Recognizing Concussions During a Game

Concussions in youth sports are common, especially in certain contact sports.

A concussion affects multiple aspects of brain function, including the way people think, how they process information, how they feel (emotions), and their sleep habits. While some of these effects may show up later, well after the injury occurs, there are also some more immediate signs that coaches and athletic trainers may notice.

If you suspect an athlete may have suffered a concussion during a game or competition, general signs to look for include: inability to process information correctly, emotional instability and physical deficits, such as impaired balance or eye tracking. 

How to recognize a concussion in an athlete 

Athletes who experience a concussion on the field or court may:

  • Appear dazed or stunned or have difficulty focusing
  • Get confused about what they are supposed to be doing on the field/court
  • Forget plays
  • Look unsure of game, score or opponent
  • Move clumsily (appear off-balance or dizzy)
  • Be slow to answer questions
  • Lose consciousness (only occurs in about 10 to 15 percent of concussions)
  • Experience behavior or personality changes
  • Be unable to remember events prior to or after the injury 

Signs of a concussion may include one or more of those listed above.

Symptoms that may indicate a concussion 

Symptoms that players may report to their coach include one or more of the following:

  • Headache
  • Nausea
  • Balance problems or dizziness
  • Double or fuzzy vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling sluggish
  • Feeling mentally foggy
  • Difficulty concentrating
  • Difficulty remembering plays
  • Confused about what play it is or what part of the game it is

Please note that these deficits are relative to an individual’s specific baseline abilities. This is where a coach's knowledge of the athlete is invaluable. When one of your players is not acting or playing like himself or herself, you should always consider the possibility of a concussion.

If a player exhibits any signs of a concussion or has symptoms that raise suspicion of a concussion, your responsibility as a coach and a trusted adult is simple — immediately remove the player from the game or practice. Always have a low threshold for suspicion of a concussion: “When in doubt, sit them out!”

"Heads Up” 4-step Action Plan

The U.S. Centers for Disease Control and Prevention (CDC) recommends the “Heads Up” 4-step Action Plan for players (in both high school and youth sports) suspected of having a concussion:

  1. Remove the participant from play and keep him or her out the remainder of the day.
  2. Ensure that the participant is evaluated by an appropriate healthcare professional.
  3. Inform the participant’s parents or guardians about the possible concussion and give them information about concussions. Make sure they know that the athlete should be seen by a healthcare professional experienced in evaluating concussions.
  4. Keep the participant out of play until an appropriate healthcare professional says the participant is symptom-free and gives the OK to return to play.

Know when to call 911

There may be times when a more serious injury occurs and emergency medical services should be activated. Although these situations are rare, it is important to recognize them and know what to do.

Call 911 in these emergent medical circumstances:

  • Any time a player has a loss of consciousness for any duration. While loss of consciousness is not required for a concussion to occur, it may indicate a more serious brain injury.
  • If a player exhibits any of the following:
    • Decreased level of consciousness
    • Drowsiness or cannot be awakened
    • Irregular breathing
    • Severe or worsening headaches
    • Persistent vomiting
    • Seizures

If a player with a suspected concussion is not sent for immediate medical attention, he or she should be observed continuously until evaluated by a healthcare professional. Never send a player with a suspected concussion to the bus or to the locker room alone. Any worsening in symptoms or signs may indicate a medical emergency.

Next Steps