The growing awareness regarding the seriousness of concussion injuries has brought increased safety measures, including with youth sports.
Indeed, the old phrase that a player merely "had his bell rung" before quickly heading back to the field no longer is a phrase so easily tossed around by participants and their coaches.
Medical experts are falling into line that it's better to be safe than sorry when it comes to the possibility of a young athlete sustaining a concussion.
The Committee on Sports-Related Concussions in Youth last year revealed a study that high school athletes who played football, lacrosse, soccer and baseball were more likely to experience concussions than college-age players.
"We don't fully understand the full ramifications," said Dr. Sergio Buzzini, adolescent medicine specialist at Geisinger Medical Center in Danville. "Now, there is a body of evidence that the brain doesn't stop developing until the mid-20s. It makes sense if you get a hit on the brain, it can't be good. I think that's why there is a push for there being more conservative practices. A concussion of a younger athlete takes longer to heal."
A concussion is a traumatic brain injury that alters brain functions. Symptoms, often temporary, can include headaches and problems with concentration, memory, balance and coordination.
Many physicians and other medical professionals concur that pulling an athlete from play following a concussion or the perception of such an injury makes sense. However, because concussions are invisible, it can be impossible to know when an injured brain has completely healed.
Most concussions are mild, but studies have shown that athletes who return to play before a concussion is completely healed risk reinjuring the brain, which can have serious consequences.
In area schools, many athletes involved in contact sports undergo the impact test prior to a sports season.
The baseline test is compared with data revealed in a follow-up test taken by an athlete who may have sustained a concussion.
"We use that as a tool to help us determine a diagnosis of a concussion and return to play after the concussion," said Dr. Edward Gusick, a sports medicine physician at Susquehanna Health. "It measures four main components: verbal memory, visual memory, processing speed and reaction time. We use those numbers to help determine where someone is at."
Athletic trainers assigned to all schools and educated about concussion injuries are often present at games and practices.
And Gusick believes coaches have become more educated about concussions, and now are more likely than ever to pull kids from play who potentially suffer such injuries.
"I think coaches are understanding more about it," he said.
But athletes who might be experiencing concussion-like symptoms need to know when to step back too, he said.
It can simply mean being honest with coaches and medical professionals about symptoms.
"It's your brain," he said. "Tell us if you have symptoms. Honesty is an issue."
Gusick said the health system's sports medicine center has seen close to 500 concussions in the past two years.
Most of the concussions have resulted from football, although soccer has seen its share of the injuries as well, particularly among girl participants.
Some studies have shown that girl athletes are more likely to experience concussions than their male counterparts.
Buzzini agreed that young athletes often don't want to be honest for fear of being removed from play and future games.
"I usually tell kids, 'it's better to be safe than sorry,' " he said.