This article was originally published in the Fall 2014 Edition of the Silicon Valley Community Foundation Magazine.

Despite growing concussion awareness, the culture of “playing through the pain” after a head injury persists.

Sixteen percent of high school football players who lose consciousness return to play the very same day, according to the Center for Injury Research and Policy (CIRP). The problem goes beyond football, too. The CIRP reports that more than 40 percent of all high school athletes return to their sport too soon after a head injury. This matters because athletes who have had one concussion are three times more likely to have another, according to the Centers for Disease Control and Prevention.

Cumulative head trauma can be devastating. It can result in a number of health problems, including sleep disorders, memory loss, and depression. These multiple concussions pose the greatest risk to young athletes’ health, both short-term and long-term.

It’s vital that kids don’t return to the game too soon after a head injury, to prevent health consequences and enable a lifelong participation in sports. The long-term consequences of multiple head injuries are becoming clear. The NFL released a study that found serious memory-related diseases and other health problems in retired athletes to be nearly 20 times the normal rate.

To address this problem, the California State Legislature passed AB 25 (Hayashi) in 2011, which made California a leader in return-to-play laws. Modeled after the country’s toughest concussion safety laws in Washington and Oregon, AB 25 requires a school district to remove an athlete from a school-sponsored athletic activity immediately if he or she is suspected of sustaining a concussion or head injury.

The law prohibits the return to play until the athlete is evaluated by, and receives written clearance from, a licensed health care provider. In addition, the bill requires signatures from the athlete and his or her parent or guardian on a concussion and head injury information sheet before the first practice or competition.

To further strengthen this bill, the California legislature passed AB 1451 (Hayashi) in 2012. This bill adds concussion training to the first-aid certification required of every high school coach.

The culture of “staying in the game” is changing, but kids still believe they need to be tough and play through injuries. Too often, they’re afraid to tell their coaches, trainers or parents when they think they have a concussion. Training coaches to recognize the signs and symptoms of concussion will help ensure athletes are removed as soon as possible and reduce their risk for further injury.

We’ve made great strides in protecting the health of California’s student-athletes. We now have one of the toughest return-to-play laws in the country. The next step is to implement AB 25 and AB 1451 fully. Doing so will require the efforts and awareness of student-athletes, parents, coaches, schools and health care professionals. If we can prevent multiple concussions and the health issues that come with them, those efforts will be worthwhile.