What should I do when I suspect one of my athletes has sustained concussion?

Remove the athlete from play and don’t allow him or her to return to any physical activity that day even if they report that all symptoms have subsided. If you’re not sure if a concussion has occurred, err on the side of caution and sit them out.

The following signs but not limited to may be observed by the coaching staff: The athlete…

• Is confused about assignments or position
• Can’t recall events prior to his/her injury
• Appears dazed or stunned
• Answers questions slowly
• Loses consciousness
• Forgets simple instructions
• Shows behavior or personality changes
• Is unsure of game, score or opponent
• Moves clumsily
• Forgets events before or immediately after the injury

The athlete may also complain of the following:

• Headaches
• Sensitive to noise and sound
• Dizziness
• Feeling slow
• Nausea
• Fatigue
• Difficulty remembering and/or concentrating

With the onset of any of the above signs or symptoms, the athlete should be evaluated by a medical professional when available in the field and parents notified immediately. In the absence of a medical professional, the athlete should be sent to the nearest emergency room for assessment.

Concussions can develop up to 48 hours after the incident. Communication to parents about a possible injury in the absence of clear signs is also advised. Parents should be notified in the event of any head injury for proper assessment. Ignoring any signs or symptoms of a concussion is putting the child’s health at risk – in both the short and long term.

You should also monitor for worsening signs and symptoms. If any of the following DANGER SIGNS present themselves, the child should be evaluated by a medical professional IMMEDIATELY (sent to the emergency department at the nearest hospital and his or her pediatrician or general practitioner notified).

• Severe or increased headache
• Double vision
• Unequal pupils
• Convulsions
• Unusual/increased drowsiness
• Bleeding/clear fluid from the ear/nose
• Projectile or repeated vomiting
• Unusual stiffness in the neck area
• Severe personality changes
• Weakness in either arm(s) or leg(s)
• Numbness in the face/extremities

Make sure there is a return to play policy in effect and follow it. Do not allow the athlete to return to play without a clear understanding that the athlete is safe to return to full activity. It usually consists of a series of clearances by pediatrician or general practitioner in agreement with the therapist/ or trainer of the athlete. An athlete requires an exertion test to be cleared for return to play. A doctor’s note should include the words ‘clear to return to sports, the athlete no longer has symptoms at rest and post exertion’.

How can I assist my athletes on preventing a concussion?

There are a few things you can do to decrease your athletes’ chances of getting a concussion.

• Demand good sportsmanship and following the rules.
• Ensure that your athletes wear properly fitted equipment and that it is checked and maintained regularly (if applicable).
• Prevent any horsing around or misbehavior
• Encourage the use of proper footwear
• Ensure athletes are aware and use caution in less that perfect ground conditions and weather
• Stay on top of changes to best and safest techniques

What is my role in the athlete’s recovery?

Make sure you are in communication with your concussion management team for individual instructions and that the athlete is following the guidelines for both mental and physical rest as proposed by the management team. Recommendations usually involves accommodations for home and school activities and is specific to the athletes unique concussion.

When can an athlete safely return to full participation in sports after a concussion?

The child should be completely free of symptoms and participating in school fully (if applicable) before beginning to play sports again. Once released by an appropriate health care provider, the child should participate in a well-formulated rehabilitation program supervised by a physical therapist doctor trained in concussions.

More information

At Concussion Management of New York we count with Neurologists, Pediatricians, and Physical therapists specifically trained in the diagnosis, management and rehabilitation of sports related concussions. We offer discounted certified baseline testing and seminars for coaches continued education and updates. Contact us by clicking here.