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Major Gaps Found in Coach Concussion Education Across States

More than 40% of concussions diagnosed each year occur in youth athletes, yet many states lack clear enforcement of concussion education for coaches. A new study published in PM&R: The Journal of Injury, Function and Rehabilitation shines a light on these critical gaps. Led by researchers from Stanford University and the TeachAids Institute for Brain Research and Innovation, the report uncovers stark differences in how states regulate, and sometimes fail to regulate, concussion training for coaches.

“There’s a disconnect between what we ask student athletes to do before playing sports and what we actually ensure they do,” said Dr. Daniel Daneshvar, Co-Director of Sports Concussion at Mass General Brigham, Chief of Brain Injury Rehabilitation at Harvard Medical School, and senior investigator of the study. “Many states or governing bodies mandate different levels of education, but the actual enforcement varies substantially.”

When Policy Falls Short

Concussions are a major public health concern, with youth athletes particularly at risk of long-term effects. Despite the dangers, the study found that only 68% of states explicitly require youth coaches to complete an actual concussion education training. Even in states with mandates, training frequencies and content vary widely, and enforcement mechanisms are often absent.

In some cases, states delegate enforcement to local sports organizations without oversight, leaving a patchwork of compliance. “The biggest risk is that these policies, which legislators passed to protect kids, aren’t actually being implemented,” Daneshvar noted.

Beyond State Laws: Local Gaps

The research also explored how regional youth sports governing bodies, like those affiliated with the National Federation of State High School Associations (NFHS) and other independent organizations, fill in or fall short where state laws leave gaps. “We wanted to ensure there wasn’t some other organization filling the enforcement gap,” said Daneshvar. Instead, researchers found that responsibility often falls to local entities without real accountability.

Another concern is the narrow reach of many policies, which typically apply only to school-based sports and overlook millions of kids in community leagues. “When there’s no check-in, these athletes miss out on the concussion education that keeps them safe,” Daneshvar said.

He added a direct note to young athletes: “Playing through a concussion doesn’t just put your brain at risk, it also raises your chances of injuries elsewhere because your reaction time and balance are off.”

Toward Stronger Protections

The researchers argue that addressing these gaps goes beyond better-written laws, it’s about protecting young athletes’ long-term health. “One issue is that you don’t know what you don’t know,” Daneshvar said. “If no one ensures you get the legally mandated education, you’re left vulnerable to the dangers of playing with an injured brain.”

For athletes hesitant to report concussions, he added: “You’re not just protecting your brain for the season, you’re preserving your career and your team’s chance of success.”

This message resonates with legendary Stanford Tennis Coach Dick Gould, who led the university to 17 NCAA championships over his 38-year coaching career and has been a national advocate for athlete well-being. “As coaches, our greatest responsibility isn’t just building winning teams, it’s protecting the lives and futures of our athletes,” Gould said. “I’ve seen firsthand how education, like that offered through CrashCourse, can empower young people to recognize the signs of injury and speak up. We owe them more than policies; we owe them knowledge, support, and a culture that puts safety first.”

A Roadmap for Change

The study’s dataset is publicly available through TeachAids, offering a comprehensive summary of each state’s concussion laws and related policies. “We aggregated all that information so parents, teachers, and researchers can easily access it and use it to advocate for better protections,” Daneshvar said.

Ultimately, the researchers hope the findings will spark action to ensure all student athletes are truly protected. “These gaps present opportunities for growth,” Daneshvar concluded.

About the Study and CrashCourse Resources

The report, “Variability in Youth Coach Concussion Education Requirements Across States,” offers a rigorous analysis of concussion education policies in all 50 states, alongside a review of 69 independent sports governing bodies’ rules. This dataset is publicly available to support further research and advocacy.

The study is part of a larger effort using TeachAids’ CrashCourse concussion education series, which was developed in partnership with over 100 medical and sports experts and informed by feedback from more than 300 student-athletes. CrashCourse aims to make concussion education more engaging, accessible, and actionable, helping fill gaps in knowledge and support athlete safety across diverse sports communities.

All TeachAids’ CrashCourse education is available for free.

Read the full study here: https://doi.org/10.1002/pmrj.13274