"Coach, I have a headache", those five words make every coach grimace, dreading the worse, hoping the athlete does not have a concussion. A headache is the most common symptom of concussed athletes, but by no means the only one. No one concussion sign or symptom is more important than the others and all must be taken seriously. To start we will define the difference between signs and symptoms. A sign is something that you as the coach, parent, trainer or fellow athlete will notice. They include poor balance, slow or slurred speech, poor concentration, vacant stare, delayed response to questions and a change in the level of performance. Symptoms, how the athlete tells you they feel, fall under four categories. Somatic (physical), emotional, sleep disturbances and cognitive. Somatic symptoms include headaches, nausea, vomiting, balance problems, visual disturbances, dizzy spells, sensitivity to light and sensitivity to noise. Emotionally an athlete may be sad, depressed, nervous and more irritable. They may sleep more or less and may have trouble falling asleep. Cognitively, they may have difficulties concentrating, trouble with remembering, feel mentally slowed down or that they are in a fog.
If an athlete presents with any of these signs or symptoms they need to be removed from activity immediately and evaluated further. As a coach, parent or trainer, use the Sport Concussion Recognition Tool to determine what further care is needed and refer them to a trained health professional in the area of concussions. It is very important to rule out a cervical spine injury as well with any athlete that is displaying concussion symptoms. Typically concussion symptoms are quick in there onset and involve short lived impairment for the athlete. It should be noted though that in some cases signs and symptoms are delayed in their onset.
Next to knowing what signs and symptoms to look for the greatest tool you need comes from knowing your athletes. Being able to recognize the difference in your athletes is key. An athlete may tell you that they do not feel right and if you ask many parents and coaches who have dealt with concussions will say the athlete was not themselves. Even though they are symptoms take notice of them. Coaches one of your biggest indicators to watch will be how well the athlete is performing. If a skill typically always done well can is being done poorly, something is causing it. Remove the athlete and evaluate, it may not be a concussion but no matter what it is always better to error on the side of caution. Parents, pay attention to how your child is acting. They may not tell you they are suffering but you will notice changes in their behavior. Everything from how they are sleeping, eating and interacting with the family and friends will be an indicator of how they are feeling.
Many of the former athletes when asked about concussions will say they never knew that they had one and definitely did not know what to do when did occur. Recognize that a concussion has occurred and remove the athlete from activity, do not let them return until evaluated by a trained health care professional. Next is proper management, following the proper return to play can be the difference from a quick return to activity or the unnecessary lengthening of symptoms.