WHAT IS A CONCUSSION?
A concussion is a type of traumatic brain injury that disrupts the normal functioning of the brain. . A
concussion can be caused by a bump, blow, or jolt to the head or body that causes the head
and brain to move rapidly back and forth. Concussions are a type of Traumatic Brain Injury
(TBI), which can range from mild to severe and can disrupt the way the brain normally functions.
Concussions can cause significant and sustained neuropsychological impairment affecting
problem-solving, planning, memory, attention, concentration, and behavior.
The Centers for Disease Control and Prevention estimates that 300,000 concussions are
sustained during sports-related activities annually and more than 62,000 concussions are
sustained each year in high school contact sports. The second-impact syndrome occurs when a
person sustains a second concussion while still experiencing symptoms of a previous
concussion. It can lead to severe impairment and even death of the victim.
The Safety in Youth Sports Act signed into law in November of 2011 mandates measures to be
taken in order to ensure the safety of student-athletes involved in interscholastic sports in
Pennsylvania. It is imperative that athletes, coaches, and parent/guardians are educated about
the nature and treatment of sports-related concussions and other head injuries. The Act states
that:
• A student participating in or desiring to participate in an athletic activity and the student's
parent or guardian shall each school year, prior to participation by the student in an
athletic activity, sign and return to the student's school an acknowledgment of receipt
and review of a concussion and traumatic brain injury information sheet.
• A school entity may hold an informational meeting prior to the start of each athletic
season for all ages of competitors regarding concussions and other head injuries, the
importance of proper concussion management and how preseason baseline
assessments can aid in the evaluation, management and recovery process.
• In addition to students, parents, coaches and other school officials, the informational
meetings may include physicians, neuropsychologists, athletic trainers and physical
therapists.
• A student who, as determined by a game official, coach from the student's team, certified
athletic trainer, licensed physician, licensed physical therapist or other official designated
by the student's school entity, exhibits signs or symptoms of a concussion or traumatic
brain injury while participating in an athletic activity shall be removed by the coach from
participation at that time.
• The coach shall not return a student to participation until the student is evaluated and
cleared for return to participation in writing by an appropriate medical professional.
• The governing body of a school entity may designate a specific person or persons, who
must be appropriate medical professionals, to provide written clearance for return to
participation.
• In order to help determine whether a student is ready to return to participation, an
appropriate medical professional may consult any other licensed or certified medical
professionals.
• Once each school year, a coach shall complete the concussion management
certification training course offered by the Centers for Disease Control and Prevention,
the National Federation of State High School Associations or another provider approved
by the Department of Health.
• A coach shall not coach an athletic activity until the coach completes a concussion
management certification training course.
• The governing body of a school entity shall establish the penalties for a coach found in
violation of the requirements of removing a player or returning to play.
Quick facts
• Most concussions do not involve loss of consciousness.
• Athletes who have, at any point in their lives, had a concussion have an increased risk of
another concussion.
• Young children and teens are more likely to get a concussion and take longer to recover
than adults.
• You can sustain a concussion even if you do not hit your head.
• A blow elsewhere on the body can transmit an “impulsive” force to the brain and cause a
concussion.
• Signs and symptoms of a concussion can show up right after the injury or may not
appear or be noticed until days or weeks after the injury.
Danger signs
In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and
crowd the brain against the skull. An athlete should receive immediate medical attention if after
a bump, blow, or jolt to the head or body s/he exhibits any of the following danger signs:
• One pupil larger than the other.
• Is drowsy or cannot be awakened.
• A headache that not only does not diminish but gets worse.
• Weakness, numbness, or decreased coordination.
• Repeated vomiting or nausea.
• Slurred speech.
• Convulsions or seizures.
• Cannot recognize people or places.
• Becomes increasingly confused, restless, or agitated.
• Has unusual behavior.
• Loses consciousness (even a brief loss of consciousness should be taken seriously).
Examples of signs of concussions observed by coaches, athletic trainers,
parents/guardians
• Appears dazed or stunned.
• Is confused about assignment or position.
• Forgets plays or demonstrates short term memory difficulties.
• Unsure of game, score, or opponent.
• Exhibits difficulties with balance, coordination, concentration, and attention.
• Answers questions slowly or inaccurately.
• Demonstrates mood, behavior or personality changes.
• Unable to recall events prior to or after the hit or fall.
Examples of symptoms of concussions reported by student-athletes
• Headache or “pressure” in the head.
• Nausea/vomiting.
• Balance problems or dizziness.
• Double vision or changes in vision.
• Sensitivity to light and/or sound.
• Feeling sluggish, hazy, or foggy.
• Difficulty with concentration and/or short term memory.
• Confusion.
• Just not “feeling right” or “feeling down.”
Why should a student-athlete report their symptoms?
• If an athlete has a concussion, his/her brain needs time to heal. While an athlete’s brain
is still healing, s/he is much more likely to have another concussion.
• Repeat concussions can increase the time it takes to recover.
• In rare cases, repeat concussions in young athletes can result in brain swelling or
permanent damage to their brains. They can even be fatal.
What should a student-athlete do if they think they have a concussion?
• Don’t hide it. Tell your Athletic Trainer, Coach, School Nurse, or Parent/Guardian.
• Report it. Don’t return to competition or practice with symptoms of a concussion or head
injury. The sooner you report it, the sooner you may return-to-play.
• Take time to recover. If you have a concussion your brain needs time to heal. While
your brain is healing you are much more likely to sustain a second concussion. Repeat
concussions can cause permanent brain injury.
What can happen if a student-athlete continues to play with a concussion or returns to
play to soon?
• Continuing to play with the signs and symptoms of a concussion leaves the studentathlete vulnerable to second impact syndrome.
• Second impact syndrome is when a student-athlete sustains a second concussion while
still having symptoms from a previous concussion or head injury.
• Second impact syndrome can lead to severe impairment and even death in extreme
cases.
What should you as a parent/guardian do if you think your athlete has a concussion?
• If you suspect that an athlete has a concussion notify the school and seek medical
attention.
• Do not try to judge the severity of the injury yourself.
• Keep your athlete out of play until a health care professional, experienced in evaluating
for concussions, says s/he is symptom-free and it’s OK to return to play.
• Rest is the key to helping an athlete recover from a concussion.
• Exercising or activities that involve a lot of concentration, such as studying, working on
the computer, or playing video games, may cause concussion symptoms to reappear or
get worse.
• Remember that after a concussion returning to sports and school is a gradual process
that should be carefully managed and monitored by a health care professional.
Should there be any temporary academic accommodations made for student-athletes
who have suffered a concussion?
• To recover cognitive rest is just as important as physical rest. Reading, texting, testingeven watching movies can slow down a student-athletes recovery.
• Stay home from school with minimal mental and social stimulation until all symptoms
have resolved.
• Students may need to take rest breaks, spend fewer hours at school, be given extra time
to complete assignments, as well as being offered other instructional strategies and
classroom accommodations.
Student-athletes who have sustained a concussion should complete a graduated returnto-play before they may resume competition or practice, according to the following
protocol:
• Step 1: Completion of a full day of normal cognitive activities (school day, studying for
tests, watching practice, interacting with peers) without reemergence of any signs or
symptoms. If no return of symptoms, next day advance.
• Step 2: Light Aerobic exercise, which includes walking, swimming, and stationary
cycling, keeping the intensity below 70% maximum heart rate. No resistance training.
The objective of this step is to increase heart rate.
• Step 3: Sport-specific exercise including skating, and/or running: no head impact
activities. The objective of this step is to add movement.
• Step 4: Noncontact training drills (e.g. passing drills). Student-athlete may initiate
resistance training.
• Step 5: Following medical clearance (consultation between school health care personnel
and student-athlete’s physician), participation in normal training activities. The objective
of this step is to restore confidence and assess functional skills by coaching and medical
staff.
• Step 6: Return to play involving normal exertion or game activity.
Remember
Concussions affect people differently. While most athletes with a concussion recover quickly
and fully, some will have symptoms that last for days, or even weeks. A more serious
concussion can last for months or longer. It’s better to miss one game than the whole season
For more information on Sports-Related Concussions and other Head Injuries, please visit the
following websites:
www.cdc.gov/concussion
www.gopats.org
www.biapa.org
www.brainsteps.net
www.stopsportsinjuries.org/concussion
www.ncaa.org/health-safety
www.concussionwise.com/pennsylvania

References: The Centers for Disease Control and Prevention (CDC): “Heads Up Tool Kit for Youth
Sports” and NCAA: “Concussion- A Fact Sheet for Student-Athletes”