Download Yawkey Amateur Baseball League Concussion Policies Concussion-Awareness-2017.docx
What Is a Concussion?
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
Concussions Are Serious
Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.
Concussion Signs and Symptoms
Players who show or report one or more of the signs and symptoms listed below, or simply say they just “don’t feel right” after a bump, blow, or jolt to the head or body, may have a concussion or more serious brain injury.
Concussion Symptoms Observed
- Can’t recall events prior to or after a hit or fall.
- Appears dazed or stunned.
- Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
- Moves clumsily.
- Answers questions slowly.
- Loses consciousness (even briefly).
- Shows mood, behavior, or personality changes.
Concussion Symptoms Reported
- Headache or “pressure” in head.
- Nausea or vomiting.
- Balance problems or dizziness, or double or blurry vision.
- Bothered by light or noise.
- Feeling sluggish, hazy, foggy, or groggy.
- Confusion, or concentration or memory problems.
- Just not “feeling right,” or “feeling down”.
Signs and symptoms generally show up soon after the injury. However, you may not know how serious the injury is at first andd some symptoms may not show up for hours or days. For example, in the first few minutes, the player might be a little confused or a bit dazed, but an hour later might not be able to remember how he got hurt.
The player’s family should continue to check for signs of concussion right after the injury and a few days after the injury. If your player’s concussion signs or symptoms get worse, someone should take him to the emergency department right away.
If you think an athlete has a concussion, implement the HEADS UP Action Plan:
HEADS UP Action Plan
Remove the athlete from play. When it doubt, sit them out!
Seek Medical Attention
Keep an athlete with a possible concussion out of play the same day of the injury and until cleared by a health care provider. Do not try to judge the severity of the injury yourself. Only a health care provider should assess an athlete for a possible concussion. After you remove an athlete with a possible concussion from practice or play, the decision about return to practice or play is a medical decision that should be made by a health care provider. As a coach, recording the following information can help a health care provider in assessing the athlete after the injury:
- Cause of the injury and force of the hit or blow to the head or body
- Any loss of consciousness (passed out/knocked out) and if so, for how long
- Any memory loss right after the injury
- Any seizures right after the injury
- Number of previous concussions (if any)
Inform and Educate Family
Inform the athlete’s family about the possible concussion, and give them the HEADS UP fact sheet. This fact sheet can help relatives watch the athlete for concussion signs or symptoms that may show up or get worse once he is at home or returns to school.
Materials You Can Give to Families
Customize and download PDFs with your team’s colors and logo. Click here to create PDF
HEADS UP to High School Sports
Parents Fact Sheet[PDF – 272 KB] a href=”https://www.cdc.gov/headsup/pdfs/highschoolsports/parents_fact_sheet-a.pdf”>Click to download PDF.
Hoja Informativa para los Padres[PDF – 420 KB] Click to download PDF.
Information for Parents/Family
A player with a concussion needs to be seen by a medical provider. If you think someone has a concussion, the family should contact his health care professional.
Remove From Play
If the concussion happens while playing sports, you should also:
- Remove the athlete from play.
- Keep the athlete out of play the day of the injury and until a medical provider, experienced in evaluating for concussion, says he is symptom-free and it’s OK to return to play.
Athletes who return to play too soon—while the brain is still healing—risk a greater chance of having a repeat concussion. Repeat or later concussions can be very serious. They can cause permanent brain damage, affecting the athlete for a lifetime.
Seek Medical Care
Most athletes are treated in the ER or in a medical office after a concussion and get to go home. However, when the injury is more serious, they may need to stay in the hospital overnight.
What to Tell the Medical Provider
Be sure to tell the medical provider if the athlete is taking medications—prescription, over-the-counter medicines, or “natural remedies.”
Tests for Concussion & Brain Injury
The athlete’s medical provider may do a scan of his brain (such as a CT scan) to look for signs of a more serious brain injury. Other tests such as “neuropsychological” or “neurocognitive” tests may also be performed. These tests help assess the athlete’s learning and memory skills, the ability to pay attention or concentrate, and how quickly he can think and solve problems. These tests can help the medical provider identify the effects of the concussion.
Get Written Concussion Care Instructions
Ask for written instructions from the athlete’s health care provider on return to play. These instructions should include information about when they can return to play and what steps you should take to help them safely return to play. Before returning to play an athlete should:
- Be back to doing their regular school/work activities.
- Not have any symptoms from the injury when doing normal activities.
- Have the green-light from their health care provider to begin the return to play process.
Baseline testing is a pre-season exam conducted by a trained health care professional. Baseline tests are used to assess an athlete’s balance and brain function as well as the presence of any concussion symptoms. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a health care professional during the season if an athlete has a suspected concussion.
Concussion Danger Signs
In rare cases, a dangerous collection of blood (hematoma) may form on the brain after a bump, blow, or jolt to the head or body that may squeeze the brain against the skull. Call 9-1-1 right away, or take the player to the emergency department if he has one or more of the following danger signs after a bump, blow, or jolt to the head or body:
- One pupil larger than the other.
- Drowsiness or inability to wake up.
- A headache that gets worse and does not go away.
- Slurred speech, weakness, numbness, or decreased coordination.
- Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
- Unusual behavior, increased confusion, restlessness, or agitation.
- Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.
Recovery from Concussion
- Take it slow
- Talk to your health care provider
Rest is very important after a concussion because it helps the brain heal. Your child or teen may need to limit activities while he or she is recovering from a concussion. Physical activities or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms (such as headache or tiredness) to come back or get worse. After a concussion, physical and cognitive activities—such as concentration and learning—should be carefully watched by a medical provider. As the days go by, your child or teen can expect to slowly feel better.
- Have the athlete get plenty of rest. Keep a regular sleep routine, including no late nights.
- Make sure the athlete avoids high-risk/high-speed activities that could result in another bump, blow, or jolt to the head or body, such as riding a bicycle, playing sports, climbing playground equipment, and riding roller coasters. Athletes should not return to these types of activities until their medical provider says they are well enough.
- Share information about concussion with siblings, teachers, counselors, friends, coaches, and others who spend time with the athlete. This can help them understand what has happened and how to help.
Talk to a Medical Provider about Concerns
- Give the athlete only medications that are approved by their medical provider.
- If the player already had a medical condition at the time of their concussion (such as ADHD or chronic headaches), it may take longer for them to recover from a concussion. Anxiety and depression may also make it harder to adjust to the symptoms of a concussion.
While most athletes with a concussion feel better within a couple of weeks, some will have symptoms for months or longer. Talk with their health care provider if their concussion symptoms do not go away or if they get worse after they return to their regular activities.
If the athlete has concussion symptoms that last weeks to months after the injury, their medical provider may talk to you about post-concussive syndrome. While rare after only one concussion, post-concussive syndrome is believed to occur most commonly in patients with a history of multiple concussions.
There are many people who can help you and your family as your athlete recovers. You do not have to do it alone. Keep talking with your medical provider, family members, and loved ones about how the athlete is feeling. If you do not think he or she is getting better, tell your medical provider.
Returning to Sports and Activities
After a concussion, an athlete should only return to sports practices with the approval and under the supervision of their health care provider. When available, be sure to also work closely with your team’s certified athletic trainer.
Below are five gradual steps that you, along with a health care provider, should follow to help safely return an athlete to play. Remember, this is a gradual process. These steps should not be completed in one day, but instead over days, weeks, or months.
Return to Play Progression
It is important for an athlete’s parent(s) and coach(es) to watch for concussion symptoms after each day’s return to play progression activity. An athlete should only move to the next step if they do not have any new symptoms at the current step. If an athlete’s symptoms come back or if he or she gets new symptoms, this is a sign that the athlete is pushing too hard. The athlete should stop these activities and the athlete’s medical provider should be contacted. After more rest and no concussion symptoms, the athlete can start at the previous step.
Baseline: Back to School First
Athlete is back to their regular school activities, is no longer experiencing symptoms from the injury when doing normal activities, and has the green-light from their health care provider to begin the return to play process.
Step 1: Light aerobic activity
Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weight lifting at this point.
Step 2: Moderate activity
Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (less time and/or less weight from their typical routine).
Step 3: Heavy, non-contact activity
Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).
Step 4: Practice & full contact
Athlete may return to practice and full contact (if appropriate for the sport) in controlled practice.
Step 5: Competition
Athlete may return to competition.