Coaching a Concussed Athlete: What to Anticipate and How to Support Their Return to The Team

As a coach, you play a critical role in developing your athlete’s skills and getting them back to sport after a concussion can be a task you haven’t been anticipating doing. Rushing an athletes’ return to sport can lead to poor performance, other injuries and an overall delayed recovery from a concussion. 
Here’s how you can support an athlete through recovery and guiding them safely back to join the team.

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So were on the same page,
A concussion is a brain injury caused by a hit to the head or body that makes the brain move inside the head

Recognizing and Responding to a Concussion
If you suspect a concussion during practice or a game it is essential to sit them out.

Athletes are often eager to push through an injury, but continuing to play after a hit or crash and when something seems off, your gut is probably picking up something. 
The risk of having another concussion on top of an unrecovered ones may set athletes up for second-impact syndrome—a rare potentially life-threatening condition that can occur if anyone takes another hit before their brain has healed.

  • Best first steps are:
    Remove the athlete from play immediately. Even if symptoms seem mild, they should not return to the game until they have been checked out medically, by their family doctor or medical professional.
  • Check for red flag symptoms (worsening headache, repeated vomiting, confusion, seizures, loss of consciousness). If any of these occur, they need emergency medical attention, a more detailed explanation can be found here.
  • Inform parents and support staff about the event and check that your athlete is further evaluated by a healthcare provider.

When Can Athletes Start Training Again?
Returning to sport after a concussion isn’t about waiting for symptoms to disappear completely—it’s about following a progressions in activity to allow their brain and body adapt until your athlete is back to full capacity. Often athletes take a minimum of two weeks off training and games and need to be back at school full time before starting sport. Returning to the team is unfortunately one of the later stages in recovery.

I or another health care provider can help guide this process, but here’s a general return-to-play framework:
1.Moderate progressing to intense aerobic activity (potentially under your supervision)

  • Moderate Aerobic activity 
  • Working up to resistance training or high-intensity cardio

2.Sport-specific drills and Non-contact practice with progressive intensity 

  • Light jogging, footwork drills, passing drills
  • No contact, no high-impact movements
  • Athlete engagement should be limited to a limited irritation in symptoms (touch base with them often to see how they’re handing things during and after practice)

3.Full-contact/Max intensity practice (only with medical clearance)

  • If the athlete remains symptom-free at full exertion, they can return to full play with contact and after touching base with a healthcare provider

4.Return to competition

  • Once cleared by a healthcare provider again, they can resume full engagement in practices

It may be encouraged that athletes come to practices prior to they’re cleared to play so they can watch. It helps them stay connected to their social circle and feel supported during their healing. This can be a frustrating time, so showing support can make an immense difference to your athletes.

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How Coaches Can Support Recovery

  • Encourage honest communication. Many athletes will try to hide a concussion or symptoms to get back to your sport (this almost goes for any injury).
  • Educate athletes and parents. Reinforce that concussions are injuries, just like a sprained ankle or torn muscle—they need proper rehab and support.
  • Modify training. Allow injured athletes to participate in team activities in a limited capacity (watching plays, light skill drills) to keep them engaged without risking re-injury. Medical professionals can give you support for what this could look like. A physiotherapist or athletic therapist specializing in concussion rehab can create a customized plan for safe return to play based on the nuances of your sport and athletes presentation.

Keeping Athletes Safe and Strong
As a coach, your leadership makes all the difference in shaping young athletes. A well-managed return-to-play plan ensures that athletes don’t just get back on the field, but that they do so safely and at a high level of performance.
If your athlete is recovering from a concussion, I can help with their transition and guide you through their return to play. 
Contact me if you want support on how to return to your athlete to sport.