When Wendell Say started coaching football more than 44 years ago, concussions were rarely talked about. “Kids would get dizzy, but we’d send them back in and tell them, ‘If you’re not laying down and don’t have to be carried out, you should be fine.’ But nowadays, it’s not something you want to play with,” he says.
Say is the assistant athletic director at Kamehameha Schools – Kapalama, where his focus is on winning and, of course, keeping players safe.
Ready for action
One of those athletic trainers is Liana Finer, vice president of the Hawaii Athletic Trainers’ Association. She spends much of her time on the sidelines, monitoring the game and players, so she’s always ready. “There are signs we look for: if they don’t get up from a hit, if they stand up but they stumble, if they look dazed or confused. We’ll pull them aside to talk to them and start our evaluation if we suspect a concussion,” she says.
Cognitive questions like, “What day is it?” and “Where are you right now?” assess a player’s thinking ability and memory, which help determine whether there’s any cognitive impairment. Finer also conducts tests to determine an athlete’s physical function, including their coordination and balance.
Setting a baseline
Before the season begins, most athletes take what’s called a baseline test, a computerized diagnostic that checks their memory and reaction time when they’re healthy. “It’s preferably given before a season so that if the athlete gets a concussion, we have a test to compare the scores to before the injury,” Finer says. “The goal is to get their scores back up to where they were before the concussion.”
Treatment options
If Finer suspects a concussion, there’s no debate about what comes next: the player is taken out of the game.
Depending on the situation, the athlete might go straight to the emergency room, or athletic trainers may contact the athlete’s parents and recommend a doctor’s visit.
Once a doctor clears the athlete, trainers guide them through a slow return-to-play protocol: light walking first, then gradual increases in activity over several days. Recovery times vary; some athletes heal within two weeks, while others need a month or more.
“The recovery process involves coaches, teammates, athletic trainers, parents, teachers, and counselors. We communicate with everyone in the group so if something looks off, they can let us know and then we can address it as needed,” says Finer. “It takes all these eyes at different points in the student’s day-to-day life to know what’s going on so we can make sure they’re doing OK.”
Keeping safe
These concussion protocols help protect athletes, but unfortunately, the risk of concussion is inevitable with contact sports. So, how many concussions are too many? Finer says it’s different for every athlete. The key is for the athlete to be honest with themself, their coach, and their team. “As important as this game is, your brain is more important, and your life after high school or your sport is more important,” says Finer. “You have one brain, and you need to take care of it.”
For Say, that honesty is everything. “We tell our players that being tough isn’t about hiding injuries,” he says. “It’s about being smart. Sports are great, but nothing’s more important than keeping our kids safe.”
Check out this video to hear from experts about concussion awareness and athlete safety:
This is the fourth article in our concussion series. The first, concussions and children, was the cover story for the spring 2025 issue of Island Scene. The second, head games, appeared in the fall 2025 issue. And the third, playing it safe, appeared in the winter 2026 issue.
Protecting keiki
Read below for more stories on how to keep our keiki safe from all kinds of dangers, so they can grow up happy and healthy:
