Coaches and other team personnel need to improve their ability to recognize the signs of concussion. Players themselves are often not able to acknowledge and report their own symptoms for a variety of reasons. A culture of safety among all athletes should be encouraged so that they can serve as important sources of information relating to a teammate that has been concussed.


If an athlete is suspected of having a concussion it will be important to assess in some uniform way their physical, cognitive and subjective functioning. Any concern about spinal injury, prolonged unconsciousness or declining mental or physical functioning warrants immediate medical attention. When assessing cognitive skills it is preferred to use a consistent and objective method to evaluate orientation, attention, concentration and memory. Consider downloading and using the two-sided Sport Concussion Assessment Tool 5 (SCAT5) updated during the Berlin (2016) Concussion in Sport Group meeting:

If any symptom is present, cognitive, physical or subjective, remove the athlete from the game or practice and arrange to have a clinician experienced with sports concussions formally evaluate the athlete before they are allowed to return to practice or to play. The National Federation of High School Associations in September 2009 modified their concussion guidelines to prohibit a player from returning to play after a suspected concussion even if their symptoms resolve within 15 minutes. They must first be cleared medically and then complete a stepwise return-to-play process.

When in doubt, sit them out

Younger athletes have been shown to be more vulnerable to the effects of concussions; they take more time to recover and may be uniquely susceptible to the potentially life-threatening Second Impact Syndrome. The Centers for Disease Control (CDC, 2017) Heads Up to School Sports: Athletes emphasizes that it continuing to play when symptomatic increases the risk of further concussion. 

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