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Concussion Information

What is a Concussion?

National Athletic Trainers Association (NATA): A concussion is a “trauma induced alteration in mental status that may or may not involve loss of consciousness.”


Centers for Disease Control and Prevention (CDC): “A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth.” - CDC, Heads Up: Concussion


Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious” - CDC, Heads Up: Concussion Fact Sheet for Coaches


The Concussion Education Plan and Guidelines for Connecticut Schools was approved by the Connecticut State Board of Education in January 2015 is accessible on the CSDE website.

A concussion should be suspected if any one or more of the following signs or symptoms are present, or if the coach/evaluator is unsure, following an impact or suspected impact as described in the CDC definition above.

Signs of a concussion may include (i.e. what the athlete displays/looks like to an observer):

  • Confusion/disorientation/irritability  
  • Trouble resting/getting comfortable  
  • Lack of concentration  
  • Slow response/drowsiness  
  • Incoherent/ slurred speech  
  • Slow/clumsy movements  
  • Loses consciousness  
  • Amnesia/memory problems
  • Acts silly/combative/aggressive  
  • Repeatedly ask same questions  
  • Dazed appearance  
  • Restless/irritable  
  • Constant attempts to return to play  
  • Constant motion  
  • Disproportionate/inappropriate reactions  
  • Balance problems


Symptoms of a concussion may include (i.e. what the athlete reports):  

  • Headache or dizziness  
  • Nausea or vomiting  
  • Blurred or double vision
  • Oversensitivity to sound/light/touch  
  • Ringing in ears  
  • Feeling foggy or groggy


State law requires that a coach MUST immediately remove a student-athlete from participating in any intramural or interscholastic athletic activity who: a) is observed to exhibit signs, symptoms or behaviors consistent with a concussion following a suspected blow to the head or body, or b) is diagnosed with a concussion, regardless of when such concussion or head injury may have occurred. Upon removal of the athlete, a qualified school employee must notify the parent or legal guardian within 24 hours that the student athlete has exhibited signs and symptoms of a concussion.
 

Concussion Management Requirements and Return to Play (RTP) Protocol:

  1. No athlete SHALL return to participation in the athletic activity on the same day of concussion.
  2. If there is any loss of consciousness, vomiting or seizures, the athlete MUST be immediately transported to the hospital.
  3. Close observation of an athlete MUST continue following a concussion. The athlete should be monitored for an appropriate amount of time following the injury to ensure that there is no worsening/escalation of symptoms.
  4. Any athlete with signs or symptoms related to a concussion MUST be evaluated by a licensed healthcare professional (physician, physician assistant, advanced practice registered nurse (APRN), athletic trainer) trained in the evaluation and management of concussions.
  5. Any athlete who requires accommodations beyond four weeks due to a history of concussion must provide updated medical information at least every four weeks.
  6. The athlete MUST obtain an initial written clearance from one of the licensed health care professionals identified above directing her/him into a well-defined RTP stepped protocol similar to the one outlined below. If at any time signs or symptoms return during the RTP progression, the athlete should cease activity*.
  7. After the RTP protocol has been successfully administered (no longer exhibits any signs or symptoms or behaviors consistent with concussions), final written medical clearance is required by one of the licensed health care professionals identified above for the athlete to fully return to unrestricted participation in practices and competitions.

 

Medical Clearance RTP Protocol:

(Recommended one full day between steps)*

  1. Rehabilitation Stage: No Activity
    • Functional Exercise: Complete physical and cognitive rest until asymptomatic. School may need to be modified.
    • Objective: Recovery
  2. Rehabilitation Stage: Light Aerobic Exercise
    • Functional Exercise: Walking, swimming or stationary cycling maintaining intensity, <70% of maximal exertion; no resistance training.
    • Objective: Increase Heart Rate
  3. Rehabilitation Stage: Sport Specific Exercise
    • Functional Exercise: No contact skating drills in ice hockey, running drills in soccer; no head impact activities
    • Objective: Add Movement
  4. Rehabilitation Stage: Non-contact sport drills
    • Functional Exercise: Progression to more complex training drills, ie. passing drills in football and ice hockey; may start progressive resistance training
    • Objective: Exercise, coordination, and cognitive load
  5. Rehabilitation Stage: Full Contact Sport Drills
    • Functional Exercise: Following final medical clearance, participate in normal training activities
    • Objective: Restore confidence and assess functional skills by coaching staff
  6. Rehabilitation Stage: Full Activity
    • Functional Exercise: No restrictions
    • Objective: Return to full athletic participation


* If at any time signs or symptoms should worsen during the RTP progression the athlete should stop activity that day. If the athlete’s symptoms are gone the next day, she/he may resume the RTP progression at the last step completed in which no symptoms were present. If symptoms return and don’t resolve, the athlete should be referred back to her/his medical provider.

  • A concussion should be suspected if any one or more of the following signs or symptoms are present, or if the coach/evaluator is unsure, following an impact or suspected impact as described in the CDC definition above.

    Signs of a concussion may include (i.e. what the athlete displays/looks like to an observer):

    • Confusion/disorientation/irritability  
    • Trouble resting/getting comfortable  
    • Lack of concentration  
    • Slow response/drowsiness  
    • Incoherent/ slurred speech  
    • Slow/clumsy movements  
    • Loses consciousness  
    • Amnesia/memory problems
    • Acts silly/combative/aggressive  
    • Repeatedly ask same questions  
    • Dazed appearance  
    • Restless/irritable  
    • Constant attempts to return to play  
    • Constant motion  
    • Disproportionate/inappropriate reactions  
    • Balance problems


    Symptoms of a concussion may include (i.e. what the athlete reports):  

    • Headache or dizziness  
    • Nausea or vomiting  
    • Blurred or double vision
    • Oversensitivity to sound/light/touch  
    • Ringing in ears  
    • Feeling foggy or groggy


    State law requires that a coach MUST immediately remove a student-athlete from participating in any intramural or interscholastic athletic activity who: a) is observed to exhibit signs, symptoms or behaviors consistent with a concussion following a suspected blow to the head or body, or b) is diagnosed with a concussion, regardless of when such concussion or head injury may have occurred. Upon removal of the athlete, a qualified school employee must notify the parent or legal guardian within 24 hours that the student athlete has exhibited signs and symptoms of a concussion.
     

  • Concussion Management Requirements and Return to Play (RTP) Protocol:

    1. No athlete SHALL return to participation in the athletic activity on the same day of concussion.
    2. If there is any loss of consciousness, vomiting or seizures, the athlete MUST be immediately transported to the hospital.
    3. Close observation of an athlete MUST continue following a concussion. The athlete should be monitored for an appropriate amount of time following the injury to ensure that there is no worsening/escalation of symptoms.
    4. Any athlete with signs or symptoms related to a concussion MUST be evaluated by a licensed healthcare professional (physician, physician assistant, advanced practice registered nurse (APRN), athletic trainer) trained in the evaluation and management of concussions.
    5. Any athlete who requires accommodations beyond four weeks due to a history of concussion must provide updated medical information at least every four weeks.
    6. The athlete MUST obtain an initial written clearance from one of the licensed health care professionals identified above directing her/him into a well-defined RTP stepped protocol similar to the one outlined below. If at any time signs or symptoms return during the RTP progression, the athlete should cease activity*.
    7. After the RTP protocol has been successfully administered (no longer exhibits any signs or symptoms or behaviors consistent with concussions), final written medical clearance is required by one of the licensed health care professionals identified above for the athlete to fully return to unrestricted participation in practices and competitions.

     

  • Medical Clearance RTP Protocol:

    (Recommended one full day between steps)*

    1. Rehabilitation Stage: No Activity
      • Functional Exercise: Complete physical and cognitive rest until asymptomatic. School may need to be modified.
      • Objective: Recovery
    2. Rehabilitation Stage: Light Aerobic Exercise
      • Functional Exercise: Walking, swimming or stationary cycling maintaining intensity, <70% of maximal exertion; no resistance training.
      • Objective: Increase Heart Rate
    3. Rehabilitation Stage: Sport Specific Exercise
      • Functional Exercise: No contact skating drills in ice hockey, running drills in soccer; no head impact activities
      • Objective: Add Movement
    4. Rehabilitation Stage: Non-contact sport drills
      • Functional Exercise: Progression to more complex training drills, ie. passing drills in football and ice hockey; may start progressive resistance training
      • Objective: Exercise, coordination, and cognitive load
    5. Rehabilitation Stage: Full Contact Sport Drills
      • Functional Exercise: Following final medical clearance, participate in normal training activities
      • Objective: Restore confidence and assess functional skills by coaching staff
    6. Rehabilitation Stage: Full Activity
      • Functional Exercise: No restrictions
      • Objective: Return to full athletic participation


    * If at any time signs or symptoms should worsen during the RTP progression the athlete should stop activity that day. If the athlete’s symptoms are gone the next day, she/he may resume the RTP progression at the last step completed in which no symptoms were present. If symptoms return and don’t resolve, the athlete should be referred back to her/his medical provider.