Course Content
Rule – 4 Ball in Play, Dead Ball, Out of Bounds
Rule 11 – The Officials: Jurisdiction and Duties
Appendix A Game-Official Guidelines for Serious On-Field Player Injuries
Appendix B Lightning Policy
Appendix C Concussions
Appendix D Field Diagrams
Appendix E Equipment: Additional Details
Appendix F – Official Football Signals
Appendix G Summary of Penalties
Appendix H Accommodations for Student-Athletes with Disabilities
Part II: Interpretations
Table of Contents for Approved Rulings
List of New and Modified Approved Rulings
NCAA Rules
About Lesson

A concussion is a brain injury that may be caused by a blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head. Concussions can occur without loss of consciousness or other obvious signs. A repeat concussion that occurs before the brain recovers from the previous one (hours, days or weeks) can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in brain swelling, permanent brain damage and even death.

Recognize and Refer: To help recognize a concussion, watch for the following two events among your student-athletes during both games and practices:

  1. A forceful blow to the head or body that results in rapid movement of the head.


  1. Any change in the student-athlete’s behavior, thinking or physical functioning (see signs and symptoms).


Signs Observed By Coaching Staff                   Symptoms Reported By Student-Athlete

  • Appears dazed or • Headache or “pressure” in head.
  • Is confused about assignment or • Nausea or vomiting.
  • Forgets • Balance problems or dizziness.
  • Is unsure of game, score or • Double or blurry vision.
  • Moves • Sensitivity to light.
  • Answers questions • Sensitivity to noise.
  • Loses consciousness (even briefly). Feeling sluggish, hazy, foggy or groggy.
  • Shows behavior or personality • Concentration or memory problems.
  • Can’t recall events before hit or • Confusion.
  • Can’t recall events after hit or • Does not “feel right.”

An 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 get checked.


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





FR-122                                                                         aPPEndiX C / Conussions


  1. Ensure that the student-athlete is evaluated right away by an appropriate health care professional. Do not try to judge the severity of the injury yourself. Immediately refer the student-athlete to the appropriate athletics medical staff, such as a certified athletic trainer, team physician or health care professional experienced in concussion evaluation and management.
  2. Allow the student-athlete to return to play only with permission from a health care professional with experience in evaluating for Allow athletics medical staff to rely on their clinical skills and protocols in evaluating the athlete to establish the appropriate time to return to play. A return-to-play progression should occur in an individualized, step-wise fashion with gradual increments in physical exertion and risk of contact. Follow your institution’s physician supervised concussion management protocol.
  3. Develop a game plan. Student-athletes should not return to play until cleared by the appropriate athletics medical staff. In fact, as concussion management continues to evolve with new science, the care is becoming more conservative and return-to-play time frames are getting longer. Coaches should have a game plan that accounts for student-athletes to be out for at least the remainder of the day.

For further details please refer to the “NCAA Sports Medicine Handbook Guideline on Concussions” or online at and

Reference to any commercial entity or product or service on this page should not be construed as an endorsement by the Government or its products or services.

Join the conversation