Football and Fall sports are in full swing. Along with the start of these seasons there is a heightened awareness of concussions and how to properly man­age a concussion. It is important for athletes, coaches, parents, and family members to be educated on what to do when a loved one suffers a concussion and the affect it has on the athlete and dangers of playing while the concussion is still ongoing.

A concussion is a traumatic brain injury that alters the way your brain functions. Although concussions are usually caused by a blow to the head, they can also occur when the head and upper body are violently shaken. Concussions can cause a loss of conscious­ness but not all do. Concussions can affect everyone of all ages. Symptoms include problems with head­aches, concentration, memory, judgment, balance, and coordination. Symptoms can also have a delayed onset.

If an athlete suffers or is suspected to suf­fer a concussion while in a game, that athlete needs to be immedi­ately removed from the game and not be allowed to return to play until cleared by a medical professional experienced in concussions. This is also true when an athlete suffers a concussion off field. After the concussion, the athlete needs to follow a graduated step-wise return to play protocol. The steps are as follows:

Step I: In addition to not playing the game, the athlete needs to rest both physically and mentally. This gives the brain time to recover from the concus­sion. Once he or she is symptoms free, without the assistance of medication, then the athlete can move on to the next steps.

Step 2: Light aerobic exercise, such as, walking, swimming, or stationary cycling. No resistance train­ing, such as, weight lifting should not be done during this step. The goal is to increase the heart rate.

Step 3: Sport-specific exercise, such as, skat­ing drills in hockey and running drills in football and soccer. No head impact activities should be clone during this step. The goal is to add movement.

Step 4: Non-contact training drills, such as pass­ing drills in football and ice hockey. The athlete may also start progressive resistance training. The goal is to increase and assess exercise, coordination, and cognitive load.

Step 5: Full-contact practice, following medical clearance, the athlete may participate in normal train­ing activities. The goal is to restore confidence and assess functional skills by coaching staff.

Step 6: Return to normal game play.

Each step should take 24 hours; so therefore, it should take approximately one week before an athlete can return fully to play following a concus­sion. During the return to play process, should the athlete become symptomatic at any step, then the athlete should drop back to the previous step and try to progress to the next step again after 24 hours of rest.

Should the return to play protocol not be followed, there is a risk of second impact syndrome or playing and exerting the brain that is still undergoing a con­cussion which can result in residual and permanent damage and injuries. There are resources in Colorado for athletes and families who suffer from residual or ongoing effects of a concussion or brain injury, such as the Brain Injury Association of Colorado.

Fortunately, many concussions are mild in nature and if the athletes and loved ones follow the above guidelines, they are likely to recover from the concus­sion and symptoms and be able to return to play their favorite sport fully.