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What is a concussion?
A concussion is a type of traumatic brain injury 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 quickly back and forth. This fast 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.
What is a subconcussive head impact?
A subconcussive head impact is a bump, blow, or jolt to the head that does not cause symptoms. This differs from concussions, which do cause symptoms. A collision while playing sports is one way a person can get a subconcussive head impact. Studies are ongoing to learn about subconcussive head impacts and how these impacts may or may not affect the brain of young athletes.
How can I spot a possible concussion?
Athletes who show or report one or more of the signs and symptoms listed below—or who simply say they just “don’t feel right”—after a bump, blow, or jolt to the head or body may have a concussion or other serious brain injury. Concussion signs and symptoms often show up soon after the injury, but it can be hard to tell how serious the concussion is at first. Some symptoms may not show up for hours or days.
Signs coaches or parents may observe:
• Seems confused
• Forgets an instruction or is unsure of the game, position, score, or opponent
• Moves clumsily
• Answers questions slowly or repeats questions
• Can’t remember events before or after the hit, bump, or fall
• Loses consciousness (even for a moment)
• Has behavior or personality changes
Symptoms athletes may report:
• Nausea or vomiting
• Dizziness or balance problems
• Bothered by light or noise
• Feeling foggy or groggy
• Trouble concentrating or problems with short- or long-term memory
• Does not “feel right
Signs of a more serious brain injury
In rare cases, a concussion can cause dangerous bleeding in the brain, which puts pressure on the skull. Call 9-1-1 if an athlete develops one or more of these danger signs after a bump, blow, or jolt to the head or body:
• A headache that gets worse and does not go away
• Significant nausea or repeated vomiting
• Unusual behavior, increased confusion, restlessness, or agitation
• Drowsiness or inability to wake up
• Slurred speech, weakness, numbness, or decreased coordination
• Convulsions or seizures (shaking or twitching)
• Loss of consciousness (passing out)
As a coach, if you think an athlete may have a concussion, you should:
When in doubt, sit them out! Record and provide details on the following information to help the school nurse, athletic trainer, or first responders assess 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) and for how long
• Any memory loss right after the injury
• Any seizures right after the injury
• Number of previous concussions (if any)
Do not try to judge the severity of the injury yourself. Only a healthcare provider should assess an athlete for a possible concussion and decide when it is safe for the athlete to return to play.
Let parents know about the possible concussion and give them the CDC HEADS UP fact sheet for parents to help them watch the athlete for concussion signs and symptoms at home.
This should include information about when the athlete can return to play and steps you should take to help the athlete safely return to play. Athletes who continue to play while having concussion symptoms have a greater chance of getting another concussion. A repeat concussion that occurs before the brain has fully healed can be very serious and can increase the chance for long-term problems. It can even be fatal.
An athlete may feel frustrated, sad, angry, or lonely while recovering from a concussion. Talk with them about it, and allow an athlete recovering from a concussion to stay in touch with their teammates, such as cheering on their team at practices and competitions.
An athlete’s return to school and sports should be a gradual process that is approved and carefully managed and monitored by a healthcare provider. When available, be sure to also work closely with your team’s certified athletic trainer. There are six gradual steps to help an athlete safely return to play. These steps should not be done in one day, but instead over days, weeks, or months. An athlete should move to the next step only if they do not have any new symptoms at the current step.
Step 1: Return to non-sports activities, such as school, with a greenlight from the healthcare provider to begin the return-to-play process
Step 2: Light aerobic exercise
• Goal: Increase the athlete’s heart rate
• Activities: Slow to medium walking or light stationary cycling
Step 3: Sport-specific exercise
• Goal: Add movement
• Activities: Running or skating drills; no activities with risk for contact
Step 4: Non-contact training drills
• Goal: Increase exercise, coordination, and thinking
• Activities: Harder training drills and progressive resistance training
Step 5: Full-contact practice
• Goal: Restore confidence and have coaching staff assess functional skills
• Activities: Normal training activities
Step 6: Return to regular sports activity
For additional resources visit HEADS UP to Youth Sports.