Sports Medicine & Performance

Concussion Management

Management Information

List of 7 items.

  • Post-Concussion Home / School Instructions

    Adapted version of Children’s National Medical Center ACE Post-concussion Instructions

    concussion is a disturbance in brain function caused by direct or indirect force resulting from a blow to the head, face, neck, or elsewhere on the body with an “impulsive” force transmitted to the head. This force results in compression of the brain against the skull. Concussion results in clinical signs and symptoms that may or may not involve loss of consciousness.
  • When to Seek Care Urgently (Emergency Room)

    New signs and symptoms could arise over the first 24-48 hours after injury. If any of the following conditions exist post-injury, you should seek immediate emergency medical care.

    Fainting or loss of consciousness Repeated vomiting
    Increased confusion or disorientation Slurred speech
    Headaches that worsen Weakness/numbness in arms/legs
    Very drowsy, can't be awakened Unusual behavior change
    Less responsive than usual Significant irritability
    Can't recognize people or places Behavioral changes
  • Common Signs & Symptoms

    It is common to have one or many concussion symptoms. Keep track of them and record them.

    • Headache
    • Nausea/Vomiting
    • Dizziness
    • Balance Problems
    • Visual Problems
    • Numbness/Tingling
    • Sensitivity to light or noise

    • Feeling mentally foggy
    • Fatigue
    • Feeling tired
    • Feeling slowed down
    • Difficulty remembering
    • Difficulty concentrating

    • Irritability
    • Sadness
    • More emotional
    • Nervousness

    • Drowsiness
    • Sleeping less than usual
    • Sleeping more than usual
    • Trouble falling asleep
  • Follow Up

    A follow up appointment with your primary care physician is recommended due to the student’s history with the doctor and his/her ability to provide care for the student’s injuries/illnesses that may be present in addition to concussion.
  • Returning to Daily Activities

    The key to recovery is sleeping, resting physically and mentally, and avoiding activities that might cause another head injury. It is hard to change from the normal routine. The injured person will need help from parents, teachers, coaches, school nurse, and athletic trainers to help manage their activity level.

    • Physical activities that produce concussion symptoms, as this can increase recovery time.
    • Lengthy mental activities requiring concentration (i.e. Homework, schoolwork, job-related work, and video game playing) as these activities worsen symptoms and prolong recovery.
    • Get good sleep and take naps if tired. No late nights or sleepovers.
    • It is NOT necessary to wake up periodically.
    Dos & Don'ts
    The injured person should NOT exercise (causing increase in heart rate and blood pressure) which includes participation in ANY high risk activities that might result in head injury until examined and cleared by a qualified health care professional. High risk activities include sports, physical education (PE), climbing, or riding a bike.

    It is OK to:Not Necessary to:Do NOT:
    Take pain medicine as prescribed by the doctor
    Use ice pack on head and neck for comfort
    Go to sleep
    Wake up every hour 
    Stay in bed
    Drive while you have symptoms
    Exercise or lift weights
    Participate in sports or high-risk activities
    Drink alcohol
  • Returning to School

    If symptoms are severe (cannot concentrate for more than 30-45 minutes without symptoms worsening), staying home and resting may be indicated until symptoms improve. If symptoms are less severe, rest breaks during school can help recovery.
    • Inform the advisor, teacher(s), school nurse, school counselor, athletic trainers, dean, and administrator(s) about your son’s injury and symptoms. Accommodations will be put in place immediately.
    • Students back in school, that still experience some symptoms of concussion need periodic rest breaks in the school nurse’s office and need extra help to perform school activities. They may not perform at their best on classroom or standardized tests.
    • As symptoms decrease, the rest breaks at the nurse’s office during school can be removed slowly.
    School Personnel
    School personnel should watch for indications of worsening symptoms, specifically:
    • Worsening headaches and increased fatigue
    • Increased problems paying attention, concentrating, remembering or learning new information
    • Needing longer time to complete a task
    • Increased irritability or less of an ability to cope with stress
    *These are important signs that the brain is doing too much for the current state of recovery. The student should only do school tasks that do not worsen their symptoms.
  • Returning to Sports and Recreation

    The injured person should NEVER return to sports or active recreation with ANY symptoms unless directed by a qualified health care professional. NO PE class, physical activity at recess, or sports practices or games.
    • Tell the Athletic Trainers, Nurse, and all coaches of the injury and symptoms.
    • Have the student check in with a qualified health care professional on the first day he/she returns.
    • It is normal for the child/teenager to feel frustrated, sad, and even angry because they cannot return to sports or recreation right away. With an injury, a full recovery will lower the chances of getting hurt again.
    It is better to miss one or more games than the whole season.

    Stepwise Return to Activity/Play
    Once the student’s symptoms resolve and neurocognitive abilities are comparable to baseline levels (when applicable), the Athletic Trainers, will progress him back to activity via a 5 step Gradual Return to Play Plan.
    1. Low levels of physical activity. This includes walking, light jogging, light stationary biking.
    2. Moderate levels of physical activity with body/head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting.
    3. Heavy non-contact physical activity. This includes sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills.
    4. Full contact in controlled practice.
    5. Full contact in game play.
    Any questions or concerns should be directed to the athletic trainers or nurse.

Contact Information

Matthew Virtue, MS, ATC
(202) 537-5516

Deanna Smith, MS, ATC
(202) 537-5511

Amy P. Harper, RN, MSN, ACNP-BC
(202) 537-6433
Located in Washington D.C.,  St. Albans School is a private, all boys day and boarding school. For more than a century, St. Albans has offered a distinctive educational experience for young men in grades 4 through 12. While our students reach exceptional academic goals and exhibit first-rate athletic and artistic achievements, as an Episcopal school we place equal emphasis upon moral and spiritual education.