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Cody Spanberger had a concussion every year at Granite City High School. Three he got playing football. The other he had during baseball season, which he didn't report.

"We didn't really tell anyone about that," said Spanberger, "because it was not likely to happen again."

That attitude might not cut it this year. A new state law is requiring that any student athlete even suspected of having a concussion get an OK from a doctor before playing again. The law is meant to curb the kind of serious — even fatal — brain injuries that young athletes can get after repeated, jarring blows to the head on the playing field.

But with football season moving into high gear, some are questioning how the new rule will be applied — and whether it will have a real impact on the rough-and-tumble world of student sports.

"Kids can be competitive to a fault," said Collinsville High School Athletic Director Chris Kusnerick. "Our hope is that they'll be honest and our trained medical professionals will be able to recognize when a condition warrants attention."

Put me in coach

The law Gov. Pat Quinn signed late last month essentially forces coaches to remove any player who might have had a head injury during a practice or game. It applies to all sports and all ages and mandates that school districts work with the Illinois High School Association on developing plans to make sure the rule is followed.

The onus is put on coaches, trainers, players and referees to spot signs of a concussion, which the legislation broadly defines as "loss of consciousness, headache, dizziness, confusion or balance problems."

Jason Bennett, a St. Louis University athletic trainer and physical therapist, said concussions have gone overlooked for far too long because the injuries aren't taken seriously.

"If an athlete can get up and run around, and there's no obvious injury, there's a less serious sense of urgency," he said.

He said athletes who head back to the field before a concussion is healed run the risk of 'second impact syndrome." The potentially fatal condition can result from even a mild blow that rattles the brain, stopping its ability to regulate blood flow. This can cause swelling, permanent brain damage or death.

Of the 138 traumatic deaths of high school football athletes over the past 30 years, 17 were attributed to second impact syndrome, according to the American Academy of Pediatrics.

Former Collinsville High School quarterback Austin Hails is familiar with concussions: He sat out four varsity games last year after a rough play.

"I hit my head and I remember standing up and doing the signs for a play," Hails recalled.

But other than having a case of the giggles and forgetting who his opponent was, Hails said, his head was in the game.

"I was ready to go back in way before they said I was OK," he said.

I'm ready to play today

Hails and Spanberger, who both graduated in May, highlight the potential challenge of enforcing the new rule: It's sometimes difficult to tell when someone has a concussion. In his experience, Hails said, players would rather risk further injury than ride the bench.

"There was one kid on my team who was having some head pain and he didn't want to sit out," he said. "So he didn't say anything to the trainer."

Coaches say keen eyes of trainers, refs and physicians will be key to making the new legislation work. Many area teams keep trainers and physicians on the field during varsity matches to help them spot suspect symptoms that players might not be aware of, or trying to cover up.

"My biggest fear is when the underclassmen go on the road, they may not have trainers on the field," said Joe Iorio, Columbia High School athletic director.

Coaches say teaching proper technique early on also helps.

"If I don't think a kid is ready for contact, they won't put on pads and a helmet," said Jeff Hasty, who coaches 6-year-olds for the O'Fallon Little Panthers Sports Club.

The minute a player complains of a headache or other concussion symptom, Hasty pulls them off the field until they've been checked out.

In the end, education will be key to making sure kids stay safe while not altering the spirit of the game, said Eddy Harkins, president of the Tri-County Junior Football league, which has teams in Madison, St. Clair and Monroe counties.

"It's an impact sport, a collision sport. We encourage that," he said. "It's safe when we teach it properly."

Contact reporter Sarah Baraba at 618-344-0264, ext. 105