August in Oklahoma means two things: hot weather and high school football. But before players at some schools hit the field, they will have to make another stop — at the doctor’s office.

Following a cascade of similar bills around the nation since 2009, Gov. Brad Henry signed Senate Bill 1700 into law this year, which calls for any athlete suspected of sustaining a head injury or concussion during a practice or game to be removed from the sporting event. In addition, the student cannot participate further until he or she is examined and given written clearance by a health care provider trained in evaluation and management of concussions.

Dr. Troy Glaser, a physician with Central States Orthopedic Specialists, which provides sports medicine services to several area athletics programs, explained the brain is suspended in cerebral spinal fluid inside the skull, making it succeptable to injury.

“When you get hit, you actually sustain two injuries: the initial impact to the head or the chest and then the secondary impact where the brain shifts and hits the other part of the skull,” Glaser said. “So you could actually end up with bruising on two separate parts of the brain.”

In athletics, one of the most common dangers, and what the new law attempts to mitigate, is that a player will suffer another trauma before fully healing, Glaser said.

“It’s called second impact syndrome,” he said. “A player has a concussion and is slowly getting better, but then they go back in to play before they are fully healed because they didn’t tell someone about still having symptoms. If they get hit again, and it doesn’t take much, it can cause the brain to swell or herniate, which could lead to paralyzation or even death.”

Glaser said the “walk it off” mentality among athletes contributes to the problem.

“Many student athletes are not reporting concussion symptoms to avoid being taken out of the game,” he said.

The year-round nature of modern youth athletics is also a contributing factor.

“Kids are more likely to sustain injury because they are playing more,” he said.

Glazer recounted a young athlete who sustained a concussion during a noncontact summer sports camp through incidental contact.

“He decides he’s OK to attend a hitting camp the next day, where he gets a worse concussion,” he said. “Now he has poor sleep, headaches, nausea and vomiting, and his mood is down, and that hasn’t cleared for three weeks.”

It is this lack of knowledge and sometimes judgment, that Glaser said makes physician intervention crucial, as well as what makes a tool called the ImPACT test so valuable. ImPACT is a computer-based neuropsychological test that analyzes an athlete’s symptoms and normal memory, timing, word and picture-matching skills. Should the athlete incur a head injury, the test will be given 48 hours after a concussion is sustained then compared with a baseline test.

“The ImPACT test quickly identifies concussion symptoms in a student athlete when a head injury occurs,” Glaser said. “If concussions are not correctly evaluated, the injury can become much more severe.”

A few Tulsa-area schools have mandated that all student athletes participating in a contact sport receive the test before their sport’s season begins.

Glaser said the raised awareness created by the new law would especially help smaller schools.

“I think it’s great because a lot of the smaller areas that don’t have athletic trainers are more aware of concussion symptoms now,” he said.