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Appendix

The Safety in College Football Summit was held January 22-23, 2014, in Atlanta.  The Summit was co-sponsored by the College Athletic Trainers’ Society and the NCAA.  The summit arose from discussions between Scott Anderson, president of the society, and Brian Hainline, NCAA chief medical officer.  The intent of the summit was to bring together a multifaceted group of experts who share a common interest in improving the culture of safety in intercollegiate sports in general, and football in particular.  The summit was not an open meeting; rather, it was a working group with defined short-term and intermediate-term goals.  The working group participants were established by reaching out to medical groups, NCAA representatives and coaches. The short-term goal of the summit was to conduct a two-day working meeting that addressed three key issues:

  1. independent medical care in the collegiate setting;
  2. concussion diagnosis and management; and
  3. football practice contact.

The intermediate goal of the summit was to draft three consensus documents that arose from the working group discussion of these three key issues, to circulate these documents for editing and to then present the final edited documents for endorsement.

The summit working group was composed of:

Jeff Allen ATC

University  of Alabama (director of sports medicine, head football athletic trainer)

Scott Anderson ATC

College Athletic Trainers’ Society (president)/University of Oklahoma (head athletic trainer)

Ben Anguish ATC

University of Nevada, Reno (assistant director of sports medicine, head football athletic trainer)

Julian Bailes MD

American Association of Neurological Surgeons; Congress of Neurological Surgeons; NCAA Concussion Task Force/University of Chicago

Laura Balcer MD

NCAA Concussion Task Force/New York University

Britton Banowsky

Conference USA (commissioner)

Jeffrey Bazarian MD

University of Rochester

Brant Berkstresser ATC

NCAA Competitive Safeguards and Medical Aspects of Sport Committee (chair)/Harvard University (head athletic trainer)

Jeff Bytomski DO

American Osteopathic  Academy of Sports Medicine

Carolyn Campbell-McGovern

Ivy League (deputy executive director)

General Peter Chiarelli

U.S. Army

Randy Cohen PT, ATC

National Athletic Trainers’ Association/University of Arizona (associate director of athletics, medical services)

Bob Colgate

National Federation of State High School Associations (director of sports medicine)

Ron Courson PT, ATC

University of Georgia (director of sports medicine)

Bill Curry

College Athletic Trainers’ Society

Terry DeZeeuw ATC

Colorado State University (associate athletics director for sports performance)

Woodie Dixon

Pac-12 Conference (general counsel and senior vice-president of business affairs)

Ruben Echemendia PhD

NCAA Concussion Task Force; Sports Neuropsychology Society

Christopher Giza MD

NCAA Concussion Task Force/University of California, Los Angeles

Kevin Guskiewicz PhD

NCAA Concussion Task Force/University of North Carolina, Chapel Hill (distinguished professor and senior associate dean)

Brian Hainline MD

NCAA (chief medical officer)

Kimberly Harmon MD

American Medical Society for Sports Medicine/University of Washington (team physician)

Steve Hatchell

National Football Foundation (president and chief executive officer)

William Heinz MD

National Federation of State High School Associations (chair, sports medicine advisory committee)

Stan Herring MD

American College of Sports Medicine; NCAA Concussion Task Force/University of Washington (team physician)

Tony Hill ATC

California State University, Fresno (head football athletic trainer)

Tim Hosea MD

American Orthopedic Society for Sports Medicine

Thomas Blaine Hoshizaki PhD

NCAA Concussion Task Force

Barry Jordan MD

NCAA Concussion Task Force

Tim Kelly ATC

U.S. Military Academy  (head athletic trainer)

Kerry Kenny

Big 10 Conference (associate director, compliance)

Kerri Krawczak

Mid-American Conference (director of football operations/special events)

Peter Kriz MD

American Academy of Pediatrics/Brown University (assistant team physician)

Jeff Kutcher MD

NCAA Concussion Task Force/University of Michigan (team physician)

Adria Lamba

Montgomery McCracken Walker & Rhoads

Will Lawler

Southeastern Conference (associate commissioner)

Josephine Lee ATC

College Athletic Trainers’ Society (executive director)

Cheryl Levick

National Association of Collegiate Directors of Athletics/Georgia State University (director of athletics)

Don Lowe ATC-R

College Athletic Trainers’ Society (chairman of the  board)

Terrie Meyer

NCAA

Jenny Moshak ATC

College Athletic Trainers’ Society

Robert Murphy ATC

College Athletic Trainers’ Society/Georgia State University (associate athletic director for sports medicine)

Scott Oliaro ATC

College Athletic Trainers’ Society/University of North Carolina, Chapel Hill (associate director of sports medicine)

Steven Pachman

Montgomery McCracken Walker & Rhoads

John Parsons PhD ATC

NCAA (director, Sport Science Institute)

Scott Petersmeyer

Pac-12 Conference

Ryan Pinson ATC

University of Wyoming (director of sports medicine)

Sourav Poddar MD

NCAA Competitive Safeguards and Medical Aspects of Sport Committee/University of Colorado (team physician)

Kenneth Podell PhD

NCAA Concussion Task Force

Margot Putukian MD

NCAA Concussion Task Force/Princeton University (team physician)

Rogers Redding

NCAA (national officiating coordinator)

Doug Rhoads

Atlantic Coast Conference (coordinator of football officiating)

Eric Rozen ATC

College Athletic Trainers’ Society/University of Rochester (head athletic trainer)

Greg Sankey

Southeastern Conference (executive associate commissioner)

Matthew Sign

National Football Foundation (chief operating officer)

Ed Stewart

Big 12 Conference (associate commissioner)

Thomas Talavage PhD

NCAA Concussion Task Force/Purdue University

Grant Teaff

American Football Coaches Association (executive director)

Jim Thornton ATC

National Athletic Trainers’ Association (president)

Scott Trulock ATC

University of North Carolina, Chapel Hill (head football athletic trainer)

James Tucker MD

College Athletic Trainers’ Society

Gary J Walenga

Mountain West Conference (director of special projects)

Robert Waller ATC

University of New Mexico (director of sports medicine)

Jim Whitehead PhD

American College of Sports Medicine (executive director)

Kyle Wilson ATC

University of Nevada, Las Vegas (director of athletic training)

 

The agenda of the summit follows.

Agenda: Safety in College Football Summit

Wednesday, Jan. 22, 2014

8 a.m. – noon              NCAA Concussion Task Force

Noon                           Lunch

1 p.m.                          Welcome, Overview, and Objectives
                                           Scott Anderson ATC

1:15 p.m.                     Today’s NCAA
                                                Brian Hainline MD

1:45 p.m.                     2005 – Today
                                                Ron Courson ATC

2:05 p.m.                     Less Contact … Less Injury … Time to Change
                                                Coach Grant Teaff

2:25 p.m.                     Concussions in Football: The Legal Landscape and Defense Considerations
                                                Steve Pachman

3:05 p.m.                     Break

3:25 p.m.                     History of the Army Head Trauma Protocol
                                                General Peter Chiarelli

3:40 p.m.                     Practice Contact
                                                Scott Oliaro ATC & Scott Trulock ATC

4 p.m.                          Ivy League Football Practice Standards
                                                Brant Berkstresser ATC

4:20 p.m.                     Legislating Player Safety: Recent Rules Committee Results
                                                Rogers Redding

4:40 p.m.                     Subconcussive Impact
                                                Julian Bailes MD

5 p.m.                          Discussion & Consensus: Contact Limitations

5:45 p.m.                     Adjourn

 

Thursday, Jan. 23, 2014

7:30 a.m.                     Breakfast

8 a.m.                          Innovation: Independent Collegiate Athletics Medical Care
                                                Commissioner Britton Banowsky

8:30 a.m.                     Best Practices
                                                Ron Courson ATC

8:50 a.m.                     A Conflict-of-Interest Free Environment
                                                Brian Hainline MD

9:20 a.m.                     Break

9:40 a.m.                     Standardized Assessment and Return to Play
                                                Kevin Guskiewicz PhD, ATC

10:10 a.m.                   Changing the Culture
                                                Jeff Kutcher MD

10:40 a.m.                   Discussion & Consensus: Collegiate Athletics Medical Care & Concussion Management

11:40 a.m.                   Parting Pearls of Wisdom
                                                Coach Bill Curry

noon                            Next Steps & Adjourn

 

The summit began with a half-day meeting of the NCAA Concussion Task Force. This task force met for the first time in April 2013. The primary purpose of meeting at the beginning of the summit was to review any emerging evidence-based data with regard to the effects of limiting contact during football practice. The task force members acknowledged that there was a paucity of scientific evidence regarding the causal effects of limiting contact during football practice. The secondary purpose of the meeting was to discuss research initiatives that may better address the science of limiting contact during football practice. Within this context, the committee expressed strong support for developing further an initiative between the NCAA and Department of Defense (presented in detail by Brian Hainline) that could lead to a prospective, clinical, longitudinal study that would help define the natural history of concussion.

Following this meeting, there were a series of presentations that are noted in the agenda. Each presentation was followed by a question-and-answer period, and there was also time allotted for the development of key summary points for independent medical care in the collegiate setting, concussion diagnosis and management and football practice contact. At the end of the summit, a working group (Scott Anderson, Brian Hainline, Margot Putukian, Kevin Guskiewicz) was assigned to write draft guidelines for these three issues. The draft guidelines were then circulated to all summit participants so they could distribute the guidelines widely within their organizations for review and comment. All comments were reviewed and considered by the working group, and this resulted in the final consensus guidelines that are distributed with this appendix for endorsement.

All of these guidelines must be differentiated from legislation.  As these guidelines are based on consensus and available science, they are best viewed as “living, breathing” documents that will be updated, as we have with other health and safety guidelines, based on emerging science or sound observations that result from application of these guidelines.  The intent is to reduce injury risk, but we must also be attentive to unintended consequences of shifting a practice paradigm based on consensus.  These guidelines are established in good faith as an important resource as institutions consider the formation of their own policies in football and in other sports that have risks of concussion.