Hanlan Boat Club
Concussion Management Policy
March 2020
Scope
This policy will be enforced for all Hanlan Boat Club (“Hanlan”) activities and applies to all Hanlan Boat Club employees, members, volunteers and athletes.
Policy
Hanlan is focused on ensuring the well-being and safety of all participants, members, volunteers and staff. We recognize the potential severity of a head injury and the commitment and intent behind research to manage concussions. We are committed to educating those involved with Hanlan, creating awareness to help prevent injuries and appropriately managing any suspected concussions and diagnosed concussions.
Hanlan’s Concussion Policy is committed to the following actions in regards to concussions:
Committed to increasing awareness regarding what concussions are and the potential for serious complications.
Enforcing procedures and training that promotes preventative actions to help reduce the number of concussions.
Providing procedures that support Hanlan staff, volunteers, members and athletes in ensuring quick recognition and removal of any individual with a suspected concussion from rowing or other Hanlan activities.
Ensure that following a suspected concussion there are clear steps for both the individual and Hanlan to follow before a return to sport occurs to ensure the focus is on the individual’s long-term health.
Note that this policy, and associated procedures, complements Hanlan’s Safety Policy. Due to the potential seriousness of concussions and the need for increased awareness and training around concussions, Hanlan created this additional document specific for concussion management and the associated return to sport procedures.
This Concussion Policy is based on the ROWONTARIO Concussion Management Policy, which also applies whenever an employee, volunteer, member or athlete is engaged in ROWONTARIO activities or events.
Board approval date: March 9, 2020
Operational Procedures
Concussion Education and Prevention
Hanlan will conduct annual training for all Hanlan coaches. This educational session will include up to date information on what concussions are, how to recognize potential concussions and best practices on concussion prevention in rowing. Training will also include the contents of this concussion policy including their roles and responsibilities in recognizing and removing athletes/participants who are involved in a situation that potentially could result in a concussion or have a concussion. Additionally, employees will be trained on the education components for participants and parents, and the related information in the Athlete Code of Conduct.
Concussion education resources will be made available to Hanlan members (and their parents/guardians in cases of minors) to help build awareness and understanding of concussions. During practices and programs, coaches will remind participants of the need to take care around the docks as well as while moving and setting up boats, also ensuring everything is working properly. Ongoing reminders for members to be aware of potential situations where head injuries could occur will help build awareness and prevention related to concussions.
Hanlan employees, members or athletes who engage in dangerous or reckless behaviour that could potentially create a high risk for a concussion causing situation will be subject to disciplinary actions as described in the Athlete Code of Conduct and Member Responsibilities.
Recognition, Removal and Referral
If any individual suffers any kind of injury where there is potential for there to have been direct or indirect force to the head, neck or face, and is experiencing or demonstrating any concussion related signs or symptoms, the individual will be removed from activity immediately and rest. The employee or volunteer in charge of the program or practice will err on the side of caution in their decision making.
In competition, coaches, member, parents and athletes all have a responsibility to communicate openly and honestly about situations where direct or indirect hits to a head occur. If a situation occurs where a concussion is possible, the head coach will communicate with the athlete, umpires and regatta officials and parents/guardian as appropriate. The coach in attendance at the competition will make the decision for their athlete if they can continue based on a direct or indirect hit to the head.
Hanlan employees and volunteers recognize that symptoms may not appear immediately and that concussions can occur in many different situations. In the case of a suspected concussion, the individual may not be in a condition to assess themselves or make appropriate decisions.
For individuals under 18, all suspected concussions or situations that occurred that potentially could result in a concussion will be reported to the Head Coach, the athlete’s parent /guardian and any chaperone travelling with the athlete. The parent or chaperone should monitor the individual for delayed signs and symptoms for the next 72 hours.
All individuals of any age with a suspected concussion will be referred to a medical doctor (or nurse practitioner) for medical assessment and diagnosis as per the Return to Sport Procedures. Additionally upon removal each individual, and their parent/guardian if they are under 18, will be given a handout detailing ROWONTARIO’s concussion procedures for removal from sport and return to sport. The coach will also ensure they are aware of their responsibility to disclose any concussion diagnosis to any other sport organization they are registered with and/or their school.
If a direct force to the head results in immediate injury or “red flag” signs and symptoms of a concussion, the Head Coach or the parent/guardian or chaperone should take the athlete to the nearest emergency room or call 911.
(More information on signs and symptoms of a concussion as well as appropriate response needed for various signs can be found in our concussion resources provided to coaches, instructors, parents and athletes and available within the ROWONTARIO Emergency Procedures as well as Appendix A of this policy).
Reporting
As per ROWONTARIO’s Emergency Procedures, any incident resulting in injury or removal from activity will be reported on an ROWONTARIO’s Incident Report Form. These are to be submitted (electronic images acceptable) to the ROWONTARIO Executive Director within 24 hours.
The Executive Director, or designate, tracks all incident reports for patterns and trends as well as individual situations.
The coach will keep a copy and update the report to document the athlete’s progression to return to sport regularly updating the Executive Director until the incident is closed with the receipt of medical clearance which will be added to the report and securely filed. In documenting the incident and follow up all of ROWONTARIO’s Privacy Policy will be followed.
Participant Disclosure
If an individual discloses, or staff/volunteers become aware through any means, that an individual suffered a possible concussion through other activities they will be unable to participate in ROWONTARIO activities. Discovery or disclosure of a suspected concussion will be reported on an athlete disclosure form to ROWONTARIO’s Executive Director within 24 hours, following procedures for incident reporting.
Members of the ROWONTARIO Team who fail to disclose a possible concussion as described in their Code of Conduct may be subject to discipline as described in the Athlete Code of Conduct.
The individual’s return to ROWONTARIO activities will be treated the same as individuals who incur concussions during ROWONTARIO activities.
Returning to Rowing
If removed from rowing due to a suspected concussion the athlete may return once they have confirmed to the coach that they have undergone an assessment by a physician or nurse practitioner and have not been diagnosed as having a concussion.
If diagnosed with a concussion, each individual will have their own individualized and medically supervised Return to Sport plan. The plan is a graduated strategy to ensure the long-term health of the individual. ROWONTARIO is committed to supporting the individual in their recovery and have provided a rowing focused suggested starting Return to Sport Plan. For athletes at any level of education, we work to ensure a Return to Learn strategy be followed before Return to Sport and focus the individual on commencing their educational components first.
Before a participant or athlete is permitted to return to any ROWONTARIO led practice or program after experiencing signs or symptoms of a concussion, or having reported a concussion, they will need to submit proof of medical clearance that permits them to return to participating in a full range of physical activities.
The written clearance must be provided by a medical doctor or nurse practitioner and submitted to the coach or instructor who will forward to the Executive Director. The clearance will be filed with ROWONTARIO’s original copy of the incident report or athlete disclosure.
Due to the unpredictability of water conditions, they can rejoin activities on the water once they have medical clearance to return to normal training activities (Stage 5 of the Standard Return to Sport Strategy as found in Appendix B).
Once cleared, coaches and instructors will gradually build the activity level to help progress the individual slowly. This will include ensuring the first time on the water is in mild weather conditions.
Competition (Stage 6) will only be permitted once they have demonstrated symptom free completion of a minimum of two on the water training experiences involving a mix of conditions.
(The time required to complete this may depend on the weather conditions occurring in the location. The coach/instructor will work with the individual focusing on an individualized progression with the individual’s long-term health as the priority.)
Last reviewed: March 2020
Operational procedures are not approved by the Board of Directors. Operational procedures are approved by the Head Coach and Club Captain
Appendix A - Signs and Symptoms of a Concussion
Appendix B - Return to Sport Plan
A CONCUSSION is a serious event, but you can recover fully from such an injury if the brain is given enough time to rest and recuperate. Returning to normal activities, including sport participation, is a stage-wise process that requires patience, attention, and caution.
Each stage must take a minimum of one day but could last longer, depending on the athlete and their specific situation.
If symptoms reappear at any stage, go back to the previous stage until symptom-free for at least 24 hours.
STAGE 1: Symptom limited activity – Goal: A gradual reintroduction of activity
After an initial short period of rest of 24-48 hours, light cognitive and physical activity can be initiated as long as they don’t worsen symptoms. A physician, preferably one with experience managing concussions, should be consulted before beginning the staged process to return.
STAGE 2: Light aerobic exercise – Goal: Increased heart rate
Activities such as walking or stationary cycling. The athlete should be supervised by someone who can help monitor for symptoms and signs. No resistance training or weight lifting. The duration and intensity of the aerobic exercise can be gradually increased over time if no symptoms or signs return during the exercise or the next day.
Symptoms? Return to previous stage and only engage in activities as tolerated. If symptoms persist consult a physician.
No symptoms? Proceed to Stage 3 after 24 hours.
STAGE 3: More Diverse Cardio – Goal: Add movement
Activities such as light running or gentle body weight resistance exercises can begin at stage 3. There should be no body contact or other jarring motions such as high speed stops or hitting a baseball with a bat.
Symptoms? Return to previous stage and only engage in activities as tolerated. If symptoms persist consult a physician.
No symptoms? Proceed to Stage 4 after 24 hours.
STAGE 4: Building Cardio with Increased Cognitive Challenges
Goal: Exercise, coordination, and increased thinking
Activities such as indoor rowing and resistance training can be added to activities from previous stages.
Symptoms? Return to previous stage and only engage in activities as tolerated. If symptoms persist consult a physician.
No symptoms? The time needed to progress will vary with the severity of the concussion and with the athlete. Proceed to Stage 5 only after medical clearance.
STAGE 5: On water practice, once cleared by a doctor – Goal: Restore confidence and assess functional skills by coaching staff
Coaches and instructors will allow return to the water in gradually challenging conditions.
Symptoms? Return to previous stage and only engage in activities as tolerated. If symptoms persist consult a physician.
No symptoms? Proceed to Stage 6 after minimum of two on water situations without symptoms.
STAGE 6: Competition
Return to sport with normal activities
