Concussion Information
California state law AB 2007 (effective January 1, 2017), requires an athlete who may have a concussion during a practice or game to be removed from the activity for the remainder of the day. Any athlete removed for this reason must receive a written note from a medical doctor trained in the management of concussion before returning to practice. Before an athlete can start the season and begin practice in the sport of baseball, a concussion information sheet must be reviewed by the athlete and parent/guardian. All coaches are required to review this information about concussions annually.
What is a concussion and how would I recognize one?
A concussion is a kind of brain injury. It can be caused by a bump or hit to the head, or by a blow to another part of the body with the force that shakes the head. Concussions can appear in any sport, and can look differently in each sport.
Most concussions get better with rest and over 90% of athletes fully recover. However, all concussions should be considered serious. If not recognized and managed the right way, they may result in problems including brain damage and even death.
Most concussions occur without being knocked out. Signs and symptoms of concussions (see below) may show up right after the injury or can take hours to appear. If your child reports any symptoms of concussion or if you notice some symptoms and signs, seek medical evaluation from a medical doctor trained in the evaluation and management of concussion. If your child is vomiting, has a severe headache, or is having difficulty staying awake or answering simple questions, call 911 to take him/her immediately to the emergency department of your local hospital.
There is a link to the California Interscholastic Federation (CIF) Graded Concussion Symptom Checklist in the Reference section of this information sheet. If your child fills out this checklist after having had a concussion, it helps the doctor, trainer or coach understand how he/she is feeling and hopefully shows improvement. We ask that you have your child fill out the checklist at the start of the season even before a concussion has occurred to document if some symptoms such as headaches might be a part of his/her everyday life. This is called a “baseline” to understand what symptoms are normal and common for your child. Keep a copy for your records, and turn in the original to your league/team. If a concussion occurs, the child should fill out this checklist daily. This Checklist provides a list of symptoms to compare over time to make sure the athlete is recovering from the concussion.
What can happen if my child keeps playing with concussion symptoms or returns too soon after getting a concussion?
Athletes with the signs and symptoms of concussion should be removed from play immediately. There is NO same day return to play for a youth with a suspected concussion. Youth athletes may take more time to recover from concussion and are more prone to long-term serious problems from a concussion. Even though a traditional brain scan (e.g., MRI or CT) may be “normal”, the brain has still been injured. Animal and human research studies show that a second blow before the brain has recovered can result in serious damage to the brain. If your athlete suffers another concussion before completely recovering from the first one, this can lead to prolonged recovery (weeks to months), or even to severe brain swelling (Second Impact Syndrome) with devastating consequences. There is an increasing concern that head impact exposure and recurrent concussions may contribute to long-term neurological problems. One goal of this concussion program is to prevent a too early return to play so that serious brain damage can be prevented.
Signs observed by teammates, parents and coaches include:
Looks dizzy
Looks spaced out
Confused about plays
Forgets plays
Is unsure of game, score or opponent
Moves clumsily or awkwardly
Answers questions slowly
Slurred speech
Shows a change in personality or way of acting
Can’t recall events before or after the injury
Seizures or has a fit
Any change in typical behavior or personality
Passes out
Symptoms may include one or more of the following:
Headaches
“Pressure in head”
Nausea or throws up
Neck pain
Has trouble standing or walking
Blurred, double or fuzzy vision
Bothered by light or noise
Feeling sluggish or slowed down
Feeling foggy or groggy
Drowsiness
Change in sleep patterns
Loss of memory
“Don’t feel right”
Tired or low energy
Sadness
Nervousness or feeling on edge
Irritability
More emotional
Confused
Concentration or memory problems
Repeating the same question/comment
What is Return to Play (RTP) determined?
Following a concussion, athletes may have difficulties with short and long-term memory, concentration and organization. They will require rest while recovering from injury (e.g., avoid reading, texting, video games, loud movies), and may even need to stay home for a few days. As the athlete returns to normal they may benefit from a reduced schedule, depending on how they feel. If recovery from the concussion is taking longer than expected, they may also benefit by a more reduced activity and may require further assessment by a medical doctor trained in the management of concussion. If the athlete is in school at time of the concussion, the California Interscholastic Federation (CIF) Return to Learn and Return to Play protocols should be completed and returned to the athlete’s school before beginning any sports or physical activities, unless your doctor makes other recommendations.
Concussion symptoms should be completely gone before returning to competition. A RTP progression involves a gradual, step-wise increase in physical effort, sports-specific activities and the risk for contact. If symptoms occur with activity, the progression should be stopped. If there are no symptoms the next day, exercise can be restarted at the previous stage.
RTP after concussion should occur only with medical clearance from a medical doctor trained in the evaluation and management of concussions, and a step-wise progression program monitored by an athletic trainer, coach or other authorized person. (As a guide, California state law AB2127, effective 1/1/15, which deals with schools, states that return to play (e.g., full competition) must be no sooner than 7 days after the concussion diagnosis has been made by a physician.)
Final thoughts for Parents/Guardians: It is well known that athletes will often not talk about signs of concussions, which is why this information sheet is so important for review with them. Teach your child to tell the coaching staff if he/she experiences such symptoms, or if he/she suspects that a teammate has had a concussion. You should also feel comfortable talking to the coaches about possible concussion signs and symptoms that you may be seeing in your child.
References
CIF Graded Concussion Symptom Checklist:
http://www.cifsds.org/uploads/2/3/3/6/23368454/cif_graded_concussion_symptom_chec klist.pdf
CIF Concussion Return to Learn Protocol:
http://www.cifstate.org/sportsmedicine/concussions/CIF_Concussion_RTL_Protocol.pdf
CIF Concussion Return to Play (RTP) Protocol:
https://cifss.org/wpcontent/uploads/2015/06/CIF-CONCUSSION-RETURN-TO-PLAY-PROTOCOL-4-21- 15.pdf
CDC Concussion Action Plan:
https://www.cdc.gov/headsup/pdfs/custom/headsupconcussion_actionplan.pdf
CDC HEADS UP to Youth Sports:
https://www.cdc.gov/concussion/HeadsUp/youth.html
CDC Parent and Athlete Concussion Information Sheet:
https://www.cdc.gov/headsup/pdfs/custom/headsupconcussion_parent_athlete_info.pdf
CDC Online Concussion Training:
https://www.cdc.gov/headsup/youthsports/training/index.html