Apr 29, 2010 7:09:16 PM

The NCAA Executive Committee at its quarterly meeting Thursday adopted a policy requiring institutions across all three divisions to have a concussion management plan on file that mandates removal of a student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion from practice or competition.

Those student-athletes subsequently must be evaluated by an athletics healthcare provider with experience in the evaluation and management of concussion. Student-athletes diagnosed with a concussion shall not return to activity for the remainder of that day.  Medical clearance shall be determined by the team physician or their designee, according to their concussion management plan.

In addition, student-athletes must sign a statement in which they accept the responsibility for reporting their injuries and illnesses to the institutional medical staff, including signs and symptoms of concussions. That review and signing process should include educational material on concussions that is available on the NCAA's health and safety website. 

The Executive Committee adopted the policy to be effective by the start of the 2010-11 academic year. Committee members also asked that consequences for not following the policy be deliberated and that recommended sanctions for noncompliance be presented to the committee by its August meeting. The Executive Committee also recommended each division to consider this policy for legislation.

The policy, recommended by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, came from ongoing review of research data and discussions with the medical community, including an April 9 summit of physicians and certified athletic trainers from all three NCAA divisions who discussed concussion-management practices.

Those discussions led to a determination that appropriate care and treatment of student-athletes injuries and illness are best handled through a local institutional medical model that has team physician oversight and direction. CSMAS members agreed that the model should focus on appropriate access to healthcare providers with the unchallengeable authority to determine management and return-to-play decisions.

The effort to address concussion-management policies more broadly began in December with the competitive-safeguard committee's revision of an NCAA Sports Medicine Handbook guideline advising member institutions on appropriate response to concussions and procedures for returning student-athletes to competition or practice.

In January, the NCAA Playing Rules Oversight Panel instructed playing-rules committees to review policies for stopping play for injuries and to consider rules that may further prevent head injuries.

In response, the NCAA Football Rules Committee modified that sport's rules to require removing from play student-athletes suffering any injury (including exhibiting signs of concussion) until cleared to return by appropriate medical professionals, and the Men's and Women's Soccer Rules Committee modified rules to stop the clock and summon medical personnel onto the field in response to signs of concussion, may be substituted for without being charged a substitution and may not re-enter without medical clearance.

The NCAA Wrestling Committee also added concussions to the list of injuries that require medical attention and positions athletic trainers and physicians as the central authority for that oversight.

The April 9 summit – also an outcome of the competitive-safeguards committee's December meeting – explored emerging trends in medical management of concussions and sought to develop a consensus on best practices for responding to such injuries. These best practices, recommended by the competitive-safeguards committee, will be distributed to the membership to augment the current NCAA Sports Medicine Handbook guideline on concussions for member institutions to consider in their development of a concussion management plan. 

The basic principles are based on the 2008 Consensus Statement on Concussion in Sport Third International Conference held in Zurich, and the NCAA Sports Medicine Handbook, with expanded language that reinforces the Executive Committee's adopted policy.