress can do because every concussion is different,” he said. “If we are now saying the doctor has to do this, the trainer has to do this, Congress just doesn’t have the ability to do that. They tried to do that with diabetic care. What happened is we had more brain injuries from diabetes as the result of a mandate from what they passed than we ever had before.”

The Player Safety Bottom Line

The panel concluded that the watchword is change. Every stakeholder in sports needs to change his or her attitudes regarding player safety and injuries. “Playing hurt” is no longer to be admired; it is to be abhorred.

“I would say to all of the management, and all the administrators, all of the officials, all of us have to change,” Triplette concluded. “This is serious stuff, and it’s our job. It’s our job to protect every one of our sports.”

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