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Get a Heads Up on Concussion in Sports Policies

Information for Parents, Coaches, and School & Sports Professionals

Implementing Return to Play:
Learning from the Experiences of Early Implementers

Return to Play Implementation Guide coverCheck out a CDC report that includes lessons learned from Washington and Massachusetts on implementing their states’ concussion in sports laws.

Read the Full Report

Download Get a Heads Up on Concussion in Sports Policies PDF [590KB]

Recently many states, schools, and sports leagues and organizations have created policies or action plans on concussion in youth and high school sports. While these policy efforts show some promise, more research is needed to learn if these strategies can help educate coaches and parents about this issue and help protect children and teens from concussion and other serious brain injuries.2,3

State Laws

Beginning in 2009, the state of Washington passed the first concussion in sports law, called the Zackery Lystedt Law.4 One month later, Max’s law5 passed in Oregon. Between 2009 and 2013, all 50 states, and the District of Columbia, passed laws on concussions in sports for youth and/or high school athletes (often called Return to Play laws).6

Most concussion in sports laws include three action steps:

  1. Educate Coaches, Parents, and Athletes: Inform and educate coaches, athletes, and their parents and guardians about concussion through training and/or a concussion information sheet.
  2. Remove Athlete from Play: An athlete who is believed to have a concussion is to be removed from play right away.
  3. Obtain Permission to Return to Play: An athlete can only return to play or practice after at least 24 hours and with permission from a health care professional.

These action steps are based on recommendations presented in the International Concussion Consensus Statement.7 First created in 2002 and most recently updated in 2008, the Consensus Statement was developed by experts in the field and includes the latest science available on concussion in sports.

Local Policies and Action Plans

Along with the three action steps listed above, some school and league concussion policies include additional action steps in their policies or implementation plans. Research is needed to learn if these additional action steps can help protect children and teens from concussion and other serious brain injuries. Based on interviews by CDC with nine states, below is a list of some examples of additional action steps.

Be Ready for an Emergency by:

  • Limiting contact during sports practices (when appropriate for the sport).
  • Putting in place rule changes and/or banning or limiting the use of certain drills or techniques to help reduce the chances of injury.
  • Checking sports equipment often. This includes making sure the equipment fits the athletes well, is in good condition, stored properly, and is repaired and replaced based on instructions from the equipment companies. 

Build the Science by:

  • Collecting data from schools on the number of concussions reported by athletes during the season.
  • Studying changes in concussion knowledge and awareness among coaches and parents before and after the policy is put in place.

 Focus on Education by:

  • Posting information for parents, coaches, and athletes at schools and on the field or sidelines. Posted information often includes concussion signs and symptoms, as well as what to do if a concussion occurs.
  • Hosting or requiring regular trainings for athletes, parents, coaches, and school and health care professionals about concussion.

Manage Return to School by:

  • Providing information on returning to school. This includes creating:
    • A concussion management team to check on students with a concussion for any changes in behavior or increased problems with school work.
    • A plan that includes special support or help for students during the school day to help with their recovery.


  1. Gilchrist J, Thomas KE, Xu L, McGuire LC, Coronado VG. Nonfatal sports and recreation related traumatic brain injuries among children and adolescents treated in emergency departments in the United States, 2001-2009. MMWR 2011: 60(39);1337-1342.
  2. Shenouda C, Hendrickson P, Davenport K, Barber J, Bell KR. The effects of concussion legislation one year later--what have we learned: a descriptive pilot survey of youth soccer player associates. The Journal of Injury, Function, and Rehabilitation. Jun;4(6):427-35.2012.
  3. Murphy A, Kaufman MS, Molton I, Coppel DB, Benson J, Herring SA. Concussion evaluation methods among Washington State high school football coaches and athletic trainers. The Journal of Injury, Function, and Rehabilitation. Jun;4(6):419-26. 2012.
  4. Washington State.  Engrossed House Bill 1824, Chapter 475, Laws of 2009, 61st Legislature, 2009 Regular Session.  Effective: July 26, 2009.  Available from:  Accessed January 3, 2011.
  5. Oregon state. Senate Bill 348. 75th Oregon Legislative Assemble--2009 Regular Session. Available from: Accessed July 3, 2011.
  6. Map of Concussion in Sports Legislation. National Conference of State Legislatures. Accessed March 12, 2013.
  7. McCrory, Meeuwisse, Johnston, Dvorak, Aubry, Molloy, Cantu. Consensus statement on concussion in sport – The 3rd International Conference on concussion in sport, held in Zurich, November 2008, Journal of Clinical Neuroscience 16 (2009) 755–763.
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