Coronavirus Update:What patients and families need to know

For Coaches

The Children’s National SCORE program partners with coaches across the Washington, D.C., Maryland and Virginia region – and beyond – to support them in recognizing and responding to concussions in their players. If you are interested in learning about concussion education or further consultation please contact us.

All concussions are serious and most occur without loss of consciousness. Recognizing and properly responding to concussions when they first occur can help prevent further injury. Remember the mantra “when in doubt, sit them out,” when caring for an athlete with a suspected concussion.

Athletic organizations, trainers and coaches need to recognize and respond to a suspected concussion, and then facilitate treatment if one of their athletes is injured. It is important that all adults in a young athlete’s life support full recovery.

Concussion Basics

- No active post-concussive symptoms (physical and cognitive) at rest or with exertion
- Neurocognitive functioning is back to pre-injury level
- No problems with balance or coordination
- No other associated medical or neurological complications
Premature return to overexertion (physical and cognitive) can mean a prolonged recovery and even increased likelihood of re-injury. A child or teen who returns to practice or play when he or she still has symptoms is at significant risk for a more severe or potentially catastrophic injury. Please consult with medical staff about any child or teen’s readiness to return to the game.
Only when an athlete’s symptoms are gone, and in consultation with their health care professional, should he or she slowly and gradually return to sports practice, following a Progressive Activity Program. When available, be sure to work closely with the team’s certified athletic trainer.
Progressive Activity Program
The timing and duration of each of these steps depends on the athlete’s recovery, so this activity program should be tailored as needed.
- Step 1: Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about five to 10 minutes on an exercise bike, walking or light jogging. No weight lifting at this point.
- Step 2: 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 or moderate-intensity weight lifting (reduced time and/or reduced weight from the athlete’s typical routine).
- Step 3: Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weight lifting routine or non-contact sport-specific drills (in three planes of movement).
- Step 4: Athlete may return to practice and full contact in controlled practice.
- Step 5: Athlete may return to competition.

Frequently Asked Questions for Coaches

There are two important things to do after a concussion to help recovery. First, make sure that the athlete does not participate in any higher risk activities where they could take additional blows to the head. Second, to help the brain heal as quickly as possible, cognitive (thinking) and physical rest are also very important. Only allow the athlete to return to higher risk activities (practices, scrimmages and competition) after a qualified health care professional evaluates and clears the athlete to do so.
As the coach, you don't have to diagnose the concussion. Your job is to recognize a possible concussion by observing two things: (1) a blow to the head or body that is concerning and (2) any sign or symptom that tells you something may not be right with the athlete. Use the signs and symptoms information to assist or the CDC clipboard sticker. If you have a reasonable suspicion that these two indicators are present, follow the motto: When in doubt, sit them out. This means that if you suspect a concussion may have occurred, you should immediately pull the athlete out of practice/play, inform their parents about what happened, and direct the parents to information about concussions, and how to get medically evaluated.
A concussion is defined as a direct or indirect force to the head (could be a direct hit or a whiplash-type injury) that results in neurological impairment. If you see or are told that a child has received a blow, you should ask specific questions about their condition.
A gradual return to play (RTP) program is the last step in concussion recovery before returning to sports participation. This RTP program starts when the athlete is fully without any symptoms at rest. The RTP program typically takes place over 5 days with close monitoring for the return of any post-concussion symptoms at each stage. The athlete goes through a set of physical activities that gradually increase in intensity and movement. Once the athlete is able to demonstrate a high level of physical activity, with sport-specific movements, and controlled contact (when appropriate), they are then ready to return to full sports participation, including practice and games.
First, educate yourself about the injury. The next thing to do in preseason is to emphasize to the athletes and their parents the importance of taking these injuries seriously. Explain that a concussion is an injury to the brain and is very serious. Next, to help with recognition, review the signs and symptoms of concussion, using the CDC Athlete Fact Sheet. Stress to the athletes that they are responsible for not only themselves but also their teammates. Also, emphasize the importance of wearing properly fitted equipment (e.g., helmets, mouthguards) for general protection. Teaching proper technique in the sports is also important. Explain to the team that you will not allow unsafe play.
Parents must also be educated about concussions, including their signs and symptoms. Direct them to the CDC Heads Up website. They can also obtain a similar app for their smartphone that can give them information about concussions, and tools to check their son or daughter if they suspect a concussion.
Further training on concussion recognition and response can be obtained by viewing the available coach training videos:

Resources for Athletic Organizations and Coaches

- CDC - Coaches Online Training Video
- NAN, NATA, NHL, NHLPA - Concussions in Hockey: Signs, Symptoms and Playing Safe
- NAN, NATA and NFL - Raising Concussion Awareness Educational Video (Football)
- USA Football and CDC - Concussion Awareness Video (Football)
- Washington State - Youth Sports Head Injury Guide
- National Federation of State High School Associations - Concussion in Sports: What You Need To Know
Apps
- The CDC has developed two concussion-related apps that coaches, parents and schools may find helpful.
Websites

Coronavirus Update:What patients and families need to know

For Coaches

Email

Concussion Basics

What is the definition of full recovery from a concussion?

What are the risks of incomplete recovery?

How should an athlete return to play after a concussion?

Frequently Asked Questions for Coaches

As a coach, what is important for me to know about the treatment for a concussion?

How do I know if an athlete on my team had a concussion?

What is a Gradual Return to Play program?

What should I be doing before our season starts to protect my athletes?

What should I tell the parents of my athletes who are worried about concussions?

Where can I get more information?

Resources for Athletic Organizations and Coaches

General information

Videos

Helpful apps and websites