Rothman Concussion Network


For Coaches

Monday, April 17th, 2017
Sports are a great way for children and teens to stay healthy and active. As a youth sports coach, you can create a culture of safety and help lower a student athlete's chance of concussion or other serious injury.
For Coaches


As a coach, what are some ways to help keep my athletes safe?

  • Talk with athletes about the importance of reporting their concussion symptoms. Tell them that safety comes first and you expect them to tell you and their parent(s) if they think they have a concussion.

  • Teach athletes how to lower the chance of getting a concussion by consistently practicing proper form and technique for their sport.

  • Enforce the rules of the sport for fair play, safety, and sportsmanship. Ensure athletes avoid unsafe actions, such as striking another athlete in the head, striking another athlete with their head or helmet, illegal contact, checking, tackling or colliding with an unprotected athlete, or trying to injure another athlete.

  • Tell athletes that you expect good sportsmanship at all times, both on and off the playing field. Aggressive and/or unsportsmanlike behavior can increase chances of concussion or serious injury.


How do I spot a possible concussion?

Some signs of concussion for coaches and their assistants to watch for include if an athlete:

  • Appears dazed or stunned.

  • Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.

  • Moves clumsily.

  • Answers questions slowly.

  • Loses consciousness (even briefly).

  • Shows mood, behavior, or personality changes.

  • Can't recall events before or after a hit or fall.

In rare cases, blood may accumulate on or around the brain (hematoma) after a bump, blow, or jolt to the head or body and can squeeze the brain against the skull. Call 911 or take the athlete to the emergency department immediately if they show any of the following serious danger signs:

  • One pupil larger than the other.

  • Drowsiness or inability to wake up.

  • A headache that gets worse and does not go away.

  • Slurred speech, weakness, numbness, or decreased coordination.

  • Repeated vomiting or nausea, convulsions, or seizures (shaking or twitching).

  • Unusual behavior, increased confusion, restlessness, or agitation.

  • Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.


What Should I Do If I Think an Athlete Has a Concussion?

As a coach, if you think an athlete may have a concussion, you should:

  • Remove the athlete from play. When in doubt, sit them out!

  • Keep an athlete with a suspected concussion out of play on the same day of the injury and until cleared by a healthcare provider.

Do not try to judge the severity of the injury yourself. Only a healthcare provider can determine whether an athlete has sustained a concussion. After removing an athlete from practice or play, the decision about return to practice or play is a medical decision that a healthcare provider will make. As a coach, recording the following information can help a healthcare provider in assessing the athlete after the injury:

  • Cause of the injury.

  • Force of the hit or blow to the head or body.

  • Any loss of consciousness (passed out/knocked out) and if so, for how long.

  • Any memory loss right after the injury.

  • Any seizures right after the injury.

  • Number of previous concussions (if any).

Concussions affect each athlete differently. While most athletes with a concussion feel better within a couple of weeks, some will have symptoms for months or longer. Talk with an athlete's parents if you notice any concussion symptoms after the athlete returns to play.

Let parents know about the possible concussion and give them the HEADS UP fact sheet for parents. This can help parents watch the athlete for signs or symptoms of concussion that may appear or become worse once the athlete is at home or returns to school.

Ask for written instructions from the athlete's health care provider on return to play. These instructions should include information about when they can return to play and what steps you should take to help them safely return to play. Work with the athlete's health care provider and follow the graduated return to play protocol. An athlete's return to school and sports should be a gradual process that is carefully managed and monitored by a health care provider.


Why should I remove an athlete from play when they possibly have a concussion?

The brain needs time to heal after a concussion. An athlete who continues to play with a concussion has a greater chance of getting another concussion. A repeat concussion that occurs while the brain is still healing from the first injury can be very serious and can affect an athlete for a lifetime. It can even be fatal.


How can I help an athlete safely return to play after a concussion?

An athlete's return to school and sports should be a gradual process that is carefully managed and monitored by a healthcare provider. Below are five gradual steps that you should follow to help safely return an athlete to play. Remember that this is a gradual process, and should take place over days, weeks, or months.



The athlete is back to their regular school activities, no longer experiencing symptoms from the injury when doing normal activities, and has been cleared by a healthcare provider to begin the return to play process.

An athlete should only move to the next step if they do not have any new symptoms at the current step.


Begin with light aerobic exercise only to increase an athlete's heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weightlifting at this point.


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, moderate-intensity weightlifting (less time and/or less weight than a typical routine).


Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).


An athlete may return to practice and full contact (if appropriate for the sport) in controlled practice.


An athlete may return to competition.



It is important for you (and the athlete's parents) to monitor the athlete for any signs of concussion symptoms during and after each day's return to play activity. If an athlete shows any concussion symptoms (repeated symptoms or new) when becoming more active at any step in the progression, this is a sign that the athlete is working too hard. The athlete should stop activity and the healthcare provider should be contacted. After clearance from the healthcare provider, the athlete can begin at the previous step.


Partially adapted from 'A Fact Sheet for Youth Sports Coaches.'

For Your Brain The Best Minds

For Your Brain The Best Minds

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