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Coach Management Plan (CMP)

Concussion Protocol

The following policies and procedures have been instituted and will be strictly enforced by Greeneville Lacrosse Club (GLC) in an effort to identify, manage and return athletes safely to competition following a concussion.

Concussions are a risk associated with any sport, physical activity or accident. It is important that everyone understands the symptoms, risks, and management of a suspected brain injury. Please take the time to review the below information and view the below links. It is information everyone needs to understand. Please read the below management plan and the additional links. The video for parents and players is especially useful.

It is important to understand that no current helmet can eliminate concussions. All current helmet standards are designed to reduce the risk of severe brain injury and skull fracture, not to prevent concussion. There are substantial efforts towards developing standards and helmets that can reduce the risk of concussions, but this remains a challenge. Additionally, there is no evidence that any helmet or headgear can be used to reduce the risk of a second concussion or allow an earlier return to participation. (See our helmet fitting guide link below)
An athlete who exhibits signs, symptoms or behaviors suggestive of a concussion should be removed from practice or competition and not returned to play until evaluated by a health care professional with experience in the evaluation and management of concussions. Athletes diagnosed with or suspected of a concussion should not return to activity for the remainder of that day.

Every year, players of all ages in all sports receive concussion injuries during games and practice.

“Concussion is a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include:

1. Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an ‘‘impulsive’ force transmitted to the head.

2. Concussion typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours.

3. Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.

4. Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is important to note that in some cases symptoms may be prolonged.”

It is very important that coaches, parents and players understand the symptoms and have clear communication about expected and appropriate steps. Once a concussion is suspected, it is the responsibility of the family to follow-up with a health care professional and provide your child's coach with information from the doctor.

YOUR SON or DAUGHTER will NOT be allowed to return to play without a signed and dated medical release from a Doctor!

Concussion Management Plan Guidelines for U-19 Programs per USA Lacrosse:

Return to Physical Activity

Athletes diagnosed with a concussion should rest both physically and cognitively until they are back to their baseline level of symptoms. A graduated return to activity program should be used when the athlete has been cleared to do so by an appropriate healthcare professional. The athlete should gradually increase their level of exertion and risk for contact and be followed for the development of any new symptoms or complications. The following return to activity program is provided as an example.

The return to play progression is an individualized one that should incorporate the individual’s past medical history related to the specific injury (e.g. the nature, burden and duration of symptoms, prior concussion history, history of migraines, learning disabilities, depression/anxiety) as well as how the athlete responds to each step of the progression. There is no cookbook approach and no definitive timeline for return-to play.

Step 1: Rest

Step 2: Return to school and/or daily activities (non-athletic)

Step 3: Begin Aerobic Exercise

Step 4: Sport Specific Training, catching and throwing

Step 5: Non-Contact Drills, line drills, star drills, etc

Step 6: Controlled Full Contact Activity, scrimmage

Step 7: Full Return to Play – Game/Competition

Return to School

Student-Athletes who sustain a concussion should receive the necessary support from their school for classes, exams, and schoolwork that may be affected as a result of a sustaining concussion and post-concussive symptoms. Parents and their healthcare provider should inform their child’s school requesting appropriate support. Types of academic support could include extended time on tests, reduced workload, limited homework time, decreased computer use, testing in a distraction free environment, etc.

Concussion Management Plan for Greeneville Lacrosse Club
All coaches are educated on the signs/symptoms and have been instructed to strictly enforce our CMP.

Pre-Participation:

Clearance for participation or need for further consultation, evaluation or testing will be at the discretion of the athlete’s personal healthcare physician.
In following protocol for any documented concussion, written clearance is required and must be provided by the athlete’s personal healthcare physician to the athlete’s Head Coach prior to participation.

Recognition and Diagnosis of Concussion and Post-Concussion Management:

Any athlete who exhibits signs or symptoms consistent with a concussion as deemed by the Head Coach or on site certified athletic trainer, with or without a witnessed injury, will be removed from activity (practice or game) immediately and referred to their personal healthcare physician for evaluation. Head Coaches are not responsible or allowed to evaluate athletes with signs and symptoms of a concussion nor are they allowed to participate in any decision making regarding return to competition.
Once an athlete has been formally diagnosed by a healthcare physician with any form of concussion or mild traumatic brain injury,he/she will NOT be allowed to return to any practice or competition.
Following initial injury, the athlete should be evaluated and monitored by their personal healthcare physician.

Return to Play:

Athletes diagnosed with a concussion will undergo follow-up with their personal healthcare physician.
In following protocol for any documented concussion, written clearance is required and must be provided by the athlete’s personal healthcare physician to the athlete’s Head Coach prior to return to play.

Reducing Head Trauma Exposure Management Plan:

Efforts will be made to reduce exposure to head trauma. Examples of methods to minimize head trauma exposure include but are not limited to: