SIGNS AND SYMPTOMS 

Signs observed by coaching staff

Appears dazed or stunned Is confused about assignment or position Forgets sports plays Is unsure of game, score, or opponent Moves clumsily Answers questions slowly Loses consciousness (even briefly) Shows behavior or personality changes Can’t recall events prior to hit or fall Can’t recall events after hit or fall

Symptoms Reported By Athlete

Headache or “pressure” in head Nausea or vomiting Balance problems or dizziness Double or blurry vision Sensitivity to light Sensitivity to noise Feeling sluggish, hazy, foggy, or groggy Concentration or memory problems Confusion Does not “feel right”

Adapted from Lovell et al. 2004

 

Athletes who experience any of these signs or symptoms after a bump or blow to the head should be kept from play until given permission to return to play by a health care professional (see Licensed Health Care Provided list below) with experience in evaluating for concussions. Signs and symptoms of concussion can last from several minutes to days, weeks, months, or even longer in some cases.

PREVENTION AND PREPARATION

• Educate athletes and parents about concussion. Talk with athletes and their parents about the dangers and potential long-term consequences of concussion. For more information on long-term effects of concussion, view the following online video clip: http://www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm#Video. Explain your concerns about concussion and your expectations of safe play to athletes, parents, and assistant coaches. Pass out the concussion fact sheets for athletes and for parents at the beginning of the season and again if a concussion occurs.   
• Insist that safety comes first. o Teach athletes safe playing techniques and encourage them to follow the rules of play.
  o Encourage athletes to practice good sportsmanship at all times.
  o Make sure athletes wear the right protective equipment for their activity (such as shin guards). Protective equipment should fit properly, be well maintained, and be worn consistently and correctly.
  o Review the athlete fact sheet with your team to help them recognize the signs and symptoms of a concussion. 
   
• Teach athletes and parents that it’s not smart to play with a concussion. Sometimes players and parents wrongly believe that it shows strength and courage to play injured. Discourage others from pressuring injured athletes to play. Don’t let athletes persuade you that they’re “just fine” after they have sustained any bump or blow to the head. Ask if players have ever had a concussion.   
• Prevent long-term problems. A repeat concussion that occurs before the brain recovers from the first—usually within a short period of time (hours, days, or weeks)—can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in brain swelling, permanent brain damage, and even death. This more serious condition is called second impact syndrome.4,5 Keep athletes with known or suspected concussion from play until they have been evaluated and given permission to return to play by a health care professional with experience in evaluating for concussion. Remind your athletes: “It’s better to miss one game than the whole season.”

 

1. Remove the athlete from play. Look for the signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head. Athletes who experience signs or symptoms of concussion should not be allowed to return to play. When in doubt, keep the athlete out of play.   
2. Ensure that the athlete is evaluated right away by an appropriate health care professional. Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions. As a coach, recording the following information can help health care professionals in assessing the athlete after the injury:
   • Cause of the injury and force of the hit or blow to the head
   • Any loss of consciousness (passed out/knocked out) and if so, for how long
   • Any memory loss immediately following the injury
   • Any seizures immediately following the injury
   • Number of previous concussions (if any)
3. Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion. Make sure they know that the athlete should be seen by a health care professional experienced in evaluating for concussion.
4. Allow the athlete to return to play only with permission from a health care professional with experience in evaluating for concussion. A repeat concussion that occurs before the brain recovers from the first can slow recovery or increase the likelihood of having long-term problems. Prevent common long-term problems and the rare second impact syndrome by delaying the athlete’s return to the activity until the player receives appropriate medical evaluation and approval for return to play.

Licensed Health Care Providers

What licensed health care providers are trained in the evaluation and treatment of concussions/brain injuries and authorized to allow the athlete to return to play?

Medical Doctors (MD)

Research is currently being done to determine which other licensed health care providers may have sufficient training to qualify to authorize return to play. Washington Youth Soccer will update clubs/associations and the wsysa.com website as this information becomes available.