Preventing Concussion

General Prevention

• Car and Booster Seats
  Always using age- and size-appropriate car seats and booster seats that are properly installed.
• Helmets
  Making sure your child always wears the right helmet for their activity and that it fits correctly. Wearing a helmet is a must to help reduce the risk of a serious brain injury or skull fracture. However, helmets are not designed to prevent concussions. There is no "concussion-proof" helmet.
• Stair Gates
  Using gates at the top and bottom of stairs to prevent serious falls in infants and toddlers.
• Soft Surfaces
  Using playgrounds with soft material under them like mulch or sand, not grass or dirt.

Sports Prevention

Create a Safe Sport Culture

Young athletes deserve to play sports in a culture that celebrates their hard work, dedication, and teamwork, and in programs that seek to create a safe environment—especially when it comes to concussion. As a youth sports coach or parent, your actions can create a safe sport culture and can lower an athlete’s chance of getting a concussion or other serious injury.

Athletes thrive when they:

• Have fun playing their sport.
• Receive positive messages and praise from their coaches for concussion symptom reporting.
• Have parents who talk with them about concussion and model and expect safe play.
• Get written instructions from a health care provider on when to return to school and play.
• Support their teammates sitting out of play if they have concussion.
• Feel comfortable reporting symptoms of a possible concussion to coaches.¹

Enforce the Rules

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;
• Using their head or helmet to contact another athlete;
• Making illegal contacts or checking, tackling, or colliding with an unprotected opponent; and/or
• Trying to injure or put another athlete at risk for injury.

Tell athletes you expect good sportsmanship at all times, both on and off the playing field.

Talk about Concussion Reporting

Talk with athletes about the importance of reporting a concussion.

Some athletes may not report a concussion because they don’t think a concussion is serious. They may also worry about:

• Losing their position on the team or during the game.
• Jeopardizing their future sports career.
• Looking weak.
• Letting their teammates down.
• What their coach or teammates might think of them.^2,3,4

Get a Concussion Action Plan in Place

Create an action plan that includes information on how to teach athletes ways to lower their chances of getting a concussion. If you think an athlete may have a concussion, you should:

1. Remove the athlete from play.
2. Keep an athlete with a possible concussion out of play on the same day of the injury and until cleared by a health care provider. Do not try to judge the severity of the injury yourself. Only a health care provider should assess an athlete for a possible concussion.
3. Record and share information about the injury, such as how it happened and the athlete’s symptoms, to help a health care provider assess the athlete.
4. Inform the athlete’s parent(s) or guardian(s) about the possible concussion and refer them to CDC’s website for concussion information.
5. Ask for written instructions from the athlete’s health care provider about the steps you should take to help the athlete safely return to play. Before returning to play an athlete should:
   • Be back to doing their regular school activities.
   • Not have any symptoms from the injury when doing normal activities.
   • Have the green-light from their health care provider to begin the return to play process.

Why This Is Important

Athletes May Try to Hide Concussion Symptoms.

• As many as 7 in 10 young athletes with a possible concussion report playing with concussion symptoms.⁵
• Out of those, 4 in 10 said their coaches were unaware that they had a possible concussion.⁵

Enforce Safe Play. You Set the Tone for Safety.

• As many as 25% of the concussions reported among high school athletes result from aggressive or illegal play.⁶

Young Athletes Are More Likely to Play With a Concussion During a Big Game.

• In almost all sports, concussion rates are higher during competitions than in practice.⁷
• Athletes may be less likely to tell their coach or athletic trainer about a possible concussion during a championship game or other important event.⁸

Most Sports-Related Concussions Are Caused by Player-to-Player Contact.

• Over two-thirds (70%) of concussions among young athletes result from contact with another athlete.⁷
• This is followed by player-to-surface contact (17%), such as hitting the ground or other obstacle.⁷

Headache Is Most Commonly Reported Concussion Symptom.

• Almost all (94%) high school athletes with a concussion reported having a headache.7
• Other commonly reported symptoms include:⁷
  • Dizziness (76%)
  • Trouble concentrating (55%)
  • Confusion (45%)
  • Bothered by light (36%)
  • Nausea (31%)

When to Call the Doctor: Signs and Symptoms of Concussion

Here is a list of common signs and symptoms of a concussion. If you or a family member has an injury to the head and you notice any of the symptoms on the list, call your doctor right away. Describe the injury and symptoms and ask if you should make an appointment to see your doctor or another specialist.

Signs and Symptoms of Concussion

• Dif­ficulty thinking clearly
• Feeling slowed down
• Diffi­culty concentrating
• Diffi­culty remembering
• Difficulty following conversation or directions
• Answers questions more slowly or repeatedly
• Dazed or stunned
• Headache
• Nausea or vomiting
• Clumsiness or balance problems
• Dizziness
• Fuzzy or blurry vision
• Feeling tired all of the time, having no energy
• Sensitivity to light
• Sensitivity to noise
• Numbness/tingling
• Irritability
• Sadness
• More emotional
• Nervousness or anxiety
• Sleeping more than usual
• Sleeping less than usual
• Trouble falling asleep
• Drowsiness

When you visit your doctor, here are some important questions to ask:

• What can I do to help my recovery from this injury?
• When is it safe to get back to my daily routine, such as school, work, or playing sports and doing other physical activities?
• What can I do to keep from injuring myself again?

Additional information

Centers for Disease Control and Prevention (CDC)
CDC’s National Center for Injury Prevention and Control works to reduce disability, deaths, and costs associated with injuries. CDC has a wide variety of resources and materials about concussion and other types of injuries. Call CDC toll-free at 1-800-CDC-INFO (1-800-232-4636) or visit CDC’s Injury Center on the Web at www.cdc.gov/headsup.

Brain Injury Association of America
The Brain Injury Association of America (BIAA) focuses on prevention, research, education, and advocacy. BIAA has a national network of more than 40 state affiliates across the country and hundreds of local chapters and support groups. Call BIAA toll-free at 1-800-444-6443 or visit BIAA on the Web at www.biausa.org.

References

1. Centers for Disease Control and Prevention. (2015). CONCUSSION AT PLAY: Opportunities to Reshape the Culture Around Concussion. Atlanta, GA: U.S. Department of Health and Human Services.
2. Kerr ZY, Register-Mihalik JK, Marshall SW, Evenson KR, Mihalik JP, Guskiewicz KM (2014). Disclosure and non-disclosure of concussion and concussion symptoms in athletes: Review and application of the socio-ecological framework. Brain Inj. 2014;28(8):1009-21. 4
3. Register-Mihalik JK, Guskiewicz KM, McLeod TC, Linnan LA, Mueller FO, Marshall SW. (2013). Knowledge, attitude, and concussion-reporting behaviors among high school athletes: A preliminary study. J Athl Train, July 12, 2013.
4. Chrisman, S. P., Quitiquit, C., Rivara, F. P. (2013). Qualitative Study of Barriers to Concussive Symptom Reporting in High School Athletics. J Adolesc Health. March, 2013, 52(3): 330-335.
5. Rivara FP, Schiff MA, Chrisman SP, Chung SK, Ellenbogen RG, Herring SA. (2014). The effect of coach education on reporting of concussions among high school athletes after passage of a concussion law. Amer J Sports Med, May, 2014, 42(5):1197-1203.
6. Collins CL, Fields SK, Comstock RD. (2008). When the rules of the game are broken: What proportion of high school sports-related injuries are related to illegal activity? Inj Prev, 14(1):34-38.
7. Marar M, McIlvain N, Fields S, Comstock RD. Epidemiology of Concussions Among United States High School Athletes in 20 Sports. Amer J Sports Med, April 2012, 40(4):747-755.
8. Bramley H, Patrick K, Lehman E, Silvis M. (2012). High school soccer players with concussion education are more likely to notify their coach of a suspected concussion. (2012). Clin Pediatr (Phila), 2012 April, 51(4):332-336.