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Concussion Protocol Guidelines


If an athlete exhibits any signs, symptoms, or behaviors that seem suspicious that he or she may have had a concussion, that athlete must be removed from all physical activity, including sports and recreation. Continuing to participate in physical activity after a concussion can lead to worsening concussion symptoms, increased risk for further injury, and even death.

Parents and coaches are not expected to be able to “diagnose” a concussion. That is the role of an appropriate health-care professional. However, everyone involved in athletics must be aware of the signs, symptoms and behaviors associated with a concussion. If you suspect that an athlete may have a concussion, then he or she must be immediately removed from all physical activity.

Signs Observed by Coaching Staff

  • Appears dazed or stunned
  • Is confused about assignment or position
  • Forgets an instruction
  • Is unsure of game, score or opponent
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Shows mood, behavior or personality changes
  • Can’t recall events prior to hit or fall
  • Can’t recall events after hit or fall

Symptoms Reported by Athlete

  • Headaches or “pressure” in head
  • Nausea or vomiting
  • Forgets an instruction
  • Balance problems or dizziness
  • Double or blurry vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling sluggish, hazy, foggy or groggy
  • Concentration or memory problems
  • Confusion
  • Does not “feel right” or is “feeling down”

When in doubt, sit them out! 

When you suspect that a player has a concussion, follow the “Heads Up” 4-step Action Plan.

  1. Remove the athlete from play.
  2. Ensure that the athlete is evaluated by an appropriate health-care professional.
  3. Inform the athlete’s parents or guardians about the possible concussion and give them information on concussion.
  4. Keep the athlete out of play the day of the injury and until an appropriate health-care professional says he or she is symptom-free and gives the okay to return to activity.

The signs, symptoms, and behaviors associated with a concussion are not always apparent immediately after a bump, blow, or jolt to the head or body and may develop over a few hours or longer. An athlete should be closely watched following a suspected concussion and should never be left alone.

Athletes must know that they should never try to “tough out” a suspected concussion. Teammates, parents and coaches should never encourage an athlete to “play through” the symptoms of a concussion. In addition, there should never be an attribution of bravery to athletes who do play despite having concussion signs and/or symptoms. The risks of such behavior must be emphasized to all members of the team, as well as coaches and parents.

If an athlete returns to activity before being fully healed from an initial concussion, the athlete is at greater risk for a repeat concussion. A repeat concussion that occurs before the brain has a chance to recover from the first can slow recovery or increase the chance for long-term problems. In rare cases, a repeat concussion can result in severe swelling and bleeding in the brain that can be fatal.

What to do in an Emergency

Although rare, there are some situations where you will need to call 911. The following circumstances are medical emergencies:

  1. Any time an athlete has a loss of consciousness of any duration. While loss of consciousness is not required for a concussion to occur, it may indicate more serious brain injury.
  2. If an athlete exhibits any of the following:
    • decreasing level of consciousness,
    • looks very drowsy or cannot be awakened,
    • if there is difficulty getting his or her attention,
    • irregularity in breathing,
    • severe or worsening headaches,
    • persistent vomiting, or any seizures.

Return to Play

An athlete should never be allowed to resume physical activity following a concussion until he or she is symptom free and given the approval to resume physical activity by an appropriate health-care professional.

Once an athlete no longer has signs, symptoms, or behaviors of a concussion and is cleared to return to activity by an appropriate health-care professional, he or she should proceed in a step-wise fashion to allow the brain to re-adjust to exercise. In most cases, the athlete will progress one step each day.

Step 1: Light aerobic exercise- 5 to 10 minutes light jog; no weight lifting, resistance training, or any other exercises.

Step 2: Moderate aerobic exercise- 15 to 20 minutes of running at moderate intensity in the gym.

Step 3: Non-contact training drills. May begin weight lifting, resistance training and other exercises.

Step 4: Full contact practice or training.

Step 5: Full game play.

If symptoms of a concussion reoccur, or if concussion signs and/or behaviors are observed at any time during the return-to-activity program, the athlete must discontinue all activity and be re-evaluated by his or her health-care provider.

Loudoun Rebels



Loudoun Rebels
19277 Winmeade Drive 
Leesburg, Virginia 20176

Phone: 571-480-0717
Email: [email protected]

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