Concussions are a risk of all contact sports including Lacrosse. IBW Youth Lacrosse takes the risks of concussions very seriously. All coaches are trained in recognizing concussions and taking the appropriate steps should a concussion occur.

Below is information on IBW Youth Lacrosse Concussion policy as well as more general information regarding concussions.

IBW Youth Lacrosse: Concussion Policy

1. All coaches receive pre-season training in recognizing and managing concussions
2. All parents and players receive preseason information regarding concussions
3. Parents are strongly encouraged to complete preseason Impact Testing (see below)
4. In the event of a head injury during practice or play:

• Coaches will treat all sustained head injuries, whether in practice or during game, as if they are concussions
• Players will be removed from the field of play immediately and not allowed to return
• Parents or guardians will be called immediately to inform them of the head injury
• A player will not be allowed to return to practice or games until they have received written clearance to do so from a qualified medical professional

IBW Youth Lacrosse: Additional Information

• All IBW Youth Lacrosse Coaches are required to complete the concussion online training available here.
• All IBW Youth Lacrosse Coaches are required to carry the following clipboard information with them to all practices and games available here.
• Additional information for parents on concussions is available here
• Additional information for athletes on concussions is available here
• Concussion for for parents available here

ImPACT Testing: Important Information

IBW Youth Lacrosse strongly encourages all parents to have their children tested using the ImPACT screen. From ImPACT's website:

"ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the first, most-widely used, and most scientifically validated computerized concussion evaluation system.

Developed in the early 1990's by Drs. Mark Lovell and Joseph Maroon, ImPACT is a 20-minute test that has become a standard tool used in comprehensive clinical management of concussions for athletes of all ages. ImPACT Applications, Inc. was co-founded by Mark Lovell, PhD, Joseph Maroon, MD, and Michael (Micky) Collins, PhD.

Given the inherent difficulties in concussion management, it is important to manage concussions on an individualized basis and to implement baseline testing and/or post-injury neurocognitive testing. This type of concussion assessment can help to objectively evaluate the concussed athlete's post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. In fact, neurocognitive testing has recently been called the "cornerstone" of proper concussion management by an international panel of sports medicine experts.

ImPACT can be administered by an athletic trainer, school nurse, athletic director, team doctor or psychologist, provided that they have completed training in the administration of the test. Post-concussion care and the management of concussion should only be administered by a trained medical professional. ImPACT assists doctors in making return-to-play decisions and should never be used as a stand-alone tool.

ImPACT is the most widely used computer-based testing program in the world and is implemented effectively across high school, collegiate, and professional levels of sport participation."

A local ImPACT Doctor can be found here

From US Lacrosse Website, Additional Information:
Every year, players of all ages in all sports receive concussion injuries during games and practice. Characterized by an impairment of the brain's normal function and caused by violent shaking or jarring of the brain, concussions may cause alterations in cognitive function, vision, eye movement, facial movement, or speech. Contrary to popular belief, and despite ongoing design improvements, no helmet in any sport can prevent a concussion.

The study and treatment of concussions in athletes has received significant attention in recent years. A revitalized interest in concussion management is taking place in the fields of neurology, neurosurgery, neuropsychology, and sports medicine.

Toward that end, US Lacrosse has formed a strategic alliance with ImPACT Applications, Inc. (ImPACT) to launch a formal Concussion Management Program for lacrosse players that offers concussion testing, education, awareness, and state-of-the-artstandards of care. Four US Lacrosse National Teams (Men's National Team, Women's National Team, Men's U-19 Team, and Women's U-19 Team) have also adopted the program. A new online resource at uslacrosse.org provides a wealth of concussion information, as well as access to the ImPACT™ Baseline Testing Program, a computerized series of neurocognitive tests that help determine the extent and severity of concussions. This program is designed to help the doctor of an injured player diagnose the severity of a concussion and determine a safe recovery time after which the athlete may return to play. The ImPACT™ program, the world's first and most widely used computerized sports concussion evaluation system, has been utilized throughout professional sports.

Online Concussion Management Program

ImPACT's Concussion Management Program is available to all levels of lacrosse players and teams through the US Lacrosse Web site. One of the key's to ImPACT's approach to concussion management is to compare an athlete's post-concussive performance and symptoms to a baseline (pre-concussion) level for that athlete. In order to do this, athletes must take a baseline ImPACT measurement prior to sustaining a concussion.

Typically, this can be done with a 20-minute online test at the beginning of preseason training or even a few months prior to season training. This user-friendly, Windows-based computer program can be administered by a coach, athletic trainer or physician with minimal training. It is important to have athletes complete the ImPACT test before they start any type of contact that might result in a concussion (e.g., drills, scrimmages, etc.). The online test is designed to measure cognitive functions, including: attention span, working memory, non-verbal problem solving and reaction time.

More About ImPACT

Headquartered in Pittsburgh, Pennsylvania, ImPACT Applications, Inc., is a provider of computerized neurocognitive assessment tools and services that are used by medical professionals to assist them in determining an athlete's fitness to return to play after suffering a concussion. At the current time, ImPACT is being used for concussion management services at more than 1,000 high schools, colleges, sports medicine centers, and professional teams throughout the world.

• Click here for more information about Online ImPACT Testing
• Additional information and resources about concussions from US Lacrosse

How to Get Started

Open the doctor locator page linked below, then click on your state. Find a clinic in your area and contact them to arrange your baseline testing session. Most ImPACT clinics charge around $10 per baseline test. Ask the doctor if they have any discounts for US Lacrosse members or if there is a discount for testing the entire team. If you sustain any head trauma, you will want to return to that doctor for a post injury evaluation. He/she will have your baseline test on file for comparison.

ImPACT Applications, Inc. is a premier provider of computerized neurocognitive assessment tools and services that are used by medical professionals to assist them in determining an athlete's fitness to return to play after suffering a concussion. The ImPACT test provides an objective measurement of memory, reaction time, attention span, and other factors to help a clinician diagnose a concussion and decide when the patient has recovered.

ImPACT is a sophisticated, research-based computer test developed to help clinicians evaluate recovery following concussion. ImPACT is a 20-minute test battery that can be administered in the pre-season for a baseline and post-injury to track a concussion. The ImPACT approach to managing concussion has been found to be reliable, valid and extremely sensitive in determining when an athlete has recovered sufficiently from a concussion, thus insuring a safe return-to-play decision and reducing the chance of follow-up concussions.

The ImPACT baseline test is ideally administered under the supervision of a clinician, athletic trainer, coach, or even parent. The test involves puzzles and tasks to measure a variety of factors. The first test is taken before a concussion occurs and establishes baseline results. When a concussion is suspected, a clinician administers a follow-up test to see if the results have changed from the baseline to help diagnose and manage the concussion. Additional follow-up tests may be administered over several days or weeks to assist the clinician with the return to play decision.

Baseline Testing

For optimal utility, ImPACT should be administered prior to athletic competition. Typically this can be done at the beginning of preseason training or even a few months prior to season training. It is important to have the athlete complete ImPACT before they start any type of practicing that might induce a concussion (e.g., hitting drills, scrimmages, etc.)

Post-Concussion Testing

Athletes who are suspected to have sustained a concussion, even if it is considered to be mild, should seek immediate clinical care. ImPACT post-concussion follow-up evaluations can be conducted within 24 - 72 hours of injury (to help determine severity of injury) and subsequently as needed (e.g. days 5 and 10 post-injury). Please note that while these testing intervals are optimal, the athlete's situation (e.g., other injuries requiring more immediate attention) may make it difficult to follow the testing protocol. Post-Injury ImPACT testing CAN ONLY be done under the supervision of a neuropsychologist, physician, or athletic trainer. Please visit the ImPACT website to find an affiliated ImPACT clinician in your area. If you are not located near an affiliated ImPACT clinician, please contact ImPACT for further assistance.

If you do not have an ImPACT clinician in your area and know of a clinician or physician interested in providing clinical concussion management with the ImPACT program, please contact ImPACT immediately. It is our hope that clinicians throughout the country will participate in this program so that local infrastructure and resources are in place for all of the US Lacrosse members.

Baseline Test Environment

ImPACT will operate using both desktop PCs and laptops or notebooks with a color monitor/screen. However, if using a laptop it must be plugged into an electrical outlet. Do not run the laptop off of the battery as this may cause a general failure of the software with some laptops. Also, an external mouse should always be utilized to help avoid variability in the some aspects of the data profile. ImPACT can be administered individually or as a group in a computer lab. The environment should be relatively free of noise and distractions.

Administration is relatively self-explanatory. Baseline testing takes approximately 25 minutes. Post-concussion testing takes approximately 20 minutes.

Concussion Care

Proper assessment of the injury and the determination of existing symptoms that may indicate incomplete recovery is critical to the safe management of an athlete suffering from a concussion. Imaging techniques such as CT scans or MRIs identify anatomic changes in the brain but are not helpful in measuring the effects of concussion, which are functional and not anatomic alterations in the brain.

A thorough medical examination is vital and use of neurocognitive tests such as ImPACT&trade are incredibly useful in assessing brain function. With neurocognitive testing a physician has an objective tool to help determine concussion subtleties, thereby assisting with medical management and return to play decisions.

When can my athlete receive a post-concussion test?

 An ImPACT clinician can evaluate your athlete anytime after injury, though preferable within the first week of injury. Just take a minute to find a doctor in your area and make an appointment. It's important to bring your athlete in for an evaluation, even if the concussion seems minor. Our Doctors are professionals who specialize in safe concussion management techniques and their evaluation is critical to your athlete's health.

Where Can I Find an ImPACT Doctor?

Finding a doctor in your area is easy. Follow the link below to access the national database of ImPACT credentialed clinicians and find one in your area today.

What if my player didn't take a baseline test?

ImPACT's software was designed to help all players, not just the ones who took a baseline test. If your athlete sustains a concussion, but was not previously evaluated, ImPACT's system taps into a large normative database to help determine the rate of recovery.

What is a concussion?

A concussion is a brain injury caused by a bump, blow, or jolt to the head. Concussions can range from mild to severe and can disrupt the way the brain normally works. Someone affected by a concussion may exhibit headaches, nausea, dizziness, or double vision, and may seem confused, slow to react, or forgetful. Symptoms may be noticeable right away, or may show up days or weeks after the injury.

How many sport-related concussions will occur this year?

There are an estimated 1.6 million sports-related concussions each year, and consequences can be severe, especially if the individual doesn't fully recover from the concussion before returning to at-risk activities.

What are the chances that my child will sustain a concussion?

One in 10 high school athletes involved in contact sports sustains a concussion each year.

When is a head injury more than a concussion?

Most athletes recover relatively quickly from injury. However, the physician or other health professional should be aware of the warning signs of more severe injury. Transport a player immediately to the ER if he or she displays any of the following symptoms or signs:

• Any penetrating injury to the skull
• Any loss of consciousness
• Very severe headache that continues to increase in intensity (a CT scan may rule out bleeding or brain swelling)
• A pronounced decline in mental status in the minutes to hours following injury
• Sensory or motor loss in the limbs
• Persistent vomiting, particularly when accompanied by severe headaches

What symptoms indicate that an athlete has sustained a concussion?

Concussed athletes experience a wide variety of symptoms. Seek medical attention if your player experiences any of the following symptoms:

• Gross confusion
• Clumsiness
• Amnesia
• Loss of Consciousness (LOC)
• Inappropriate laughter or crying
• Headache
• Nausea
• Sluggishness
• Feeling foggy
• Double or fuzzy vision
• Concentration or memory problems
• Changes in sleep patterns

The diagnosis of concussion can be tricky under the best of circumstances. There may be no direct trauma to the head, and the concussed athlete is often not rendered unconscious. The athlete may be unaware that he or she has been injured immediately after the injury and may not show any obvious signs of concussion. To complicate this situation, athletes at all levels of competition may minimize or hide symptoms in an attempt to prevent their removal from the game, thus creating the potential for additional injury.

When is it safe for the concussed athlete to return to play?

In November 2001, the 1st International Symposium on Concussion in Sport (CIS) was held in Vienna, Australia. This symposium was organized by the International Ice Hockey Federation (IIHF), the Federation Internationale de Football Association Medical Assessment and Research Centre (FIFA, F-MARC), and the International Olympic Committee Medical Commission (IOC). The aim of the symposium was to provide recommendations addressing this important topic for the improvement and safety and health of athletes who summer concussive injuries. To this end, a range of experts were invited to address specific issues of epidemiology, basic and clinical science, grading systems, cognitive assessment, new research methods, protective equipment, management, prevention, and long-term outcome, and to discuss a unitary model for understanding concussive injury. At the conclusion of the conference, a small group of experts were given a mandate by the conference delegates and organizing bodies to draft a document describing the agreement position reached by those in attendance at that meeting*. position statement verbatim - printed Clinical Journal of Sports Medicine 2002. As outlined below, the CIS recommendations allow return to play following both the absence of symptoms at rest and following exertion and normal neuropsychological testing results. Athletes should complete the following step-wise process prior to returning to play:

1. Removal from competition following observation or reporting of signs/symptoms of concussion
2. No return to play in current game
3. Medical evaluation following injury
4. Rule out more serious skull fractures or bleeding in the brain
5. Neuropsychological testing considered "cornerstone" or proper post-injury assessment
6. Step-wise return to play

• No physical activity: rest until asymptomatic
• Light aerobic exercise
• Sport-specific training
• Non-contact drills
• Full-contact drills
• Game play

Wait 24 hours, in most cases, between steps. However, any recurrence of concussive symptoms should lead to the athlete dropping back to the previous level. If an athlete is asymptomatic at rest and develops a headache following light aerobic exercise, the athlete should return to complete rest.

Does age matter for recovery time?

In the first published study to examine age as a factor, University of Pittsburgh Medical Center (UPMC) sports concussion researchers found that high school athletes demonstrated prolonged memory dysfunction requiring longer recovery compared to college athletes. According to principal investigator and neurosurgeon Dr. Melvin Field, "Our finding that high school athletes did not recover from concussion as quickly as college athletes is a cause for concern because the largest majority of at-risk athletes are at the high school level or below."

What are the consequences of sustaining multiple concussions?

There is NO debate that repeat concussions significantly worsen long-term outcomes. After athletes sustain one concussion, they are three times more likely to sustain a second concussion compared to other players who have not been concussed. Repeat concussions, even when mild, can increase the risk of post-concussive symptoms (PCS) such as headaches, memory loss, difficulty concentrating, etc. Chances of PCS are even more increased if the second injury occurs too soon, before recovery from the first has taken place. The higher the rate of concussions, the higher the risk of long-term cognitive dysfunction.

What is Second Impact Syndrome (SIS)?

Second Impact Syndrome (SIS) refers to the catastrophic events which may occur when a second concussion occurs while the athlete is still symptomatic and healing from a previous concussion. The second injury may occur anytime from days to weeks following the first. Loss of consciousness is not required. The second impact is more likely to cause brain swelling and other widespread damage and can be fatal.

What can a coach do to help prevent concussions?

Even in contact sports, some concussions may be prevented by teaching and executing proper playing, tackling and defensive techniques, and by wearing properly fitted equipment, especially helmets.