Concussion Management

Concussion Management

The Overlake School acknowledges that as the science and understanding of Sport Related Concussion, changes that policy and procedures regarding management must change. This policy update reflects the updates in the 5th international conference on concussion in sport, published 4/26/2017.

What we know about Concussion

  • Concussion can be caused by either a direct blow to the head, face, neck or elsewhere on the body in which indirect biomechanical forces are transmitted to the head
  • Concussion typically results in rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases signs and symptoms may develop over the course of minutes to hours.
  • Concussion symptoms largely reflect a functional disturbance rather than a structural injury and as such, no abnormality is seen on standard neuroimaging studies (MRI, CT scan etc.)
  • Concussion results in a range of clinical signs and symptoms that may or may not involves Loss of Consciousness. Resolution of clinical and cognitive features typically follow a sequential course, however symptoms may be prolonged.

Diagnosis of Concussion

  • In all suspected cases of concussion, the student should be removed from play and assessed by a physician or licensed health care provider (Athletic Trainer). Lystedt Law in Washington State. If no provider is present the student will not return to play until evaluated by the Athletic Trainer.
  • Students with suspected concussion should undergo sideline evaluation utilizing the SCAT-5, symptom checklist, and SWAY balance (if available).
  • The following signs/symptoms should be assessed: headache, dizziness, nausea, visual impairments, feeling “slow” or “in a fog”, altered emotional state, behavioral changes, balance deficits, tinnitus, sensitivity to light or noise, cognitive impairments and changes in wake/sleep patterns



As part of the RTL protocol, student should meet daily with learning specialist and AT to assess symptoms and progress.

  • Step 1: Daily activities at home that do not increase symptoms
    • Start with 10-15 minutes of reading, screens, focus and work up from there if tolerated.
  • Step 2: School activities
    • Homework, reading, or other cognitive activity inside the classroom.
    • Can utilize alternative forms of notes (print vs. screen), audio-books, summarizing information
    • May not progress past step 2 of RTL process until return to classroom activities without increase in symptoms has been met
  • Step 3: Return to school part time
    • Gradual reintroduction of classroom participation
    • Can utilize alternative forms of notes, extended testing time, quiet spaces and other accommodations
  • Step 4: Return to full participation
    • Gradually increase school activities and decrease accommodations as student returns to symptom-free academic activity.


This exertional protocol allows a gradual increase in volume and intensity during the return to play process. The athlete is monitored for any concussion-like signs/symptoms during and after each exertional activity, the following steps are not to be performed all on the same day.

Please note: The Certified Athletic Trainer will oversee the RTP process and make decisions regarding progression in the protocol and final clearance. Final clearance for RTP for Overlake student athletes must be given by the AT.

  • Exertion Step 1
    • Return to normal activities of daily living
  • Exertion Step 2
    • Light cardiovascular exercise – stationary bike 20 minutes
    • Completion of return to learn progression; full classroom participation
  • Exertion Step 3
    • Non-contact, sports-specific drills for approximately 15 minutes
    • Interval bike ride, 20 to 30 minutes
    • Bodyweight circuit
  • Exertion Step 4
    • Jogging, 30 minutes
    • Plyometric exercises – jumping, cutting etc.
    • Increased non-contact sport-specific drills
  • Exertion Step 5
    • Limited, controlled return to non-contact practice and monitoring for symptoms
  • Exertion Step 6
    • Full sport participation in a practice