The soccer ball flew straight for her head.
But jumping to meet it, she met a different object — another player’s skull.
Jason Bailey, head athletic trainer for Capital Area Soccer League (CASL), picked up his phone and dialed 911. Sirens blared minutes later and, after an emergency room visit, the doctors diagnosed the young soccer player’s fourth concussion to date.
Bailey is tasked with seeking help for injured players nearly every day. Concussions, which occur when the brain slams against the skull, happen all too frequently, he said.
As traumatic brain injuries have come under intense media criticism in recent years, many Triangle-area youth sports leagues have seen an increase in the number of reported concussions.
The effort to combat concussions differs between both sports and leagues, but the overarching message remains the same: Players need to be aware of the risks, and coaches need to be well-equipped to handle these injuries.
Diagnosed concussions in the Raleigh Parks, Recreation and Cultural Resources Department’s football program have risen from four during the 2012 season to nine in 2014, a 125 percent increase.
Because concussions have received so much media attention in recent years, parents are more on the lookout for symptoms and are more likely to report concussions, said Zach Cheek, the recreation program manager for the Raleigh Parks, Recreation and Cultural Resources Department’s Athletics Division.
Cheek explained that the Youth Athletics Program, which offers nine different organized sports for children ages 5 to 18, implemented HEADS UP, a CDC initiative to protect young athletes from concussions and promote awareness of traumatic brain injuries.
Although it can be difficult to restructure tackling techniques, football team coaches have learned new fundamentals and drills to help players reduce head-to-head contact, Cheek said.
“It doesn’t take it out of the game completely, and, really, no fundamentals ever will,” he said. “But it helps reduce the likelihood of those situations occurring.”
The department’s football program instituted the HEADS UP program at the start of its fall 2014 season. HEADS UP includes online trainings for coaches and families, which all football coaches were required to complete prior to the start of the 2014 season.
Coaches trained in HEADS UP, Cheek said, are more equipped to recognize symptoms and encourage parents to seek medical help. In coming years, he hopes the new programming will bring the number of concussions down.
As the CASL’s head athletic trainer, Bailey is used to seeing players injured on the field.
“Injuries happen all the time,” he said. “You’re going to have anything from major injuries to minor injuries every game, with minor injuries being bumps and bruises.”
The CDC estimated 10,400 of youth concussion diagnoses from 2001-09 resulted from playing soccer, which equates to 6 percent of all diagnosed concussions.
Bailey said that like the Raleigh Parks, Recreation and Cultural Resources Department’s youth football program, CASL introduced the HEADS UP program in 2014.
Currently, only the coaches that oversee the league’s highest level of competitive soccer have completed the training. Bailey said he hopes the training will trickle down to the league’s other coaches until every coach is HEADS UP trained.
Athletic trainers are often the first stop after a player is injured. The trainers work to evaluate injuries and refer players to physicians if a concussion or other serious injury is suspected.
“As soon as they notice that their child is acting a little headachy, or if there are really ever any questions, it’s better to be on the safe side rather than letting them do their thing,” said Lindsey Howard, a physician’s assistant at the Charlotte-based Carolina Sports Concussion Program.
The league has its own policy on concussions, which mandates that a player can’t return to the field unless a neurologist or sports concussions doctor provides a doctor’s note, or until the player has been cleared by an on-site athletic trainer.
Cheek doesn’t consider concussions to be as much of a concern in his department’s youth basketball program as they are in football, but basketball coaches are still on the lookout for possible brain injuries.
“Not to say concussions do not occur in basketball, but more on an overview basis, (other injuries) occur more in frequency due to the nature of the sport,” he said.
Still, basketball is the fourth leading cause of diagnosed concussions in children 19 and younger, according to the CDC.
Those nearly 4,000 concussions from 2001-09, caused by hitting another player, for instance, are cause for concern in local sports leagues.
Cheek said all of the program’s coaches are certified by the National Alliance for Youth Sports. The alliance’s National Youth Sports Coaches Association aims to provide safe sporting environments by teaching appropriate coaching techniques to volunteer coaches.
“We still enforce the same ‘when in doubt, sit them out’ philosophy on any injury concern, but specifically head injuries,” Cheek said.
At Team Attraction Gymnastics in Apex, students perform tumbles everyday. Although most of these do not end in injury, Owner and Recreational Director Cindy Cotten said concussions are not uncommon in gymnastics.
“It’s not always just a blow to the head,” she said. “Sometimes a child can fall hard and have to sit out.”
Team Attraction Gymnastics saw three concussions in the past year. That number comes from only two students — one suffered two concussions in the same year.
Howard said multiple concussions like these are concerning.
“Especially in kids, if you get multiple concussions, you can have permanent deficits that can last forever, like decreased thinking speed and decreased reaction time,” Howard said.
Howard said gymnastics and cheerleading cause a large number of concussions in female athletes. The CDC estimated that from 2001-09, hospitals saw 3,300 diagnosed concussions caused by gymnastics, cheerleading and dance in patients 19 or younger.
All of TAG’s coaches are safety certified by USA Gymnastics, a governing body endorsed by the U.S. Olympic Committee and the International Gymnastics Federation.
The training teaches instructors to look for signs of concussions, when to remove children from the field of play and when to seek medical attention.
The Carolina Sports Concussion Program encourages safety precautions as well as returning players to the field only when they are ready.
“I think proper recognition is paramount,” Howard said. “It does take time for some of these symptoms to resolve, and it’s important to make sure that the child is healed before they return to any type of play.”
Cheek does not think concussion concerns should keep parents from enrolling their children in sports programs.
“There is a chance that something can happen, whether it’s just a bump or a bruise or even something to the extent of a concussion,” Cheek said. “Just knowing that likelihood can occur with any sport would just be something that you need to be aware of upfront.”