COEUR d'ALENE - A high school athlete is on the playing field, racing for the ball.

An opponent slams into him, knocking him to the ground. His head was hit, but he eventually gets up without losing consciousness and claims to be just fine.

But is he really?

"For us, there's a protocol that we have to follow," said Jeff Lake, Coeur d'Alene High School's varsity boys soccer coach. "We work with a trainer who works with a local doctor, and then we work with the athlete and the parents. The kids take a baseline test at the beginning of the year and then once they take that ImPACT baseline test, after they feel like they possibly could have had a head injury, they'll go take that ImPACT baseline test again to see where they're at. If they don't match their baseline, then they start the protocol, which lasts anywhere from seven days to months for that matter. I had a kid out four weeks last year with a concussion."

ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the most widely used computerized system for evaluating concussions; it's a tool that helps doctors and health officials make the right call when returning athletes to play after suffering head injuries or possible concussions.

"When I played 15 or more years ago, people never thought twice about them," Lake said. "I think most parents are pretty aware and understanding of procedures and protocol, and the school does a good job of letting them know too."

Kootenai Health recently hosted a seminar in The Coeur d'Alene Resort on sports-related concussions and traumatic brain injuries - "Concussion: A Perfect Storm, A Call for Education and Advocacy." Featured speaker Dr. Richard G. Ellenbogen, chairman of neurological surgery at the University of Washington School of Medicine and co-chair of the NFL's Head, Neck and Spine Committee, shared his insight and knowledge from his work with sports-related head injuries. He emphasized the importance of keeping young athletes off the field or court until they are 100 percent recovered from suspected concussions.

"The key thing in youth sports, when in doubt, sit your kid out," Ellenbogen said. "If you think he or she has a concussion, pull them off the field. There's no discussion."

According to Kootenai Health, a concussion is "a brain injury which results in a temporary disruption of normal brain function. The individual does not have to lose consciousness in order to have a concussion." The majority of people will show symptoms and recover within a few days or weeks, but Ellenbogen said the 10 percent who show later symptoms are the ones who will have the most problems; if a concussion is even suspected, it is best to sit players out to prevent further damage. Resuming sports too soon increases the risk of more concussions and of lasting or even fatal brain injury.

"People who are concussed multiple times without recovery do poorly," Ellenbogen said. "By their second or third concussion in the season, they're done, they're out because they are neurologically impaired."

Collision sports, especially football, have been targeted for some time because of the amount of head injuries and concussions that occur during practice and play. Ellenbogen said this is not the first time in history that people have voiced their concerns about the safety of the sports, but in modern times, technological and medical advancements coupled with educated coaches, parents and trainers can help keep athletes safe.

"The health benefits of sports far outweigh the risks," he said, explaining that a lot of learning happens while youths are out on the soccer field or on the basketball court.

"I can assure you they're not going to outlaw soccer" or other contact sports anytime soon, he said, "so we are left with how we can make the sport safer."

While collision sports have become less dangerous than in bygone years, athletes who play sports such as football, volleyball, soccer and baseball or softball still run the risk of head injuries. But concussion is not "just a football thing," as Ellenbogen said. Surprisingly, he said the most dangerous sport in college in terms of concussion is actually women's ice hockey.

"For whatever reason, they have the highest concussion rate in the (National Collegiate Athletic Association)," he said. "Don't know why."

Ranell Bond of Hayden is the mother of a Coeur d'Alene High School freshman who plays on the junior varsity boys soccer team. She said her son, Docker, 14, has never had a concussion, "but yes, I have a concern every time they hit that field."

"We do try to tell them not to (head the ball) from a goal kick, just because that takes so much more force to the head then just a pass or something," she said. "Coming from the keeper, the coaches kind of like them to (head the ball), but I'm not a huge fan of it. Does he do it? Yes."

She said she has often thought goalkeepers should wear soft helmets to protect their heads from flying soccer balls. She is also aware that even volleyball can cause some headaches.

"My daughter played volleyball for CHS, and so many of her friends got concussions," she said, explaining that she heard of several head-to-floor injuries rather than ball-to-head in that sport.

"They dove and they'd knock their head onto the floor."

North Idaho has several resources for ImPACT Testing and concussion management, including Family Medicine Hayden Sports Medicine and Concussion Care, 625-5155. The Centers for Disease Control and Prevention also have a comprehensive site on the subject at www.cdc.gov/headsup/basics/index.html.

"It's their brain, their brain is a very important part of their body," Lake said. "We don't want to injure that or further injure that or make things worse. It's about what's best for the athlete. Obviously winning and losing isn't what's best for the athlete when it comes to their health."

Symptoms of a concussion

- School sports are now in session. Keep your athlete safe from long-term concussion damage by knowing these symptoms:

Balance problems

Blurry or double vision

Difficulty concentrating

Difficulty thinking clearly

Feeling sluggish, groggy or confused

Headache

Irritable

More emotional than normal

Nausea

Sensitivity to light