2010-11 Wrestling Points of Emphasis

2010-11 NFHS Wrestling Points of Emphasis Concussion Recognition and Management- Communicable Diseases- Fleeing the Mat- Slide Comment: The following three wrestling points of emphasis were selected by the NFHS Wrestling Rules Committee for the 2010-11 high school wrestling season. Each of these wrestling points of emphasis need to be stressed to all coaches, referees, wrestlers, parents, school administrators, appropriate health-care professionals and all others who have an interest in high school wrestling.

Concussion Recognition and Management A concussion is a brain injury that results in a temporary disruption of normal brain function- A concussion occurs when the brain is violently rocked back and forth or twisted inside the skull as a result of a blow to the head or body- Neither referees, nor coaches, are expected to “diagnose” a concussion, as that is the job of an appropriate health-care professional- Referees, coaches and administrators are being asked to make all efforts to ensure that concussed athletes do not continue to participate- Concussion Recognition and Management (Point of Emphasis): Adolescent athletes are particularly vulnerable to the effects of concussion. Once considered little more than a minor “ding” on the head, it is now understood that a concussion has the potential to result in death, or short- and long-term changes in brain function. A concussion is a brain injury that results in a temporary disruption of normal brain function. A concussion occurs when the brain is violently rocked back and forth or twisted inside the skull as a result of a blow to the head or body. The NFHS has been at the forefront of national sports organizations in emphasizing the importance of concussion education, recognition and proper management for the past several years. In 2008, the NFHS Sports Medicine Advisory Committee (SMAC) advocated that a concussed athlete be removed from play and not allowed to return to play on that same day. In 2009, this position was adopted by the leading group of sports medicine experts and the National Football League (NFL). To highlight the continuing importance of this issue, the NFHS SMAC and each sport’s rules committee have taken the unprecedented step of including Concussion Recognition and Management as a point of emphasis in each NFHS sport rules book for the 2010-11 year. The purpose of this point of emphasis is to explain the change in verbiage in the NFHS rules books regarding the referee’s recognition of a possibly concussed athlete and to emphasize the importance of proper concussion management. Concussions at all levels of sports have received a great deal of attention in the past few years. Attention has increased even more so over the past year, culminating with the NFL, NCAA and NFHS testifying before the United States Congress about what each organization is doing to protect athletes from concussion. Change in verbiage Previous rules books for most sports included language directing officials to remove an athlete from play if “unconscious or apparently unconscious.” The wrestling rules language has been changed to the following: Any contestant who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion or balance problems) shall be immediately removed from the match and shall not return to competition until cleared by an appropriate health-care professional. The common signs, symptoms and behaviors of concussed athletes may be found in Appendix B on page 80 of the 2010-11 NFHS Wrestling Rules Book. Given that most concussed athletes do not lose consciousness, yet they often show other common signs, symptoms and behaviors of concussion, the NFHS SMAC strongly believes that referees must be empowered to remove these contestants from competition, thus protecting them from potential further injury. Continued participation in any sport following a concussion can lead to worsening concussion symptoms, as well as increased risk for further injury to the brain, and even death. Neither referees, nor coaches, are expected to “diagnose” a concussion, as that is the job of a medical professional. The previous rule called upon referees to determine “apparently unconscious” which appeared to expect some level of medical judgment. Referees are now being asked to use their best judgment again in observing the signs, symptoms and behaviors as listed above, but are no longer being asked to make what could be perceived to be a medical opinion. The well-being of the athlete is of paramount concern during any athletic contest. Referees, coaches and administrators are being asked to make all efforts to ensure that concussed athletes do not continue to participate.

Concussion Recognition and Management The referee is not responsible for the evaluation or management of the athlete after he or she is removed from competition- If an appropriate health-care professional on the mat determines that the athlete HAS NOT suffered a concussion, the athlete may return to competition- If there is no appropriate health-care professional available to evaluate the athlete, the athlete SHOULD NOT be allowed by the coach to return to competition- Athletes with continued concussion symptoms are at significant risk for recurrent, cumulative and even catastrophic consequences of a second concussive injury- Concussion Recognition and Management (Point of Emphasis): Continued The referee is not responsible for the on-the-mat evaluation or management of the contestant after he or she is removed from the match. The responsibility of further evaluating and managing the athlete with a possible concussion falls upon the head coach, appropriate health-care professional or other individual designated by school administrators. If the mat-side appropriate health-care professional (if present) determines that the contestant HAS NOT suffered a concussion, the contestant may return to competition, if injury or recovery time has not expired. If there is no appropriate health-care professional available to evaluate the contestant, the contestant SHOULD NOT be allowed by the head coach to return to competition. Please see the “NFHS Suggested Guidelines for Management of Concussion in Sports” at www.nfhs.org for further information. The referee does not need written permission for an athlete to return to competition nor does the referee need to verify the credentials of the appropriate health-care professional. Ensuring compliance with the Suggested Management Guidelines is a health and safety issue and should be the responsibility of the head coach and school administration, NOT the wrestling referee. Suggested Concussion Management 1. No athlete should return to play (RTP) or practice on the same day of a concussion. 2. Any athlete suspected of having a concussion should be evaluated by an appropriate health-care professional that day. 3. Any athlete with a concussion should be medically cleared by an appropriate healthcare professional prior to resuming participation in any practice or competition. 4. After medical clearance, RTP should follow a step-wise protocol with provisions for delayed RTP based upon return of any signs or symptoms. The suggested guidelines for concussion management fall outside the realm of meet management, but are clearly a health and safety issue for coaches and administrators. These guidelines should also be applied to practices. The position of the NFHS SMAC is that no athlete should return to play or practice on that same day after suffering a concussion. Studies have shown medical professionals that the school-aged brain does not recover quickly enough for a high school athlete to return to activity in such a short time. An “appropriate health-care professional” must be determined by each member state association and/or school district with respect to state laws and local preferences. Such individuals should be knowledgeable in the evaluation and management of sports-related concussions and may, depending on controlling law, include MDs, DOs, nurse practitioners, physicians’ assistants and certified athletic trainers. Athletes with continued concussion symptoms are at significant risk for recurrent, cumulative and even catastrophic consequences of a second concussive injury. Such risks are minimized if the athlete is allowed time to recover from the concussion and return to play decisions are carefully made. No athlete should return-to-sport or other at-risk participation when symptoms of concussion are present and recovery is ongoing. For further details, please see the “NFHS Suggested Guidelines for Management of Concussion in Sports” at www.nfhs.org.

Concussion Recognition and Management Concussion Recognition and Management (Point of Emphasis): See “Suggested Guidelines for Management of Concussion” in Appendix B on page 80 of the 2010-11 NFHS Wrestling Rules Book.

Communicable Diseases (Point of Emphasis): Communicable skin conditions are a major concern in wrestling and with the emergence of MRSA infections, the concern is greater than ever. If a participant has a suspect skin condition, NFHS rules require current, written documentation from an appropriate health-care professional stating the athlete’s participation would not be harmful to an opponent. The NFHS has developed a form that can be used for that documentation and several state associations have adopted that form for use in their state. Regardless of the form used, it is imperative that ALL coaches perform routine skin checks of their wrestlers and require any wrestlers with a suspect condition to seek medical attention and treatment. It is also imperative that ALL referees perform skin checks as part of their pre-meet duties prior to EVERY meet. If there is a suspect condition, the wrestler, or coach, must present the proper clearance form at the weigh-in for the dual meet or tournament, if the wrestler is to be allowed to compete. One of the keys in preventing the spread of communicable skin conditions are coaches and referees fulfilling their responsibilities professionally. It is, however, only one of the keys. The other, equally important key is proper prevention. While prevention can be complicated, it requires that a few basic steps must be taken by ALL teams. • Educate coaches, athletes and parents about communicable skin conditions and how they are spread. • Clean wrestling mats daily with a solution of 1:100 bleach and water or an appropriate commercial cleaner. • Maintain proper ventilation in the wrestling room to prevent the build-up of heat and humidity. • Clean all workout gear (including towels, clothing, headgear, shoes, knee pads, etc.) after each practice. • Require each wrestler to shower after each practice with an antibacterial soap. Do not share bars of soap. Use individual soap dispensers. • Perform daily skin checks to ensure early recognition of potential communicable skin conditions. • Refrain from sharing razors or other personal hygiene supplies.

Communicable Diseases (Point of Emphasis): Rules 4-2-3, 4, 5: ART. 3 . . . If a participant is suspected by the referee or coach of having a communicable skin disease or any other condition that makes participation appear inadvisable, the coach shall provide current written documentation as defined by the NFHS or the state associations, from an appropriate health-care professional stating that the suspected disease or condition is not communicable and that the athlete’s participation would not be harmful to any opponent. This document shall be furnished at the weigh-in for the dual meet or tournament. The only exception would be if a designated, on-site meet physician is present and is able to examine the wrestler either immediately prior to or immediately after the weigh-in. Covering a communicable condition shall not be considered acceptable and does not make the wrestler eligible to participate. ART. 4 . . . If a designated, on-site meet physician is present, he/she may overrule the diagnosis of the appropriate health-care professional signing the medical release form for a wrestler to participate or not participate with a particular skin condition. ART. 5 . . . A contestant may have documentation from an appropriate health-care professional only indicating a specific condition such as a birthmark or other non-communicable skin conditions such as psoriasis and eczema, and that documentation is valid for the duration of the season. It is valid with the understanding that a chronic condition could become secondarily infected and may require re-evaluation.

Fleeing the Mat (Point of Emphasis): Intentionally going out of the wrestling area to prevent being scored upon or forcing an opponent out of the wrestling area to avoid wrestling is a technical violation. When a wrestler is fleeing the mat or forcing an opponent off the mat (from any position) the call should be made immediately, there is no warning. There can be no technical violation for fleeing the mat if near-fall points have been earned (two-second near-fall count or more). These situations must be recognized and penalized differently than a stalling violation. Both wrestlers are charged with making every effort to remain inbounds and are not allowed to avoid wrestling. Too often wrestlers are using the edge of the mat to avoid being scored upon – takedowns, reversals, or when near-fall is imminent but no near-fall points have been earned (back is exposed but less than two-second near-fall count). The goal of the match is to have continuous action and conduct the match with minimal stoppages. Wrestlers are obligated to make every effort to remain inbounds, but the boundary line should not serve to handicap a wrestler or place them in a position of disadvantage.

Fleeing the Mat (Point of Emphasis): Continued Fleeing the mat and forcing an opponent off the mat shall be recognized as a technical violation, not stalling; therefore, penalized without hesitation. When a Technical violation occurs due to fleeing the mat or forcing an opponent off the mat, penalty points are awarded in addition to any match points scored (Example: Points should be awarded for a reversal, escape or takedown if earned, in addition to penalty point(s) for a technical violation of fleeing the mat or forcing an opponent off the mat.)