Concussion, a form of mild traumatic brain injury (TBI), is a common consequence of trauma to the head in contact sports. An estimated 1.6 to 3.8 million sports-related concussions occur in the United States each year. While the majority of concussions are self-limited injuries, catastrophic results can occur and the long-term effects of multiple concussions are unknown. A history of prior concussion significantly increases risk for recurrent concussions. The effect of concussion on developing brains is of particular concern. Children with concussion, particularly multiple concussions, are at high risk for developing headaches and suffering from impaired memory, cognitive function, attention, or other behavioral changes. Unfortunately, during the last decade, emergency department visits for sports- and recreation-related TBIs, including concussions, among children and adolescents increased by 60 percent. (source: American Academy of Neurology)

FC Boulder annually requires, in compliance with The Jake Snakenberg Youth Sports Concussion Act, that all coaches and staff complete the Center for Disease Control’s “Head’s Up Online Training Course”. This training course educates coaches on how to recognize a concussion, that a player is removed from play if a concussion is suspected and that the student athlete must be signed off by a medical professional before returning to play.

Furthermore, FC Boulder coaches and staff attend an annual Concussion Management Presentation conducted by the CU Sports Medicine and Performance Center Medical Staff to stay current with the latest information.

If the mechanism for a concussion is present, then RECOGNIZE AND REMOVE at the field:

      1.   Remove the athlete from play.  Coaches have the International Olympic Committee (IOC) Pocket Recognition Tool- to help recognize a concussion.  Athletes who experience signs or symptoms of a concussion should not be allowed to return to play in that game or practice.

2.   The athlete will then need to be evaluated by an appropriate qualified health care provider.  Do not try to judge the severity of the injury yourself.  Health care professionals have a number of different methods hey can use to assess the severity of a concussion.  Notify your appropriate FC Boulder Director of Competitive Programs who can assist in acquiring appropriate health care evaluation.
3.      Inform the athlete parent or guardians about the known or possible concussion.  Make sure they know the athlete must immediately sit out and must be seen by a qualified health care professional.
NOTE: Any FC Boulder player MEDICALLY diagnosed with a concussion, not matter the severity, MUST provide a signed written medical clearance to their team coach from a qualified health care professional before return to any activity with FC Boulder.

From U.S. Soccer, which FC Boulder complies with:  “In accordance with current consensus guidelines, there is no mandatory period of time that a player must be withheld from play following a concussion. However, at minimum, a player MUST be symptom free at rest and upon exertion, and determined to be neurocognitively at baseline. Players under the age of 18 shall be managed more conservatively than older players. At no time shall a player under the age of 18 be returned to play sooner than seven days after becoming symptom free.”

4.  Once the player has been medically cleared to begin participation in practice, ALL players must follow the Graded Return to Play Protocol (RTP) before returning to competition (game).

Graded Return to Play Example (Prague Modified):

(1) Rest (cognitive and physical) until asymptomatic at rest (24 hours)

(2) Light aerobic exercise (e.g. stationary bicycle) for 15-20 minutes.

(3) Moderate intensity aerobic exercise (30 minutes).

(4) Sport-specific training (ball handling, passing, light running, NO HEADING).

(5) Non-contact training drills, including full exertion interval training (may start resistance training).

(6) Begin heading training (steps 1 & 2 below)

(7) Full contact training with heading steps 3 & 4 listed below

(8) Return to competition (game play)

Typically, progression to the next level only occurs if the player remains symptom free for 24 hours (time frame may be lessened or lengthened depending on individual player symptoms and history). If symptoms re-emerge, the player should begin with the previous step after being symptom free for 24 hours. Player should only progress to the next level when instructed to do so by FC Boulder Director of Athletic Performance, the clubs or teams  ATC or the Team Physician.

Additional Resources:

Boulder Valley School District Concussion Protocol

Center for Disease Control and Prevention 

US Soccer Recognize to Recover- Player Health & Safety Initiative

US Soccer National Teams Concussion Evaluation Management Protocol

Click here for the American Academy of Neurology’s “Recognizing Sports Concussions in Athletes”

Click here for the American Academy of Neurology’s Position Statement on Concussions

Click here for the CDC “A Fact Sheet for Athletes”

Click here for the CDC “A Fact Sheet for Coaches”

Click here for the CDC “A Fact Sheet for Parents”

Click here for the Consensus Statement on Concussion in Sports (International Conference on Concussions in Sport)

Soccer and Concussion- Glowney July 2013   Boulder Center for Sports Medicine Presentation “Concussion and Soccer”

Jake Snakenberg Youth Concussion Act

Pocket Concussion Recognition Tool

Click here to learn about FC Boulder’s Athletic Performance Program