As a result of legislation like the Lystedt Law, the National Federation of State High School Associations and the National Collegiate Athletic Associations have teamed up with the CDC to develop protocols for treating concussions, as well as a program to educate athletes, parents, coaches and trainers on the symptoms and management of a sports concussion. At the core of these laws and protocols are “The Four Rs”: 1) recognize, 2) remove, 3) refer and 4) return to play only when cleared by by a licensed health care professional.

1) Recognize the Signs
A concussion is a brain injury caused by a direct or indirect blow to the head, and thus rapid movement of the brain inside the skull. Despite a higher prevalence in boy’s football, concussions can occur in any sport, and to girls as well as boys (see chart). Signs can include immediate memory disturbance, dizziness and vomiting (download full list). Note that an athlete does not have to lose consciousness to suffer a concussion. And keep in mind that a competitive young athlete might be less than forthcoming about his or her condition (hear why from this athlete).

2) Remove the Athlete
If you have any doubt about young athletes after a head injury, sit them out. And under no circumstance let them return to a game the same day of the concussion.

3) Refer to a Professional
Don’t try and judge the severity of the injury by yourself. Have the athlete evaluated as soon as possible by a health care professional.

4) Return Only When Cleared
Treating young athletes with a concussion is uniquely challenging because their brains are
still developing. Returning to action too early can result in second-impact syndrome, which can cause severe brain injury or death. Concussed athletes should not practice or play until they’ve been cleared by a licensed health care professional, and only then after showing no signs of a concussion during the six-step graduated rehabilitation program as shown here. Graduated rehabilitation will require a minimum of five days, and probably longer for young athletes.

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