As a new NFL season gets underway, games are being played under the shadow of a massive $765 million settlement that was reached in late August between the league and more than 4,500 former players to resolve concussion-related lawsuits.

Over the last few years, the NFL has made several rule changes to take some of the violence out of the game and limit injuries, including moving kickoffs up, making head shots illegal and fineable, and requiring players to wear more padding. The good news is that they’re paying off. During the 2012-2013 NFL season roughly 160 players were diagnosed with concussion-like symptoms, an average of about 10 per week, but a drastic decline from the 270 reported the previous year.

Still, those number pale in comparison to the 62,000 concussions sustained by high school athletes each year, according to the University of Pittsburgh’s Brain Trauma Research Center.

The National Federation of State High School Associations (NFHS), the rules-setting body for interscholastic sports in the United States, has worked to improve the rules governing individual sports in order to protect student-athletes, make the sports safer, and provide coaches, athletes, and parents with education and training to prevent, identify, and treat concussions.

“Concussion in Sports,” a free online course developed by Mick Koester, chair of the NFHS Sports Medicine Advisory Committee and director of the Slocum Sports Concussion Programs, in conjunction with the Centers for Disease Control and Prevention, received its one millionth hit last month in just the third year that NFHS has offered the program.

“This course really came at a great time because across this country state legislators had been passing legislation requiring schools to either have return-to-play guidelines, or have protocols in place to educate people in dealing with suspected concussions,” said Tim Flannery, director of coach education for NFHS. “Since the launch we’re up to about 30 states that have an education requirement.”

The implementation of a sports injury surveillance system has provided NFHS with data and injury trends to support proposed rule changes in recent years in sports like football (more than once), ice hockey, pole vaulting, and field hockey.

“There are other sports where the incidence of concussion is relatively high, so this alerts our rules committees that, hey, it’s not a football-only issue. It’s really a sport issue,” said Flannery. “Basketball, soccer—they’re not collision sports like football and hockey, but they sure are contact sports, and this surveillance system has been tremendously helpful for us to monitor the situation to see if we’re making strides in the right direction.”

NFHS also has its eye on and will support legislation that is coming down the pike that will promote improved national quality standards for injury-prevention equipment used in youth sports. The Youth Sports Concussion Act’s key provisions will be based on an upcoming National Academies of Science report on concussions in youth sports.

Whatever the outcome of that legislation, keeping the concussion issue in front of people is critical, Flannery said.

“Our fear is that on these kinds of issues that it makes a big splash for a short period of time and then it goes away, but this concussion thing has been on the forefront now for quite a while and will continue to be up there,” he said. “It’s an interesting thing because we don’t know that much about it. We know a lot more than we did, but we don’t know the long-term effects, because everyone’s a little bit different. I think the medical profession is all eyes and ears now, and they’re really working hard to learn more about it, so we’re excited about that.”