NCAA Appendix G Concussions

NCAA Appendix G Concussions


Revised April 2016

A concussion is a brain injury that is most commonly caused by a blow to the head or trunk, or by the head or body forcefully impacting the ground. Concussions most commonly occur without loss of consciousness. Typically, there are subtle indications that a concussion has occurred, such as the student-athlete shaking his head, stumbling, or appearing dazed or stunned.

Game officials are often in a best position to observe student-athletes up-close, and may be the first to notice the unusual behaviors that indicate a concussion may be present. Student-athletes with a suspected concussion must be removed from competition so that a medical examination can be conducted by the primary athletics healthcare provider (i.e., athletic trainer or team physician).

Importantly, a game official is not expected to evaluate a student-athlete. Instead, if an official notices any unusual behavior, the official should stop play immediately and call an injury time-out so that an appropriate medical examination can be conducted. A simple guide to the official’s role is: “When in doubt, call an injury time-out.”

An official may observe the following behaviors by a student-athlete with a suspected concussion:

• Appears dazed or stunned.

• Appears confused or incoherent.

• Shakes head.

• Stumbles; has to be physically supported by teammates.

• Moves clumsily or awkwardly.

• Shows behavior or personality changes.

A student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion, either at rest or during exertion, should be removed immediately from practice or competition and should not return to play until cleared by an appropriate health care professional. Sports have injury timeouts and player substitutions so that student-athletes can receive appropriate medical evaluation.


1. Remove the student-athlete from play. Look for the signs and symptoms of concussion if the student-athlete has experienced a blow to the head. Do not allow the student-athlete to just “shake it off.” Each student-athlete will respond to concussions differently.

2. Ensure that the student-athlete is evaluated immediately by an appropriate health care professional. Do not try to judge the severity of the injury. Call an injury time-out to ensure that the student-athlete is evaluated by one of the primary athletics healthcare providers.

3. Allow the student-athlete to return to play only with permission from the primary athletics healthcare provider. Allow athletics medical staff to rely on their clinical skills and protocols in evaluating the student-athlete to establish the appropriate time to return to play.

Please refer to the NCAA Sports Medicine Handbook and the Diagnosis and Management of Sport-Related Concussion Guidelines for additional information and details regarding concussions. Both are available at

November 13, 2019
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