CHYSC Concussion Protocol:
- If a child/adolescent is injured during practice or a game and a concussion is suspected, the athlete should be removed from the practice/game until they can be properly evaluated by someone with expertise in evaluation of concussion (medical personnel, athletic trainer). If there is no one on the sidelines to evaluate the athlete, the athlete may not re-enter the practice/game.
- If after evaluation, it has been determined that the athlete did no sustain a concussion, then the athlete may return to the practice/game.
- If after evaluation, it has been determined that the athlete did sustain a concussion, they must remain out of contact and/or collision activities until cleared by a medical professional in accordance with Pennsylvania state laws. The athlete may participate in noncontact team activities are part of his/her concussion rehabilitation and return to play protocol.
- Head coaches are required to do CDC coaches education module.
- If an athlete sustains a concussion outside of a CHYSC team function, it is the obligation of the parents to inform the coaches of the injury.
- The athlete is not allowed to return to contact or collision activity until cleared by a medical professional.
- It is the responsibility of the parent to inform the coaches when the medical provider has cleared the athlete to return to play.
- Additional Parent resources are available at Children’s Hospital of Philadelphia Concussion Program: https://www.chop.edu/centers-programs/concussion-care-minds-matter
For Parents and Caregivers
The “return to play” plan outlines steps your child can follow to help them return to recreational physical activity after a concussion. It also provides examples of activities they can participate in at varying levels of intensity.
This “return to learn after the summer” plan provides information on how you can help your child with concussion advance through the various levels of cognitive activity to promote recovery and prevent ongoing symptoms.
This fact sheet will help you understand how you can help your child after a head injury, why physical and brain rest is important post-injury and when your child can return to school and play.
This fact sheet will help you better understand what a concussion is, symptoms of a concussion and how to treat it.
CDC concussion resources: https://www.cdc.gov/headsup/index.html
Return to Physical Activity in the First Month Post Concussion Injury
The following guidelines are suggested when participants are cleared by their concussion MD to return to activity. General guidelines are as follows:
- Standard Sports Community Protocol for Return To Sport (Table 1)
- Athletes should not return to play on the day of their injury
- When returning athletes to full play, they should be medically evaluated and then follow a stepwise supervised program, with stages of progression.
- There should be at least 24 hours (or longer) for each stage and if symptoms recur the athlete should rest until they resolve once again and then resume the program at the previous asymptomatic stage.
- Return to play protocols will adhere to all local and state requirements.
- Medical clearance should be given before return to play.
Table 1: Graduated Return-To-Sport (RTS) Strategy
|Stage||Aim||Activity||Goal of each step|
|1||Symptom-limited activity||Daily activities that do not provoke symptoms||Gradual reintroduction of work/school activities|
|2||Light aerobic exercise||Walking or stationary cycling at slow to medium pace. No resistance training||Increase heart rate|
|3||Sport-specific exercise||Running or skating drills. No head impact activities||Add movement|
|4||Non-contact training drills||Harder training drills, eg, passing drills. May start progressive resistance training||Exercise, coordination and increased thinking|
|5||Full contact practice||Following medical clearance, participate in normal training activities||Restore confidence and assess functional skills by coaching staff|
|6||Return to sport||Normal game play|
- NOTE: An initial period of 24–48 hours of both relative physical rest and cognitive rest is recommended before beginning the RTS progression.
- There should be at least 24 hours (or longer) for each step of the progression. If any symptoms worsen during exercise, the athlete should go back to the previous step. Resistance training should be added only in the later stages (stage 3 or 4 at the earliest).