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In the moments after Lee Toulon blacked out during a football game, he knew something was wrong.  After coming to, he staggered over to the sideline.  He had just suffered his third concussion.  

Toulon, 18, is a senior at Maine South High School in Park Ridge.   He said that he was kept out of practice and games for four weeks by his team’s athletic trainer following his concussion last fall.   

His coaching staff did not educate him at all about the dangers of brain injuries, he said.  In fact, he felt pressure from them to come back to the game sooner than he felt he was ready.  

“They didn’t fully understand, so that was hard,” Toulon said. 

With a new Chicago ordinance that may lead to a state-wide rule, coaches may understand better in the future.

The City’s ordinance, passed Thursday, says  an athlete suspected of having a concussion must be removed  from play immediately and  kept out of a game or practice until cleared by a doctor or team trainer.

 Dr. Hunt Batjer, a neurosurgeon at Northwestern Memorial Hospital, said the rule is rooted in the discovery that children are vulnerable to a “second impact syndrome” that comes from returning to activity too soon after suffering a concussion.  

“This really is a youth sports issue,” Dr. Batjer said.  “This issue doesn’t arise in grown people, and girls may be at a higher risk than boys.”

But questions have arisen about the effectiveness of the new rule.  

“At this point, the ordinance is considered self-enforceable,” said Donal Quinlan, press secretary for 14th Ward Ald. Edward Burke.  

Dr. Batjer, who is the co-chair of the NFL’s head, neck and spine committee, said that implementation of the rule is complicated, as some schools have access to trainers, but most do not.  

“We are working toward building a network of brain and spinal cord injury trainers to deploy in different areas to monitor kids,” he said.  

Todd Kuska, head football coach at St. Rita High School, which would be affected by the Chicago rule, is fortunate enough to have an athletic trainer at every practice and a doctor at every game, he said.  

“The rule may be new for everyone else, but for me it’s common sense,” Kuska said.  “I think this is a huge step, bringing awareness to all the schools.”

But strong incentives to play cause many athletes to neglect reporting an injury.

“My junior year when I was fighting for a spot on the team, I definitely would have kept playing if I thought I had a concussion,” Toulon said.  

That sentiment transcends the high school realm.  

Bob Christian, 42, of Evanston, is a former NFL fullback who played in the league for 11 years. Christian, who trains athletes, said he had about 10 concussions in his career.   But he doesn’t recall missing practice or a game even once in high school, college or the NFL after having suffered a concussion.

On at least two occasions in his last season in 2003, when he was with the Atlanta Falcons, Christian was knocked out cold for a few minutes, he said, but he kept playing.

“There were times where I don’t remember playing a whole half,” he said.  But watching the game film the next day with his coaches, there he was, making tackles.  

The play when Christian sustained his last concussion was his last play in the NFL.  

He said he was not and still isn’t aware of the dangers of multiple brain injuries, but he doesn’t think it’s had any lingering effects.

“I always knew there was a risk,” Christian said.  “But I think that’s what part of what makes us play the game."