From 'Shake It Off' to Speak Up: How Concussion Care Is Changing in Washington

For generations, phrases like “rub some dirt on it” or “shake it off” defined sports culture, encouraging athletes to push through pain and stay in the game. While that mindset may have fit minor bumps and bruises, it proved far more dangerous when applied to traumatic brain injuries. In recent years, however, awareness around concussions has grown significantly—especially in Washington state.

Dr. Joshua Loiseau, a sports medicine physician at MultiCare, says the approach to head injuries has shifted toward education and recognition.

“Now, there’s a big emphasis on more education and recognition,” Loiseau said.

That awareness has been reinforced by a 2020 state law requiring public K–12 school districts to report student-athlete concussions annually to the Washington Department of Health.

The most recent report, released in December, documented 1,335 concussions statewide during the 2024–25 school year—about 200 more than the year before. While the increase may seem alarming, Loiseau views it as a positive sign.

“I think there are more people who are reporting [head injuries] and getting treatment for it, which is great,” he said. “Just being able to recognize it, speaking up and saying something about it … is important.”

Washington has long been a leader in athlete safety. In 2009, it became the first state to pass a return-to-play law following the near-fatal injury of 13-year-old Zackery Lystedt. Still, cultural change took time. Keith Eggleston, a licensed Athletic Trainer at Rogers High School, recalls earlier resistance.

“Every injury was a ‘fake’ injury,” he said, noting that some coaches once discouraged athletes from reporting symptoms. “That’s a massive change where high school coaches … have gotten much, much better about being advocates for health, safety and the well-being of young kids.”

Despite progress, gaps remain. Current law only requires reporting concussions diagnosed by physicians, even though Athletic Trainers often identify and manage these injuries.

“We’re the ones to see [injured athletes] and manage them and do 95% of the work,” Eggleston said, calling the data incomplete but still valuable.

Diagnosing and managing concussions remains complex, but the protocol is clear: recognize the injury, remove the athlete from play, evaluate symptoms, and allow time to heal.

“When a person is pulled from their sport and schooling, we let them rehab and then get them back into what they were doing before,” Loiseau said.

Read the full story here!