The question applies to many sports — from hockey to football to girls soccer and cheerleading. The answer is as difficult to nail down as to which came first: the chicken or the egg?
The fact is that more athletes at every level, from high school to the pros, are suffering from concussions than ever before.
What's puzzling players, coaches, trainers, doctors and scientists alike is what exactly has caused this increase.
"Why are there more concussions? Is it because we're doing more to evaluate them and we're diagnosing more? Or is it because kids are bigger, faster and stronger and hitting harder?" asked Beverly High athletic trainer Charla Bouranis, summing up the mystery.
"Personally, I think it's a mix."
Eliminating concussions is next to impossible; in contact sports, injuries of all sorts are inevitable. That makes recognizing head injuries, treating them and ensuring an athlete is fully healed before he or she returns to the field absolutely critical.
That was the aim when Massachusetts passed Senate Bill 2469, commonly known as the Concussion Law, signed by Gov. Deval Patrick on July 19, 2010. The law requires schools to educate parents and athletes about concussions, maintain a recovery policy for both athletics and academics, and calls for reporting concussion statistics to the state's Department of Health.
Understanding head injuries is still an inexact science; the CDC describes a concussion as a traumatic brain injury that comes from a blow to the head. Most occur without a loss of consciousness and simply aren't as plainly obvious as a broken bone or a bad sprain.
Symptoms can include a mild headache, dizziness and a loss of memory and in more serious cases include nausea, vomiting, sensitivity to light and mood swings.
Since symptoms can seem trivial at first, getting the word out about how serious a head injury can be is crucial.