Concussion Care for Coaches

What is a concussion?

Concussion, a type of traumatic brain injury, is caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body that causes the head and brain to move rapidly back and forth, literally causing the brain to bounce around or twist within the skull. This sudden movement of the brain causes stretching and tearing of brain cells, damaging the cells and creating chemical changes in the brain.

How can I recognize a possible concussion?

Concussions can result from a fall or from athletes colliding with each other, the ground, or with an obstacle, such as a goalpost. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. As a coach you are on the front line in identifying an athlete with a suspected concussion. You know your athletes well and can recognize when something is off—even when the athlete doesn’t know it or doesn’t want to admit it.

To help spot a concussion, you should watch for and ask others to report the following two things:

  1. A forceful bump, blow, or jolt to the head or body that results in rapid movement of the head.
  2. Any concussion signs or symptoms, such as a change in the athlete’s behavior, thinking, or physical functioning.

Signs and symptoms of concussion generally show up soon after the injury. But the full effect of the injury may not be noticeable at first. For example, in the first few minutes the athlete might be slightly confused or appear a little bit dazed, but an hour later they can’t recall coming to the practice or game.

You should repeatedly check for signs of concussion and also tell parents what to watch out for at home. Any worsening of concussion signs or symptoms indicates a medical emergency.

Signs and Symptoms

Athletes who experience one or more of the signs and symptoms listed below, or who report that they just “don’t feel right,” after a bump, blow, or jolt to the head or body, may have a concussion.

Symptoms reported by an athlete:

  • Headache or “pressure” in head.
  • Nausea or vomiting.
  • Balance problems or dizziness.
  • Double or blurry vision.
  • Sensitivity to light.
  • Sensitivity to noise.
  • Feeling sluggish, hazy, foggy, or groggy.
  • Concentration or memory problems.
  • Confusion.
  • Just not “feeling right” or is “feeling down.”

Signs observed by the coaching staff:

  • Appears dazed or stunned.
  • Is confused about assignment or position.
  • Forgets an instruction.
  • Is unsure of game, score, or opponent.
  • Moves clumsily.
  • Answers questions slowly.
  • Loses consciousness (even briefly).
  • Shows mood, behavior, or personality changes.
  • Can’t recall events prior to hit or fall.
  • Can’t recall events after hit or fall.

What are the concussion danger signs?

In rare cases, a dangerous blood clot may form on the brain in an athlete with a concussion and crowd the brain against the skull. Call 9-1-1 or take the athlete to the emergency department right away if after a bump, blow, or jolt to the head or body the athlete exhibits one or more of the following danger signs:

  • One pupil larger than the other.
  • Is drowsy or cannot be awakened.
  • A headache that gets worse.
  • Weakness, numbness, or decreased coordination.
  • Repeated vomiting or nausea.
  • Slurred speech.
  • Convulsions or seizures.
  • Cannot recognize people or places.
  • Becomes increasingly confused, restless, or agitated.
  • Has unusual behavior.
  • Loses consciousness (even a brief loss of consciousness should be taken seriously).

What should I do if a concussion is suspected?

No matter whether the athlete is a key member of the team or the game is about to end, an athlete with a suspected concussion should be immediately removed from play. To help you know how to respond, follow the Heads Up for Concussion four-step action plan:


Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. When in doubt, sit them out!


Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions. As a coach, recording the following information can help health care professionals in assessing the athlete after the injury:

  • Cause of the injury and 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 immediately following the injury.
  • Any seizures immediately following the injury.
  • Number of previous concussions (if any).

How can I help prevent concussion and traumatic brain injury?

Insist that safety comes first. To help minimize the risks for concussion or other serious brain injuries:

  • Ensure athletes follow the rules for safety and the rules of the sport.
  • Encourage them to practice good sportsmanship at all times.
  • Make sure the athlete wears the right protective equipment for their activity. Protective equipment should fit properly, be well maintained, and be worn consistently and correctly.
  • Wearing a helmet is a must to reduce the risk of severe brain injury and skull fracture. However, a helmet doesn’t make an athlete immune to concussion. There is no “concussion-proof” helmet.

Check with your league, school, or district about concussion policies. Concussion policy statements can be developed to include:

  • The school or league’s commitment to safety.
  • A brief description of concussion.
  • Information on when athletes can safely return to school and play.
  • Parents and athletes should sign the concussion policy statement at the beginning of the season.

Concussion Laws

Click here to learn more about the PA and NJ concussion laws.