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Concussions
An athlete does not have to be knocked out to have one, and some symptoms take days to show. Here is what to watch for, and what Ohio law requires before your child plays again.
A concussion is a traumatic brain injury caused by a bump, blow or jolt to the head — or by a hit to the body hard enough to move the head and brain rapidly back and forth. That movement can make the brain bounce or twist inside the skull, changing its chemistry and sometimes damaging brain cells.
An athlete does not have to be knocked out to have one. Signs usually show soon after the injury, but some do not appear for hours or days — a child who has a headache at the game may not show trouble sleeping or mood changes until later in the week. Keep checking for several days.
Signs and symptoms
Some you will see yourself; some only your athlete can tell you. Ask them directly.
What you might see
Observed by a parent, guardian or coach:
- Appears dazed or stunned
- Forgets 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 the hit or fall
What your athlete might tell you
Symptoms they report themselves:
- Headache or “pressure” in the head
- Nausea or vomiting
- Balance problems, dizziness, or double or blurry vision
- Bothered by light or noise
- Feeling sluggish, hazy, foggy or groggy
- Confusion, or concentration or memory problems
- Just not “feeling right,” or “feeling down”
Call 911 or go to the emergency department right away
These are dangerous signs. Do not wait to see whether they pass:
- One pupil larger than the other
- Drowsiness or an 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
- Unusual behavior, increased confusion, restlessness or agitation
- Loss of consciousness — even a brief one should be taken seriously
What happens if we suspect a concussion
- Any athlete showing signs, symptoms or behaviors consistent with a concussion is removed from that practice or game. The coach, a referee, or an association official supervising can make that call — and none of them needs to be sure it is a concussion.
- That athlete does not return the same day. Not to that practice or game, and not to any other one that day.
- Before returning, the athlete must be assessed by a physician, or by a licensed health care professional our association has authorized who is working with, referred by, or supervised by a physician.
- That person must give written clearance that it is safe to return. It goes to the coach or commissioner before the athlete plays again.
This is Ohio law — Revised Code 3707.511, which governs youth sports organizations like ours. A coach who is unsure will always sit the athlete down. Please back them up on it; it is not a judgment about your child’s toughness. Read ORC 3707.511.
Every coach is trained to spot one
Ohio law says no one may coach or referee for a youth sports organization unless they hold a pupil-activity program permit or have completed an approved concussion recognition course within the previous three years. The Ohio Department of Health approves three free online courses.
NFHS — Concussion in Sports
Select Ohio, register, then “order” the free course. Prints a certificate.
CDC HEADS UP to Youth Sports Coaches
Print the certificate before you close it — you cannot get back to it later.
US Council for Athletes’ Health
Create an account with program code ODEPAP. Certificate stays in your account.
Getting back on the field
Recovery is not a rest-then-play switch. ODH publishes a step-by-step return, run under the direction of a health care professional. Each step takes at least 24 hours, and if symptoms come back the athlete drops to the previous step.
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1
Back to regular activities
Back to normal daily life such as school, with the green light from their health care provider to begin the progression.
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2
Light aerobic activity
Five to ten minutes on a bike, walking or light jogging, to raise the heart rate. No weightlifting yet.
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3
Moderate, sport-specific
Individual drills away from the team — change of direction, moderate jogging, brief running, lighter weights. Nothing that risks a head impact.
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4
Non-contact training drills
Harder training and drills with the team, still without contact.
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5
Practice and full contact
Return to practice and full contact, if the sport has it, in a controlled practice.
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6
Competition
Return to games.
Steps 4 to 6 begin only after all symptoms, cognitive effects and other clinical findings from this concussion have resolved, including during and after exertion. If sport-specific training carries any risk of an accidental head impact, medical clearance should come before step 3.
Returning to school
A concussion affects schoolwork before it affects sport. ODH publishes a separate Return to Learn strategy — shorter days, breaks, less screen time, and telling teachers what to watch for. Tell the school as well as the coach.
Be honest
Encourage your athlete to be honest with you, their coach and their doctor about symptoms. Young athletes get caught up in the moment and feel pressure to get back out there. It is better to miss one game than the whole season — or risk permanent damage.
Sheets, forms & training
From the Ohio Department of Health. These are the youth sports organization versions — there are separate ones for school athletics, which are not the rules that apply to us.
Concussion information sheet
The full ODH sheet for youth sports organizations.
What parents need to know
The return-to-play law in one page, for families.
Medical clearance form
What your doctor completes before your child plays again.
What coaches need to know
The same law from the sideline’s point of view.
Approved coach training
All three free courses ODH accepts, with sign-up steps.
Return-to-play FAQs
The state’s answers to the common questions.
CDC HEADS UP
Fact sheets for athletes, parents and coaches.
Nationwide Children’s
Concussion toolkit and clinic, here in Columbus.
Materials are maintained by the Ohio Department of Health — its youth concussions page always has the current version. The Diocese of Columbus CYO keeps its own copies here.
Tell the doctor first, then tell us
A suspected concussion is a medical question, not one for us. Once you have a clearance letter, get it to the coach or commissioner — they cannot put your child back on the field without it, and they would rather have it early than argue about it at a game.