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ATHLETIC CONCUSSIONS - REGULATIONS

West Springfield Public Schools (WSPS) seeks to prevent concussions and provide a safe return to activity for all students after an injury, particularly after a head injury. In order to effectively and consistently manage these injuries, the Athletic Department abides by the following procedures that have been developed to aid in ensuring that concussed athletes are identified, treated and referred appropriately, receive appropriate follow-up medical care during the school day, including academic assistance, and are fully recovered prior to returning to athletic activity.

Implementation:

The West Springfield School District has designated its Athletic Director (AD) to oversee the implementation of policies and protocols governing the prevention and management of sports-related head injuries. In addition, the AD will be responsible for: (1) Supporting and enforcing the protocols, documentation, required training and reporting; (2) Assuring that all documentation is in place; (3) Reviewing, updating and implementing policy every two years and including updates in annual training and student and parent handbooks.

Annual Training Requirement:

Before beginning any extracurricular athletic activity and annually thereafter, the following persons shall complete one of the concussion training programs approved by and found on the website of the Massachusetts Department of Public Health (DPH):

    1. coaches
    2. licensed athletic trainers
    3. trainers
    4. volunteers
    5. school nurses
    6. school and team physicians
    7. athletic directors
  1. directors responsible for a school marching band whether employed by a school or school district or serving as a volunteer
    1. parent or legal guardian of a child who participates in an extracurricular athletic activity
    2. student who participates in an extracurricular athletic activity

Participation Requirements for Students and Parents:

    1. Each student athlete must have a physical examination on an annual basis, within 13 months of the student’s last physical examination. Any student athlete, who does not have a current physical on file with the nurse, prior to the first day of try-outs/practice, is not eligible until a new/updated physical is turned in. If the student’s physical examination expires during the sports season, he/she must have an updated physical examination to continue to participate in the sports season. All physicals are to be turned in to the nurse.
    2. The Massachusetts concussion law requires athletes and their parents to inform coaches about prior head injuries at the beginning of each sports season. This reporting is done via the Pre-participation Head Injury/Concussion Reporting Form (found here) and should be completed by the student’s parent(s) or legal guardian(s) and the student. It must be submitted to the Athletic Director, prior to the start of each season a student plans to participate in an extracurricular athletic activity. Until the pre-participation form (found here) (or school-based equivalent) is completed and signed by the parent/guardian and student and returned to the school prior to the start of every sports season, the student cannot participate in the extracurricular sports activity.
    3. Review the Return to Play and Academics requirements. No student will be allowed to return to play in athletic activities until the medical clearance form (found here) is signed by an authorized medical professional, submitted and reviewed by the school nurse or athletic trainer.
    4. If a student athlete sustains a head injury or concussion during the season, but not while participating in an extracurricular athletic activity, the parent shall complete the Report of a Head Injury Form (found here) and submit it to the school nurse or athletic trainer.

Medical/Nursing Review of Pre-Participation Forms:

At the start of each sports season, the Athletic Director will review all pre-participation forms and forward to the school nurse those forms indicating a history of head injury. The school nurse will be responsible for:

    • Reviewing or having the school physician review completed pre-participation forms
    • Addressing any questions raised by the Athletic Director
    • Communicating with the coach regarding the student’s concussion history and discussing concerns
    • Following up with parents and students as needed prior to the student’s participation in extracurricular athletic activities

Medical/Nursing Review of Reports of Head Injury During the Season:

The following procedures will be followed when an athlete receives a head injury:

    • Athlete is removed from the contest or practice.
    • The athletic trainer conducts a Standardized Assessment of Concussion and completes the “Report of Head Injury During Sports Season Form”
    • If athletic trainer is not available, coach completes the “Report of Head Injury During Sports Season Form”
    • The certified athletic trainer/coach will give “Report of Head Injury During Sports Season Form” to Director of Athletics and the school nurse.
    • School nurse will contact athlete’s guidance counselor.

Procedure for Reporting Head Injuries:

    • Athletes who experience signs or symptoms of a concussion should not be allowed to return to play.
    • Head injuries or suspected concussions (after a bump, blow or jolt to the head or body) sustained during extracurricular athletic activities must be reported by the coach as soon as possible to the athletic trainer.
    • If an athlete sustains a sports-related head injury, including a suspected concussion, the athletic trainer or coach will notify parents immediately and the school nurse and appropriate school staff prior to the start of the next school day.
    • Any athlete who is symptomatic but stable is allowed to go home with his/her parent(s)/guardian(s).
      • If the head injury occurs at practice, parent/guardian(s) will immediately be notified and must come and pick up the student athlete and talk to the certified athletic trainer in person.
      • If the injury occurs at a game or event the student athlete may go home with the parent(s)/guardian(s) after talking with the certified athletic trainer or coach.
      • Parent(s)/guardian(s) will receive important information regarding signs and symptoms of deteriorating brain injury/function prompting immediate referral to a local emergency room as well as return to play requirements.

Post Concussion Graduated Reentry and Medical Clearance for Return to Play:

    • All students returning to school and athletics after a concussion will have a plan for reentry. School staff, such as teachers, school nurses, counselors, administrators, speech-language pathologists, coaches and others should work together to develop and implement this plan in coordination with the student, their parent/guardian and the primary care provider.
    • Graduated return to athletic plans will begin only after a student has returned to full participation in academics and is completely symptom-free at rest.
    • Following a suspected concussion, the student athlete will take a post-injury test within 24 to 48 hours or upon return to full day of school and/or as tolerated or at the discretion of the athletic trainer. STUDENT ATHLETES WILL NOT BE ALLOWED TO MOVE ONTO FUNCTIONAL/PHYSICAL TESTING UNTIL THEIR IMPACT TEST IS BACK TO THE BASELINE SCORE AND THEY ARE ASYMPTOMATIC. After a student athlete takes their first post-injury test, they will not be retested again for 5 days or at the discretion of healthcare provider or athletic trainer.
    • If after the first post-injury ImPACT test the athlete is not back to his/her baseline, the parent(s) or legal guardian(s) will be notified, and the student athlete will be referred to their healthcare provider. Student athletes who continue to exhibit concussion symptoms for a week or more must be evaluated by a physician before returning to play.
    • Following referral and clearance from a healthcare provider, the student must present the school nurse or athletic trainer with a signed note from the healthcare provider stating that they are cleared to begin a return to play progression.
    • Once a student athlete’s post-injury test is back at the student athlete’s baseline score they will go through 5 days of Exertional Post Concussion Tests. The student athlete must be asymptomatic for all functional and physical tests to return to play (RTP). All tests will be administered by a certified athletic trainer.
    • Upon clearance from the healthcare provider, the certified athletic trainer will document all post injury tests taken by the student athlete, document the date on which the athlete is asymptomatic.
    • Once the athlete completes the exertional post concussions tests, the parent(s) or legal guardian will be notified. At this time a licensed physician, licensed neuropsychologist, nurse practitioner, or certified athletic trainer will complete the Post Sports-Related Head Injury and Medical Clearance and Authorization Form (found here) and the student athlete will be medically cleared for participation in extracurricular athletic activities.

Exertional Post Concussion Tests:

Test 1: (30% to 40% maximum exertion): Low levels of light physical activity. This will include walking, light stationary bike for about 10 to 15 minutes. Light isometric strengthening (quad sets, UE light hand weights, ham sets, SLR’s, resistive band ankle strengthening) and stretching exercises.

Test 2: (40% to 60% maximum exertion): Moderate levels of physical activity. Treadmill jogging, stationary bike, or elliptical for 20 to 25 minutes. Light weight strength exercises (resistive band exercises UE and LE, wall squats, lunges, step up/downs). More active and dynamic stretching.

Test 3: (60% to 80% maximum exertion). Non-contact sports specific drills. Running, high intensity stationary bike or elliptical 25 to 30 minutes. Completing regular weight training. Start agility drills (ladder, side shuffle, zig-zags, carioca, box jumps, and hurdles).

Test 4: (80% maximum exertion). Limited, controlled sports specific practice and drills

Test 5: Full contact and return to sport with monitoring of symptoms.

Gradual Return to Play Protocol:

    1. Student athletes, with the consent of their parent(s)/guardian(s), will start taking the ImPact Test (or other approved test identified by the School District). The ImPact Test is a tool that helps manage concussions, determine recovery from injury, and is helpful in providing proper communication between coaches, parents and clinicians. The ImPact Test is a neurocognitive test that helps measure student athletes’ symptoms, as well as test verbal and visual memory, processing speed and reaction time. It is mandatory for all student athletes to take the ImPact Test for a baseline score in accordance with Massachusetts state law. The law states that all public schools must develop safety protocols on concussions and all public schools must receive information on past concussion history. The ImPact Test appears to be a promising tool in monitoring a student athlete’s prior concussions, as well as any future concussions.
    2. Each student athlete will complete a baseline test at the beginning of their sport season. All student athletes, club cheerleading members, marching band and club level athletics will undergo ImPact testing. Student athletes will be retested every other year. If a student athlete plays more than one sport during the academic year, their test will remain valid. For example, if a soccer student athlete also plays basketball in the winter, the student the student athlete will not have to take the ImPact Baseline test again in the winter. If a student athlete posts scores below the norm, the student athlete will be retested at another time with either the certified athletic trainer or school nurse. Student athletes cannot begin practice until a valid baseline score is obtained during their designated time to take the test.

Penalties:

The West Springfield School District takes the safety of student athletes seriously. All members of the school staff are expected to follow these policies and protocols to support the health and safety of student athletes. The underlying philosophy of these policies is “when in doubt, sit them out.” Failure to comply with the letter or spirit of these policies could result in progressive discipline for staff and/or forfeiture of games.

Created by: MASC (1/2012)

Approved: Policy Subcommittee –January 27, 2012

Revisions suggested by: G. Doulette, Athletic Director; C. Viens, Director of Health Services

Read, reviewed, and approved: November 2, 2016 (Policy Subcommittee)

Concussion Policy and regulations can be found here and forms can be found here