Student Athlete Concussions and Head Injuries
IHSA CONCUSSION INFORMATION SHEET
A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.
SIGNS AND SYMPTOMS OF CONCUSSION
Symptoms reported by an athlete may include one or more of the following:
- “Pressure in the head”
- Nausea or vomiting
- Neck pain
- Balance problems or dizziness
- Blurred, double, or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish or slowed down
- Feeling foggy or groggy
- Change in sleep patterns
- “Don’t feel right”
- Fatigue or low energy
- Nervousness or anxiety
- More emotional
- Concentration or memory problems (forgetting game plays)
- Repeating the same question/comment
Signs observed by teammates, parents, and coaches may include one or more of the following:
- Appears dazed
- Vacant facial expression
- Confused about assignment
- Forgets plays or is unsure of game, score, or opponent
- Moves clumsily or displays incoordination
- Answers questions slowly
- Slurred speech
- Shows behavior or personality changes
- Can’t recall events prior to hit
- Can’t recall events after hit
- Seizures or convulsions
- Any change in typical behavior or personality
- Loses consciousness
WHAT CAN HAPPEN IF MY CHILD KEEPS PLAYING WITH A CONCUSSION OR RETURNS TOO SOON?
Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often fail to report symptoms of injuries. Concussions are no different. As a result, education of administrators, coaches, parents and students is the key to the student-athlete’s safety.
IF YOU THINK YOUR CHILD HAS SUFFERED A CONCUSSION
Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. The Youth Sports Concussion Safety Act requires athletes to complete the Return-to-Play (RTP) protocols for their school prior to returning to play or practice following a concussion or after being removed from an interscholastic contest due to a possible head injury or concussion and not cleared to return to that same contest.
You should also inform your child’s coach if you think that your child may have a concussion. Remember, it’s better to miss one game than miss the whole season. When in doubt, the athlete sits out.
For current and up-to-date information on concussions, you can go to www.cdc.gov.
SCHOOL DISTRICT 225 RETURN-TO-LEARN AND RETURN-TO-PLAY PROTOCOLS
In accordance with state law, athletes are required to complete the district’s Return-to-Learn and Return-to-Play Protocols, and provide written clearance from the student’s appropriate health care provider prior to returning to play or practice following a concussion, or after being removed from an interscholastic contest due to a possible head injury or concussion and not cleared to return to that same contest. An appropriate health care provider is defined as a physician licensed to practice medicine in all its branches in Illinois (MD/DO), a certified athletic trainer, an advanced practice nurse, or a physician assistant.
SIDELINE MANAGEMENT OF CONCUSSION
- Did a concussion take place? Based on mechanism of injury, observation, history and unusual behavior and reactions of the athlete, even without loss of consciousness, assume a concussion has occurred if there is a mechanism of injury and concussion symptoms occur.
- Does the athlete need immediate referral for emergency care? If confusion, unusual behavior or responsiveness, deteriorating condition, loss of consciousness, or concern about neck and spine injury exist, the athlete should be referred at once for emergency care.
- If no emergency is apparent, how should the athlete be monitored? After the injury, mental status, attention, balance, behavior, speech and memory should be examined until stable over a few hours. If appropriate medical care is not available, an athlete even with mild symptoms should seek medical evaluation before returning to activity.
- No athlete suspected of having a concussion should return to the same practice or contest, even if symptoms clear quickly. o Six-step progression with each step being completed approximately 24 hours apart.
IF NO MEDICAL PERSONNEL ARE ON HAND AND AN INJURED ATHLETE HAS SYMPTOMS OF A CONCUSSION, HE OR SHE SHOULD SEEK APPROPRIATE MEDICAL CARE BEFORE RETURNING TO ACTIVITY.
Student athletes who have sustained a concussion may need informal or formal academic accommodations and modification of curriculum. In accordance with Youth Sports Concussion Safety Act, the school’s certified athletic trainer and registered nurse, in conjunction with the student’s health care provider, will evaluate and monitor concussion symptoms, institute academic accommodations as deemed necessary, and progress the Return-to-Learn process based on current scientific evidence.
The Return-to-Play protocol should follow a step-wise progression with provisions for delayed Return-to-Play based on return of any signs or symptoms. The Return-to-Play Protocol is as follows:
- Six-step progression with each step being completed approximately 24 hours apart.
- Step 1: Symptom-limited activity: Activities that do not worsen symptoms
- Step 2: Light aerobic exercise: Walking or stationary bike workout
- Step 3: Sport-specific exercise: Jogging, sprinting, and calisthenics
- Step 4: Non-contact drill work at practice: Includes progressive resistance training
- Step 5: Full contact practice: Participate in normal practice drills following medical clearance
- Step 6: Clear for competition: Normal game play
- If symptoms return at any point, the step must be repeated again, without symptom provocation, before moving on with the progression.
- The progression above is a guideline and will be individualized for the athlete, sport, and injury.
Adapted by the IHSA from the CDC and the Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 (document published April 2017)