Concussion Policy

Pre-Season Education

At the beginning of each season, the Eliot River Ramblers Soccer Club recommends coaches, parents and/or players review Canada Soccer’s Concussion Policy in its entirety or at a minimum review the Summary section, which states:

• A concussion is a brain injury.
• All concussions should be regarded as potentially serious.
• Most concussions recover completely with correct management.
• Incorrect management of a concussion can lead to further injury.
• Concussions should be managed according to current guidelines.
• Anyone with suspected concussion following an injury must be immediately removed from playing or training and receive a prompt assessment by a medical doctor or nurse practitioner.
• Concussions are managed by licensed health care professionals working within their scope of practice and expertise.
• Concussions are managed by a limited period of rest followed by avoiding physical and brain activities that make concussive symptoms worse, and once concussion related symptoms have resolved, a step-wise return to school, work and sports-related activities.
• Return to education or work must take priority over return to playing soccer.
• Concussion symptoms must have completely resolved and documented medical clearance completed by a medical doctor or nurse practitioner must be received before resuming full contact practice or game play.
• The recurrence of concussion symptoms subsequent to the return to full contact practice or game play requires removal from training or playing and reassessment.

Head Injury Recognition

All board members, staff, coaches, players, parents, officials and spectators are responsible for recognizing and reporting players who demonstrate signs of a head injury or who report concussion symptoms.

If any player who sustains a significant impact to the head, face, neck or body and demonstrates any of the visual clues of a suspected concussion or reports any symptoms of a suspected concussion;

or

if a player reports any concussion symptoms to one of their peers or if one of their peers witnesses a player exhibiting any of the visual signs of a concussion.

Visual clues of a concussion include:

• Dazed, blank or vacant look 
• Lying motionless on ground / slow to get up 
• Unsteady on feet / balance problems / falling over / poor coordination 
• Loss of consciousness or responsiveness 
• Confused or not aware of play or events 
• Grabbing, clutching, or shaking of the head 
• Seizure 
• More emotional or irritable than normal for that person 
• Injury event that could have caused a concussion

What an injured player might say:

• Headache or “Pressure in head” 
• Dizziness or balance problems 
• Mental clouding, confusion, or feeling slowed down 
• Trouble seeing 
• Nausea or vomiting 
• Fatigue 
• Drowsiness or feeling like “in a fog“ or difficulty concentrating 
• Sensitivity to light or noise 
• Difficulty with reading, learning or work 
• Sleep problems: getting asleep, too much or too little 
• Emotional / anger / sad / anxious

When in doubt, sit them out

If any of the following signs or symptoms are present following an injury the player should be suspected of having concussion and immediately removed in a safe manner from play or training. 

‘Red flag’ symptoms that may indicate more serious injury include:

• Neck pain or tenderness
• Double vision
• Weakness or tingling/burning in arms or legs
• Severe or increasing headache
• Seizure or convulsion
• Loss of consciousness
• Deteriorating conscious state
• Vomiting
• Increasingly restless, agitated or combative 

If a neck injury is suspected the player should not be moved and should only be removed from the field of play by emergency healthcare professionals with appropriate spinal care training. Call 911.

The Concussion Recognition Tool 5 (CRT5) can be used in concussion recognition.

Onsite Medical Assessment

A licensed healthcare professional with expertise in the evaluation and management of head injury and concussions may review a player with suspected concussion at field side. 

A player who has been removed from play who reports no concussion symptoms and no visual clues of a concussion can be returned to play. Any such player should be monitored for delayed symptoms, which may appear over the next 24-48 hours. All cases of suspected concussion require referral to medical doctors or nurse practitioners for diagnosis, even if the symptoms resolve.

If no licensed health professionals are present, the CRT5 is used for the purposes of recognition and removal and medical assessment is performed as per Section 4 (Medical Assessment) below.

For children and adolescents with suspected concussion who have not been directly transferred for medical management, coaches must communicate their concerns directly with the parents or guardians.

Medical Assessment

Once removed from play, the player with suspected concussion must be referred to a medical doctor or nurse practitioner with training in the evaluation and management of head injury and concussions.

Concussion Management

Avoiding physical and brain activities that make concussive symptoms worse is the cornerstone of current concussion management.

An initial period of 24 to 48 hours of cognitive and physical rest is implemented. Following the initial period of rest, individuals gradually resume activity as tolerated. First comes return to school and then return to sport. These protocols from Parachute Canada can guide the return to school and sports. 

If a player is not recovering in the initial days to weeks following a concussion, consultation by a physician with expertise in concussion and access to a multidisciplinary care team is recommended. Ongoing and regular contact should occur between the physician and the care team. 

Return to Sport 

Players who have been removed from play and referred for medical assessment for a suspected concussion who provide a completed Concussion Assessment Medical Report that is signed by a medical doctor or nurse practitioner which documents no active concussion may participate in training sessions and game play.

A player with prolonged concussion recovery (i.e., more than 4 weeks for youth athletes, more than 2 weeks for adult athletes), or recurrent or complicated concussions, should be assessed and managed by a medical doctor with experience in sports-related concussions, working within a multidisciplinary team.