Please note that there is not a universally accepted definition for concussion and many other factors pertaining to concussions; therefore, this SportGait application uses the United States Center for Disease Control (CDC) definition and guidance.

Concussion Danger Signs and Symptoms

  • One pupil larger than the other 
  • Drowsiness or unable to wake up 
  • Headache that gets worse and does not go away 
  • Weakness, numbness, or decreased coordination 
  • Repeated vomiting or nausea 
  • Slurred speech 
  • Convulsions or seizures (shaking or twitching) 
  • Not able to recognize people or places 
  • Increased confusion, restlessness, or agitation 
  • Unusual behavior 
  • Loss of consciousness (even a brief loss of consciousness should be taken seriously) 

If the patient has any ONE of the above symptoms, then STOP!
This is considered an emergency room event!

  • 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 
  • 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 “feeling down”

A doctor, or SportGait-enabled medical provider, in a medical facility, is qualified to diagnose a concussion.

A self-diagnosis, or diagnosis from a parent, coach, or athletic trainer is not acceptable.

If a parent believes their child is suffering from a concussion, the child should be seen by a SportGait-enabled medical provider. Parents should take the following steps if the concussion occurs in a sporting event:

  • Step 1: Remove your child from play! “When in doubt, sit them out!”
  • Step 2: Keep an athlete with a possible concussion out of play the same day of the injury and until cleared by a doctor or SportGait-enabled medical provider.
  • Step 3: Ask for written instructions from the athlete’s doctor both on Return to School and Return to Play Protocols.

A student-athlete can return to school when allowed by a SportGait-enabled Medical Provider. Please note that the return-to-school time will vary from person to person. Please follow these steps:

Step 1: Rest until symptom free

Instructions: Rest 24 hours and take symptom evaluation, using Concussion Symptom Checker. Repeat until symptom free for 24 hours.

Example Activities: Total cognitive and physical rest

Notes: Follow SportGait-enabled Medical Provider Advice. When in doubt, see SportGait-enabled Medical Provider.

Step 2: SportGait-enabled Medical Provider Approval

Instructions: Go to SportGait-enabled Medical Provider for a full examination and instruction.

Only when a SportGait-enabled Medical Provider feels it is appropriate may an athlete return to school.

An athlete can return to play when deemed appropriate by a SportGait-enabled Medical Provider. Once the athlete has been approved to Return to School or return to work, the SportGait-enabled Medical Provider will assign the athlete to the Return to Play (RTP) Protocol. This five-step program assures the athlete is safe to return to play. It is also a gradual process that should be undertaken over several days or even weeks to months. Also, the athlete should only move to the next step of the program when they no longer experience concussion symptoms (refer to Concussion Symptom Checker) at the current step.

Step 1: Light Aerobic Activity

Instructions: Increase athlete's heart rate for 5 - 10 minutes

Example Activities: Exercise bike, walking, or light jogging. Notes: Absolutely no weightlifting, jumping, or hard running

Step 2: Moderate Activity

Instructions: Continue to increase athlete's heart rate with body or head movement

Example Activities: Moderate jogging, brief running, moderate-intensity stationary biking, and moderate intensity weightlifting

Notes: Reduced time and/or reduced weight from athlete's usual routine

Step 3: Heavy, Non-Contact Activity

Instructions:More intense but non-contact

Example Activities: Running, high-intensity stationary biking, the player's regular weightlifting routine, and non-contact sport-specific drills

Notes: This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2.

Step 4: Practice & Full Contact

Instructions: Reintegrate in full contact practice

Example Activities: Moderate jogging, brief running, moderate-intensity stationary biking, and moderate intensity weightlifting

Notes: Reduced time and/or reduced weight from athlete's usual routine

Step 5: SportGait-enabled Medical Provider Approval

Instructions: Get clearance from SportGait-enabled Medical Provider to return to normal activity

Notes: See a SportGait-enabled Medical Provider for approval to return to normal activity

Concussion Facts and Statistics

While there is no universally agreed upon definition for concussion, according to the CDC, a concussion is a type of traumatic brain injury – or TBI – caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. Medical providers may describe a concussion as a “mild” brain injury because they are usually not life threatening.

There are approximately 36 million youth athletes playing organized sports in the United States. Each year there are approximately 4 to 5 million (and increasing) sports-related diagnosed concussions, with one sports-related concussion taking place every seven seconds. Concussions are not always obvious and are usually missed in radiology unless there is hemorrhaging.

  • All concussions are serious.
  • Concussions can happen in any sport or recreational activity.
  • It is important to recognize and respond to concussions when they first occur as they can seriously affect one’s health, learning, memory and even survival.
• A child who suffers a concussion is one and a half times more likely to experience another, and those who have had two concussions have a threefold greater risk of the same injury happening again.

Source: National Athletic Trainers Association

• 50 percent of all "second impact syndrome" incidents - brain injury caused from a premature return to activity after suffering an initial concussion - result in death.  

Source: Cantu RC. Second impact syndrome: immediate management. Physician Sportsmed 1992;20:55-66.

(“While the precise incidence per 100,000 participants is not known because the precise population at risk in unknown, nonetheless the second impact syndrome is more common than previous reports have suggested. Between 1980 and 1993, the National Center for Catastrophic Sports Injury Research in Chapel Hill, North Carolina, USA, identified 35 probable cases among American football players alone. Necropsy or surgery and MRI findings confirmed 17 of these cases. An additional 18 cases, though not conclusively documented with necropsy findings, most probably are cases of second impact syndrome. Careful scrutiny excluded this diagnosis in 22 of 57 cases originally suspected.”)

• High school athletes who have been concussed are three times more likely to suffer another concussion in the same season. In soccer, the rate of concussions among girls was 68 percent higher than the rate of concussions in boys, and in basketball the rate of concussions among girls was 293 percent higher than the rate of concussion in boys.

(Source: Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions among United States high school and collegiate athletes. J Athl Train. 2007;42(4):495-503. 

• Youths with a history of prior concussion have higher rates of reported sports-related concussions.

(Source: The report was sponsored by Centers for Disease Control and Prevention, U.S. Department of Defense, U.S. Department of Education, Health Resources and Services Administration, National Athletic Trainers’ Association Research and Education Foundation, the National Institutes of Health, and the CDC Foundation with support from the National Football League.  The Institute of Medicine and the National Research Council are part of the National Academy of Sciences, a private, nonprofit institution that provides independent, evidence-based advice under an 1863 congressional charter.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.)

• Females aged 10-19 years sustained sports- and recreation-related TBIs most often while playing soccer or basketball or while bicycling.

Source: Gilchrist J, Thomas KE, Xu L, McGuire LC, Coronado VG. Nonfatal sports and recreation related traumatic brain injuries among children and adolescents treated in emergency departments in the United States, 2001-2009. MMWR Morb Mortal Wkly Rep. 2011;60(39):1337-1342.

• The long-term effects of TBI may vary depending on the number and nature of “hits” to the head, the age and gender of the individual, the speed with which the person received medical attention, and genetic and other factors.

Source: National Institute of Neurological Disorders and Stroke and the National Institutes of Health paper on Traumatic Brain Injury

• About half of all people with TBI are affected by depression within the first year after injury. Even more (nearly two-thirds) are affected within seven years after injury. In the general population, the rate of depression is much lower, affecting fewer than one person in 10 over a one-year period.  More than half of the people with TBI who are depressed also have significant anxiety.

Source: MSKTC.org

• “Depression is manageable, but only if doctors know to diagnose and treat it properly, and the results suggest that anyone with a history of concussion should be monitored for signs of depression.”

Source: Neurologist Dr. John Hart, medical science director Center for BrainHealth