Concussion Education

Lacrosse is a physical game.  Much has been done over the past several years to limit the amount of unnecessary contact, especially at the youth level.  Although the men’s game is more physical than the women’s game, women (girls) are not immune from concussions.

By Act of the General Assembly approved April 7, 2014, Virginia now requires the parent or guardian and the youth who is participating in athletic competition or who is a candidate for an athletic team to sign and return on an annual basis a statement acknowledging receipt of information that explains the nature and risk of concussion and head injury, each year before participating in athletic competition or engaging in any practice, tryout, workout, or other physical activity associated with the youth’s candidacy for an athletic team.

We will remove a player from practice or a game who is suspected of having a concussion or head injury.  Before the player may return to practice or competition a written medical clearance to return stating the athlete no longer exhibits signs, symptoms, or behaviors consistent with a concussion or other head injury must be received from an appropriate health care professional.

What is a concussion?
A concussion is a brain injury and all brain injuries are serious. It is characterized by an onset of impairment of cognitive and/or physical functioning, and is caused by a blow to the head, face or neck, or a blow to the body that causes a sudden jarring of the head (i.e. a helmet to the head, being knocked to the ground). A concussion can occur with or without a loss of consciousness, and proper management is essential to the immediate safety and long-term future of the injured individual. A repeat concussion that occurs before the brain recovers from the first ‚ – usually within a short period of time (hours, days, or weeks) ‚ – can slow recovery or increase the likelihood of having long
term problems. In rare cases, repeat concussion can result in edema (brain swelling), permanent brain damage, and even death.

What are the signs and symptoms of a concussion?
*Signs observed by teammates, coaches, parents/guardians include:
1. Appears dazed or stunned
2. Is confused about assignments and positions
3. Forgets instructions and answers questions slowly or inaccurately
4. Is unsure of game, score, or opponent
5. Loss of balance/coordination and moves clumsily
6. Shows mood, behavior, or personality changes
7. Cannot recall events prior to hit or fall
8. Cannot recall events after hit or fall
*Symptoms reported by athlete may include one or more of the following:
1. Headache or ‚”pressure” in head
2. Nausea/vomiting
3. Balance problems or dizziness
4. Sensitivity to light or sound/noise
5. Feeling sluggish, hazy, groggy, or foggy
6. Difficulty with concentration, short-term memory and/or confusion
7. Double vision or changes in vision
8. Irritability
9. Just not “feeling right” or is ‚ “feeling down”
* adapted from CDC

How can you help your child prevent a concussion?
Every sport is different, but there are steps your child can take to protect themselves from concussion:

  • Ensure that they follow their coach’s rules for safety and the rules of the sport.
  • Encourage them to practice good sportsmanship at all times.
  • Make sure they properly wear the right protective equipment that is required for their sport (such as helmets, padding, shin guards, eye and mouth guards).
  • Learn the signs and symptoms

What should you do if you think your child has a concussion?
1. Seek medical attention right away. A licensed health care professional will be able to decide how serious the concussion is and when it is safe for your child to return to sports.
2. Keep your child out of play. Concussions take time to heal. Don’t let your child return to play until a licensed health care professional gives clearance to return. Children who return to play too soon-while the brain is still healing ‚ – risk a greater chance of having a second concussion. Second or later concussions can be very serious. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences.
3. Tell your child’s coach about any recent concussions. School personnel should be notified if your child had a recent concussion in any sport. Your child’s coach may not know about a concussion your child received in another sport or activity unless you tell the coach.
4. Refer to the Concussion Graduated Return to Play guidelines below to familiarize yourself with the process used to determine when it is safe for your child to gradually return to full activity.

CONCUSSION GRADUATED RETURN TO PLAY

Rehabilitation Stage Functional Exercise Objective of Each Stage
Stage 1 – No Activity Physical/Cognitive Rest Recovery
Stage 2 – Light Aerobic Exercise Running Drills, NO Contact Increase heart rate
Stage 3 – Sport-Specific Exercise Running Drills, NO Contact Add Movement
Stage 4 – Non-Contact Drills Complex Drills, Resistance
Training
Exercise, Coordination,
Cognitive Load/IMPACT
Stage 5 – Full Contact Following Clearance, Normal
Training Activities
Restore Confidence, Assess
Functional Skills by Coaches
Stage 6 – Return to Play Normal Game Play

 

* When an athlete has been evaluated by an athletic trainer and/or a physician for a concussion the following graduated functional return to play will be followed. The return to play progression will not begin until the athlete is completely symptom free. Each stage is a minimum 24 hour period; therefore the return to play
progression will be a minimum of 4-5 days.
* If the athlete experiences any symptoms, at any point during the rehabilitation stages, the progression will stop immediately and the cycle will resume at the previous asymptomatic rehabilitation stage after 24 hours of rest.
If symptoms continue to occur, the athlete will be referred back to the physician for a follow up evaluation.
* Adapted from Table 1 McCrory et al. Consensus Statement on Concussion in Sport 3rd
International Conference on Concussion in Sport, Zurich, November 2008

  • The treatment, management, and return to play determinations will be individualized to each athlete and dependent on circumstances of each specific case and injury. ImPACT testing may also be utilized in the return to play determination, treatment and evaluation of concussions.
  • A safe return to play is the ultimate goal regardless of age and level of play.
  • After being released for participation by a physician, the athlete must also be cleared by the school’s athletic trainer before beginning Stage 2 of the return to play progression above. The student-athlete must pass all six stages under the supervision of the certified athletic trainer before being allowed to return to play.

Additional websites: http://www.cdc.gov/Concussion/