U.S.

D EPARTMENT

OF H EALTH AND H UMAN S ERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION

AFactSheetfor COACHES

TodownloadthecoachesfactsheetinSpanish, please visit www.cdc.gov/ConcussionInYouthSports Paradescargarlahojainformativa para los entrenadoresenespaol,porfavorvisite: www.cdc.gov/ConcussionInYouthSports

THEFACTS Aconcussionisabraininjury. Allconcussionsareserious. Concussionscanoccurwithoutlossofconsciousness. Concussionscanoccurinanysport. Recognitionandpropermanagementofconcussionswhenthey firstoccurcanhelppreventfurtherinjuryorevendeath.

WHATISACONCUSSION? Aconcussionisaninjurythatchanges howthecellsinthebrainnormallywork. Aconcussioniscausedbyablowtothe headorbodythatcausesthebraintomove rapidlyinsidetheskull.Evenading, gettingyourbellrung,orwhatseemsto beamildbumporblowtotheheadcanbe serious.Concussionscanalsoresultfroma fallorfromplayerscollidingwitheach otherorwithobstacles,suchasagoalpost. Thepotentialforconcussionsisgreatestin athleticenvironmentswherecollisionsare common.1 Concussionscanoccur,however,
July2007

inany organizedorunorganizedsportor recreationalactivity. RECOGNIZINGAPOSSIBLE CONCUSSION Tohelprecognizeaconcussion,you shouldwatchforthefollowingtwothings amongyourathletes: 1.Aforcefulblowtotheheadorbody thatresultsinrapidmovementof thehead. and 2.Anychange intheathletesbehavior, thinking,orphysicalfunctioning.(See thesignsandsymptomsofconcussion listedonthenextpage.)

Itsbettertomissonegamethanthewholeseason.

S I G N S A N D S Y M P TO M S 2
SIGNSOBSERVEDBYCOACHINGSTAFF SYMPTOMSREPORTEDBYATHLETE

Appearsdazedorstunned Isconfusedaboutassignment orposition Forgetssportsplays Isunsureofgame,score,oropponent Movesclumsily Answersquestionsslowly Losesconsciousness(evenbriefly) Showsbehaviororpersonality changes Cantrecalleventspriortohitorfall Cantrecalleventsafterhitorfall
Adaptedfrom Lovell etal.2004

Headacheorpressureinhead Nauseaorvomiting Balanceproblemsordizziness Doubleorblurryvision Sensitivitytolight Sensitivitytonoise Feelingsluggish,hazy,foggy, orgroggy Concentrationormemoryproblems Confusion Doesnotfeelright

Athleteswhoexperienceanyofthesesignsor symptomsafterabumporblowtothehead shouldbekeptfromplayuntilgivenpermission toreturntoplaybyahealthcareprofessional withexperienceinevaluatingforconcussion. Signsandsymptomsofconcussion canlast fromseveralminutestodays,weeks,months, orevenlongerinsomecases. Remember,youcantseeaconcussionand someathletesmaynotexperienceand/or reportsymptomsuntilhoursordaysafterthe injury.Ifyouhaveanysuspicionthatyour athletehasaconcussion,youshouldkeepthe athleteoutofthegameorpractice.

PREVENTIONANDPREPARATION Asacoach,youcanplayakeyrolein preventingconcussionsandrespondingto themproperlywhentheyoccur.Hereare somestepsyoucantaketoensurethebest outcomeforyourathletesandtheteam: Educateathletesandparentsabout concussion.Talkwithathletesandtheir parentsaboutthedangersandpotential longtermconsequencesofconcussion. Formoreinformationonlongterm effectsofconcussion,takethefree onlinetrainingforcoachesandparents: www.cdc.gov/Concussion.

U.S. D EPARTMENT

OF H EALTH AND H UMAN S ERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION

Explainyourconcernsaboutconcussion andyourexpectationsofsafeplay toathletes,parents,andassistant coaches.Passouttheconcussionfact sheetsforathletesandforparentsat thebeginningoftheseasonandagain ifaconcussionoccurs. Insistthatsafetycomesfirst. > Teachathletessafeplayingtechniques andencouragethemtofollowtherules ofplay. > Encourageathletestopracticegood sportsmanshipatalltimes. > Makesureathletesweartheright protectiveequipmentfortheiractivity (suchashelmets,padding,shinguards, andeyeandmouthguards).Protective equipmentshouldfitproperly,bewell maintained,andbewornconsistently andcorrectly. > Reviewtheathletefactsheetwithyour teamtohelpthemrecognizethesigns andsymptomsofaconcussion. Checkwithyouryouthsportsleague oradministratoraboutconcussion policies.Concussionpolicystatements canbedevelopedtoincludetheleagues commitmenttosafety,abriefdescription ofconcussion,andinformationon whenathletescansafelyreturntoplay followingaconcussion(i.e.,anathlete withknownorsuspectedconcussion

shouldbekeptfromplayuntilevaluated andgivenpermissiontoreturnbya healthcareprofessional).Parentsand athletesshouldsigntheconcussion policystatementatthebeginningofthe sportsseason. Teachathletesandparentsthatitsnot smarttoplaywithaconcussion. Sometimesplayersandparentswrongly believethatitshowsstrengthandcourage toplayinjured.Discourageothersfrom pressuringinjuredathletestoplay.Dont letathletespersuadeyouthattheyrejust fineaftertheyhavesustainedanybump orblowtothehead.Askifplayershave everhadaconcussion. Preventlongtermproblems.Arepeat concussionthatoccursbeforethebrain recoversfromthefirstusuallywithina shortperiodoftime(hours,days,or weeks)canslowrecoveryorincrease thelikelihoodofhavinglongtermproblems. Inrarecases,repeatconcussionscan resultinbrainswelling,permanentbrain damage,andevendeath.3,4 Keepathletes withknownorsuspectedconcussion from playuntiltheyhavebeenevaluatedand givenpermissiontoreturntoplaybya healthcareprofessionalwithexperience inevaluatingforconcussion.Remindyour athletes:Itsbettertomissonegame thanthewholeseason.

ACTIONPLAN WHATSHOULDACOACHDOWHEN ACONCUSSIONISSUSPECTED? 1. Removetheathletefromplay. Lookfor thesignsandsymptomsofaconcussionif yourathletehasexperiencedabumpor blowtothehead.Athleteswhoexperience signsorsymptomsofconcussionshouldnot beallowedtoreturntoplay.Whenindoubt, keeptheathleteoutofplay. 2. Ensurethattheathleteisevaluated rightawaybyanappropriatehealthcare professional. Donottrytojudgethe severityoftheinjuryyourself.Healthcare professionalshaveanumberofmethods thattheycanusetoassesstheseverityof concussions.Asacoach,recordingthe followinginformationcanhelphealthcare professionalsinassessingtheathleteafter theinjury: Causeoftheinjuryandforceofthehit orblowtothehead Anylossofconsciousness(passedout/ knockedout)andifso,forhowlong Anymemorylossimmediatelyfollowing theinjury Anyseizuresimmediatelyfollowing theinjury Numberofpreviousconcussions(ifany)

3. Informtheathletesparentsorguardians aboutthepossibleconcussionandgive themthefactsheetonconcussion. Makesuretheyknowthattheathlete shouldbeseenbyahealthcareprofessional experiencedinevaluatingforconcussion. 4. Allowtheathletetoreturntoplayonly withpermissionfromahealthcare professionalwithexperienceinevaluating forconcussion.Arepeatconcussionthat occursbeforethebrainrecoversfromthe firstcanslowrecoveryorincreasethe likelihoodofhavinglongtermproblems. Preventlongtermproblemsbydelaying theathletesreturntotheactivityuntil theplayerreceivesappropriatemedical evaluationandapprovalforreturntoplay.
REFERENCES
1. 2. Powell JW. Cerebralconcussion: causes, effects, and risks in sports. Journal ofAthletic Training 2001; 36(3):307311. Lovell MR, Collins MW, Iverson GL, Johnston KM, Bradley JP. Grade 1 or ding concussions in high school athletes. TheAmerican JournalofSportsMedicine 2004; 32(1):4754. Institute ofMedicine(US).Is soccerbad forchildrens heads? Summary ofthe IOM Workshop on Neuropsychological Consequences ofHead Impact in Youth Soccer. Washington (DC): National Academy Press; 2002. Centers for Disease Control and Prevention (CDC). Sportsrelated recurrent brain injuriesUnited States. Morbidity and Mortality Weekly Report 1997; 46(10):224227. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/00046702.htm.

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Ifyouthinkyourathletehassustainedaconcussion takehim/heroutofplay,andseektheadviceofahealthcareprofessional experiencedinevaluatingforconcussion.

Formoreinformationandtoorderadditionalmaterialsfreeofcharge, visit:

Takethefreeonlinetrainingforcoachesat:

www.cdc.gov/ConcussionInYouthSports

www.cdc.gov/Concussion