Basketball Concussion Education & Resource Centre

Concussions can occur while participating in any sport or recreational activity. Since the circumstances under which a concussion can be sustained are so varied, it’s important for all coaches, parents, and athletes to be aware of the signs, symptoms, and what to do if a concussion occurs. Basketball Manitoba is committed to increased education, awareness, and established protocols that will assist you in gaining the knowledge and skills required ensuring the safety of your athletes. We can all work together to ensure a safe sport environment. If we take the following approach, we can all make basketball a safer experience for all...

REDUCE. Follow the prevention information shown in Part 1 as a player, coach, official or parent to help us all reduce the instances of concussions in our sport.
RECOGNIZE and REMOVE. Use the below tools and resources in Part 2 below to help recognize the symptoms of a concussion and get help.
REFER and RECOVER. While recovering from a concussion, use the return to play protocols shown in Part 3 to gradually get yourself back on the court.
RETURN. With the proper clearance in Part 4 make a healthy return to the court and keep basketball a sport for life!

Jeff Billeck - University of Winnipeg
Parachute Canada Basketball Concussion Protocols - October 2018

VIEW POWERPOINT PRESENTATION DOCUMENT

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PART 1 - REDUCE ^TOP

HOW CAN I HELP PREVENT CONCUSSIONS AND THEIR CONSEQUENCES?
Concussion prevention, recognition and management requires athletes to follow the rules and regulations of their sport, respect their opponents, avoid head contact, and report suspected concussions. Concussions are not just an issue in hockey and football. In basketball, they may occur while falling to the floor, during a collision of players, by an arm or elbow to the head or other causes.

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 step-wise process that requires patience, attention, and caution.

WHAT CAN YOU DO TO PREVENT CONCUSSIONS IN BASKETBALL?

AS A PLAYER ^TOP

As a player, you have a role on the court to ensure your teammates and opponents have a safe playing environment so we can all enjoy the sport of basketball. As a player, the following tips are to be followed while playing basketball in a game or practice environment…

UNDERCUTTING. When defending a player on the floor who is driving to the basket on a shot or in the air rebounding, do not undercut a player as this is probably the riskiest move in the game that may lead to serious injuries, including head injuries. All airborne players have the right to land on the floor without another player impeding that space.

BLOCKING OUT. When blocking a player out while on defense, you still need to allow an opportunity for an opponent to safely land on the floor. Undercutting any player on the floor for any reason is not an acceptable part of the game.

REBOUNDING. When rebounding the ball on offense or defense, refrain from any excessive swinging of the elbows. While in the key/restricted area, there are a lot of other players around you and a blow to the head by an elbow may lead to a serious concussion to a teammate or opponent.

CLOSEOUTS. When defending another player, properly 'close out' to contest the shot, but still allow the shooter some safe distance to land on the floor. Poor closeouts can lead to serious injuries including a concussion if the player hits the floor with his/her head.
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SCREENING. When screening another player, keep your elbows within your own “body cylinder”. Grab your wrist with the other hand and cover your groin area then press your elbows to your hips. You may also make two fists and hold them in front of your groin area and press your elbows to your hips. Letting your elbows point out can lead to a defender running at full speed into your elbow unaware and lead to serious injuries including a concussion.

SQUARING UP. When catching the ball and wanting to square up to the basket, be aware that a defender may crowd the space in front of you. You should not lead with your elbows or try to deter close defense by sweeping your elbows at the defenders head. You can sweep the ball high, low or close to your body if you want to move the ball from one side of your body to the other, as long as you keep your elbows inside your personal space cylinder.
DEFENSE. When defending a player with the ball, don’t set yourself up for an elbow to the head by overcrowding the space right in front of him/her. They may ‘rip’ the ball from side to side within their “cylinder”. Try to maintain an arm’s length gap while defending a live dribble and half an arm’s length while tracing a dead ball using your arms, bent at the elbows at 90 degrees, as a cushion in between your head and the opposing player with the ball.
UP AND UNDER MOVES. When using up and under moves (moves that include a shot fake and then sweeping the ball to the other side of the body near head height), be mindful that the defender may be caught out of position or in the air with extra momentum. Try not to lead with your elbows as the defender is out of balance and position to adjust their body and protect themselves. “Up and under” moves increase the speed that an out of position defender may catch an elbow that can lead to serious injury or concussion.

HONESTY. Be honest with yourself, your parents and your coach if and when you were to be suspected of sustaining a concussion. No game, no matter how big or small, is worth risking your long-term health and well being. Help make basketball a sport for life for everyone!

AS A COACH (reference the above videos for examples of the following points) ^TOP

DOWNLOAD: PRESEASON CONCUSSION EDUCATION SHEET
This document is for a coach to use during their preseason meeting with all parents and players on their team to discuss what a concussion is and how the team will manage suspected concussions sustained in the program. (includes Return to School and Return to Sport Strategy)

There are a number of teaching points that a coach can emphasize that will reduce the unwarranted blows to the head, that may lead to concussions. To help prevent a player on the court from the risks of a concussion, the following coaching tips are to be strongly considered by coaches at any level…

BALANCE. When players are asked to “play hard”, “be tough” or “get your head over the ball” it often create pictures in the players' mind that are different then what the coach intends. Excessive forward leaning encourages an unbalanced position leaving the head vulnerable: The arms are down so, therefore the head is protruding. The player is slow to move backward. It is important that coaches teach a balanced stance. In Diagram 1 we can see the player on the left is leaning forward. The centre of gravity is outside the body frame. The player on the right has their centre of gravity within the body frame. The player’s elbows are over the knees. Stance work can be done in warm-up as well as in skill drills.
UNDERCUTTING. Teach proper defense in defending a player driving to the basket without 'undercutting' a player shooting a layup or shot and allowing for him/her to properly land on the floor.
BLOCKING OUT. Similar to undercutting, teach a proper technique of blocking out by getting your player between the defense and rim, while still allowing an opponent a safe opportunity to land on the floor.
REBOUNDING. Teach proper offensive or defensive rebounding techniques which do not allow for excessive swinging of elbows.

CLOSEOUTS. Teach proper defensive 'close outs' to contest another player shooting the ball, while allowing the shooter to land on the floor safely.
SCREENING. When teaching how to set a proper screen, players should be taught to keep their elbows within their own “body cylinder” while grabbing their wrist with the other hand and covering the groin area and pressing the elbows to the hips. They may also make two fists and hold them in front of the groin area and press the elbows to the hips. Letting the elbows point out, can result in a defender running at full speed into an elbow which may lead to serious injuries including a concussion.

ON BALL DEFENCE. When guarding a player with the ball the same danger can occur if the defender leans in with their arms down. In the first example, the defender is moving forward to put body pressure on the ball. If the offensive player leads with the elbow the head is the first thing that will get hit. In the second example, we again see the arms up to protect the head. Offensive players should be taught to pivot without leading with the elbow. Space pivoting by using the shoulder is more effective and safer for all involved.
ARM POSITION ON DEFENCE. To reduce the chances of an offensive player colliding with the elbows of a defender, teach your players to fully extend their arms while playing on-ball defence.

This is a better defensive position for other reasons (ball deflections, bigger defensive presence) and will reduce a common injury of a player being hit in the head with an elbow. Playing with arms up on defense to protect vs elbows. When playing with the arms up the player should keep the head behind the arms. This way they provide protection. She is still within their cylinder and not violating the rules.
POST DEFENSE. When playing from behind the danger point is when the defender leans in close with the head exposed. In the first example, we see the defender has their arms down.

In the second example, the defender has one point of contact, which is allowed by rule, but the other arm is up. She is anticipating the move of the offensive player. She is on balance.
TAKING A CHARGE. One of the most dangerous area for basketball players is when she meets another player who runs or dribbles into her. The act of properly taking a charge in basketball is vital to ensure that all players involved in the action do it safely. If not properly taught by the coach, the odds of a player hitting the back of their head on the floor greatly increases. The key points to teach include how to get into the proper position at the right time, how to absorb the initial contact and how to fall and slide to the floor with your ‘butt’ taking the brunt of the fall, (vs your head).
The incorrect method is shown above. In Diagram 7 we can see that the player is unprepared for the contact. She is standing tall with their arms down. When the contact occurs in Diagram 8 the player’s movement starts by throwing their head back. She is extending the spine. In Diagram 9 you can see that this action leads to the head being the first point of contact with the floor. Many players will reach back with a hand in this situation. It may break the fall, but this is one of the main causes of injury to the hand or wrist in basketball.

To begin with the player must prepare herself for the contact. She is getting ready to TAKE ON the other player. She is flexed at the waist, the arms are up to cushion the blow and protect the body and face (Diagram 10). The player’s first action is to sit back further on their hips and to drop their chin to their chest. She is flexing not extending (Diagram 11). The first point of contact will be their butt (Diagram 12). These are the biggest muscles in the body. She is preparing to do a backward roll. She then distributes the force by rolling onto their back and putting their arms out to the side (Diagram 13). The neck stays flexed preventing the head from hitting the floor. The feet come up to protect the body if the opponent loses their balance and falls forward.

A great way to teach taking a charge is to use the ball. In a safe area, away from other players or obstructions, the player rolls the ball on the floor (Diagram 14). Slow at first. She sprints to get in front of the ball, intercepting the driveline of the ball. She prepares to take the charge by flexing at the hip with the arms up (Diagram 15). She sits on the ball and tucks their chin to their chest (Diagram 16). She then rolls back onto the floor (Diagram 18). She will go slow at first but advance the speed as she feels more comfortable. Remove the ball and now have a guided offensive player push her. We need to practice these skills and not expect that players automatically know what to do when playing tough or diving, rolling or falling on the floor.
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HEAD SMART PRACTICES. To avoid unnecessary contact of players in practices, you should eliminate drills where two players are diving on the floor for a loose ball at the same time.
SAFE ENVIRONMENT. Ensure the practice/playing area is safe. Ensure that there is adequate padding (2+ inch thick, 6+ feet tall, 10+ feet wide) on the walls under each basket (including cross courts if using them in practices), that all volleyball/badminton holes are securely covered, any other obstacles near the playing surface are removed or padded (bleachers, benches, chairs, score table, stage, climbing apparatus, etc), unused basketballs are not left on the court during practices, and the floor is swept and dry of any dust or liquids.
Many of these above points are seen as common sense in basketball but for players new to the sport or who may come from another more physical sport, you as coach should not take it for granted that the players will know this. The best treatment for a concussion is prevention. We can all play in a role in ensuring the athletes on the floor and in your care have a safe and positive experience with the game! Help make basketball a sport for life for everyone!

AS A PARENT ^TOP

INFORM THE COACH. Advise the coach at the start of the season or program that your child has sustained a concussion or concussions in the past. The more concussions a person receives makes him/her much more susceptible to sustaining them in the future.
COMMUNICATE. Your child's coach only sees your child a few hours a day at best, so you need to inform him/her if your child is suffering from, or being suspected of sustaining, a concussion from any other activity he/she is involved in. Don't assume that your child's other coaches or physical education staff are aware of this.
DON'T ASSUME. As a fan, if you suspect any player on the court from either team is showing concussion-like symptoms, inform your coach that this needs to be addressed. Don't assume the coach saw the action or is aware of what may have led to the suspected concussion. You may be closer to the situation that caused it than the coach is.
SUPPORT THE COACH. Work with your child's coach to support any decision that is made to remove your child from a game or practice. If any of the above noted symptoms are present, we all need to err on the side of caution and remove him/her from the activity. No game, no matter how big or small, is worth risking a player’s long-term health and well being. Help make basketball a sport for life for everyone!

AS AN OFFICIAL ^TOP

There are certain actions in the game that if not called early by the officials can lead to situations that promote an unsafe head environment later on as players adapt to the more physical play.

UNDERCUTTING. Ensure players are allowed to land. If a player undercuts an airborne player, this should be called as an Unsportsmanlike Foul. Talk to the defender and the coach to ensure understanding and to prevent possible future injury.
BLOCKING OUT. Similar to undercutting. If a defensive player blocks out while the shot is in the air, and then moves into his/her landing zone, an Unsportsmanlike Foul should be called. Talk to the defender and the coach to ensure understanding and to prevent possible future injury.
REBOUNDING. Do not allow excessive swinging of the elbows by a rebounder. If no contact is made, a Technical Foul should be called. If contact is made, an Unsportsmanlike Foul should be called. If contact is excessive, a Disqualifying Foul should be called. Talk to the defender and the coach to ensure understanding and to prevent possible future injury.
SCREENING. If a player’s elbows are outside the cylinder and contact occurs on the elbow, an Unsportsmanlike Foul may be called if the screen is blind and contact is excessive. At minimum, a foul should be called. Talk to the defender and the coach to ensure understanding and to prevent possible future injury.
ROUGH PLAY. Set the tone early in a game if players are being over physical with each other. What might start as chippy play may lead to intentional elbows being thrown or worse and may lead to an out of control situation.
JUMP BALLS. Call a ‘jump ball’ between two players who are fighting for the ball sooner as opposed to waiting too long which may see a player injured especially if there is a size difference between the two.
SAFE ENVIRONMENT. Ensure the playing area is safe. Ensure that there is adequate padding (2+ inch thick, 6+ feet tall, 10+ feet wide) on the walls under each basket (including cross courts if using them), that all volleyball/badminton holes are securely covered, any other obstacles near the playing surface are removed or padded (bleachers, benches, chairs, score table, stage, climbing apparatus, etc), unused basketballs are not left on the court during the game, and the floor is swept and dry of any dust or liquids.
COMMUNICATE. Advise the head coach of the team if you feel a player in the game is showing signs of a concussion or one is suspected. Don’t assume the coach sees everything. Work as a team to ensure everyone involved does so in a safe environment.

PART 2 - RECOGNIZE & REMOVE ^TOP

DOWNLOAD: CONCUSSION RECOGNITION TOOL
“Recognize & Remove”
Head impacts can be associated with serious and potentially fatal brain injuries. The Concussion Recognition Tool 5 is to be used for the identification of suspected concussion. It is not designed to diagnose a concussion.

DOWNLOAD: MEDICAL ASSESSMENT TOOL
This document can be used by an athlete’s Physician or Nurse Practitioner as the official “Medical Assessment Tool” when dealing with a suspected concussion.

PART 3 - REFER & RECOVER ^TOP

DOWNLOAD: BASKETBALL MANITOBA YOUTH CONCUSSION PROTOCOL
This detailed step by step document that walks a player through the different recovery steps including basketball related examples a coach can use to slowly return a player to full activity.
More info: Parachute Canada Return to Play Protocol

PART 4 - RETURN ^TOP

DOWNLOAD: MEDICAL CLEARANCE LETTER
Athletes who are diagnosed with a concussion should be managed according to the Canadian Guideline on Concussion in Sport including the Return-to-School and Return-to-Sport Strategies. No athlete that has been diagnosed and is being treated for a concussion can be “returned to play” without presenting this signed Medical Clearance Letter to their head coach.

All of this information can also be found on the Basketball Manitoba Scoreboard app in the 'Concussions' section. Get the free app to have this information with you court side at all games and practices!