Policy: Concussion Protocol

PURPOSE:

The following policy and procedures are being implemented by SC Toronto with the intent to reduce the potentially serious health risks associated with soccer related concussions and head injuries.

Head injuries in children’s sports have become an increasing focus for both parents and sports officials alike. In order to try to ensure a consistent approach to dealing with head injuries, SC Toronto has developed a protocol for coaches and parents to follow when a player suffers an injury.

• A concussion is a brain injury.
• All concussions are serious.
• Concussions can occur without loss of consciousness.
• Concussions can occur in any sport.

Recognition and proper management of concussions when they first occur can help prevent further injury or even death.

 

POLICY:

To help protect the soccer players, the Soccer Club of Toronto has mandated that all our soccer players, parents/guardians and coaches follow our Concussion Policy.

The information contained in this policy document should not be considered as a legal proxy or health care advice.

1. A youth athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time.
2. A youth athlete who is suspected of sustaining a concussion or head injury may not return to play until the athlete is evaluated by a licensed heath care provider trained in the evaluation and management of concussion and received written clearance to return to play from that health care provider. Players will not be allowed to return and or participate until this document is  produced.

 

FACTS

A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child/player reports any symptoms of  concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.

 

SYMPTOMS:

Symptoms may include one or more of the following:

• Headaches
• “Pressure in head”
• Nausea or vomiting
• Neck pain
• Balance problems or dizziness
• Blurred, double, or fuzzy vision
• Sensitivity to light or noise
• Feeling sluggish or slowed down
• Feeling foggy or groggy
• Drowsiness
• Change in sleep patterns
• Amnesia
• “Don’t feel right”
• Fatigue or low energy
• Sadness
• Nervousness or anxiety
• Irritability
• More emotional
• Confusion
• Concentration or memory problems (forgetting game plays) Repeating the same question/comment
•  Signs observed by teammates, parents and coaches include:
• Appears dazed
• Vacant facial expression
• Confused about assignment
• Forgets things
• Is unsure of game, score, or opponent
• Moves clumsily or displays incoordination
• Answers questions slowly
• Slurred speech
• Shows behavior or personality changes
• Can’t recall events prior to hit
• Can’t recall events after hit
• Seizures or convulsions
• Any change in typical behavior or personality
• Loses consciousness

 

PROCEDURES:

If you think a child/player has suffered a concussion

Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. Medical evaluation should be sought.

What can happen if a player keeps on playing with a concussion or returns too soon?

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to
severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athlete will often under report symptoms of injuries. And concussions are no different. As a result, education of administrators, coaches, parents and students is the key for student-athlete’s safety.

 

ROLES AND RESPONSIBILITIES OF THE CLUB:

Adopt the FIFA Sport Concussion Assessment Tool (SCAT) tool and a Return to Play (RTP) procedure. The FIFA SCAT is a tool to identify concussions and steps required in returning a player to activity. An RTP process incorporates 6 steps, with a minimum of 24 hours occurring before each step (although could be longer than 24 hours, especially for children). Guidance should be provided by a medical professional.

The 6 steps are:

1. No activity, complete rest. Once the athlete has no symptoms, they proceed to next step.
2. Light aerobic exercise such as walking, no resistance training. Performing step two without symptoms allows the athlete to proceed to level three. If symptoms return, the athlete moves back one stage then continues.
3. Sport specific training (e.g. running with a football), progressive addition of resistance training at steps three or four. Performing step three without symptoms allows the athlete to proceed to level four.
4. Non-contact training drills. Performing step four without symptoms allows the athlete to proceed to level five.
5. Full contact training after medical clearance. Performing step five without symptoms allows the athlete to proceed to level six.
6. Return to Game play.

 

• Track the number and severity of concussions during the season, including management and treatment course.
• Evaluate changes in concussion awareness and action among coaches and team officials between the pre/postseason.
• Make parents and players aware of their role in monitoring an athlete after an injury (suspected or actual) and the Clubs Return to Play procedures.
• Post information on concussions in central spots, if possible.
• Host or incorporate education sessions for team officials at the start of the season.
• Provide information in coaches and officials team packages, electronic resources and handouts, including information on the return-to-play procedure (see attached) and a Concussion Toolkit, and the SCAT 3 (see attached). Include these prominently on the Club Website.
• Suggest coach education modules through the Canadian Coaching Association’s Traumatic Brain Injury (TBI) to help coaches
  • assess the safety of practices and games
  • recognize the symptoms of TBI and remove athletes from practice and play when appropriate
  • apply the Return To Play protocol for athletes.

 

ROLES AND RESPONSIBILITIES OF TEAM COACHES AND OFFICIALS:

• Create, communicate and follow an emergency action medical plan
• Limit physical contact between players during practices and games (especially younger players)
• Utilize drills or techniques which reduce the risk of injury.
• Check equipment often. Make sure equipment is appropriate and is in proper working condition.
• Recognize that athletes might also choose not to report their injury or de-emphasize symptoms for a number of reasons (want to continue playing, do not want to let others down), therefore be on alert to incidents involving the player.
• Remove a concussed person from activity immediately and they should be assessed by a medical practitioner.
• Recognize that when concussed, their ability to assess the situation may be impaired.
• Engage in coaching training opportunities in Traumatic Brain Injury, as outlined above.
• Utilize a pre-screen for possible injury (sections of SCAT3) and follow the steps the Return-to-Play protocols
• Inform Club administrators of any concussions and treatments.
• Obtain a copy of the athlete’s health professional’s confirmation of return to play.

 

ROLES AND RESPONSIBILITIES OF PARENTS AND ATHLETES

• Recognize that recovering from a concussion takes time. It involves following progressive steps to Return to play.
• Recommend that the athlete seek medical assistance trained in concussions, and follow the six Return to Play steps (see attached). These steps do not correspond to days, though each step should take a minimum 24 hours between each step and increases (e.g., double) for children and adolescents. If symptoms return during any of the stages, the individual should stop the activity and return to rest until symptoms resolve before they try any activity again. A physician should be consulted during the process and if symptoms persist.
• Recognize that post-concussion symptoms may get worse as the athlete increases mental or physical activity, so it is important that Return to Play steps be followed.
• Recognize that athletes might also choose not to report their injury or de-emphasize symptoms for a number of reasons (want to continue playing, do not want to let others down). A concussed person should be removed from activity immediately and should be assessed by a medical practitioner
• Provide written confirmation by a medical practitioner to the Team official that the player may resume soccer activities.

Additional Resources

TSA Concussion Policy