Some athletic governing bodies have created mandates on concussion management for athletes who play in their organization. Listed is a sampling of the mandates that have been initiated to protect the athletes.

National Football League (NFL) Mandate:

When diagnosed with a concussion, athlete must be removed from game or practice, and must be cleared before return to action by the team physician and an independent neurological physician.

National Collegiate Athletic Association (NCAA):

“Institutions shall have a concussion management plan on file such that a student-athlete who exhibits signs, symptoms, or behaviors consistent with a concussion shall be removed from practice or competition and evaluated by an athletics healthcare provider with experience in the evaluation and management of concussions. 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 his or her designee according to the concussion management plan.” — 2014-2015 NCAA Sports Medicine Handbook

The National Federation of High Schools (NFHS) Mandate:

“Effective with the 2010 season, any player who shows signs, symptoms, or behaviors associated with a concussion must be removed from the game and shall not return to play until cleared by an appropriate healthcare professional.” (

State of Indiana Concussion Law: Student Athletes: Concussions and Head Injuries

A player suspected of sustaining a concussion or head injury in a practice or game shall be removed from play at the time of injury and may not return to play until the student athlete has been evaluated by a licensed health care provider trained in the evaluation and management of concussions and head injuries. The athlete must receive written clearance to return to play from the health care provider.

Forms and information regarding this law can be found on the Indiana Department of Education Learning Connection, under the community entitled “IDOE — Concussion and Head Injury in Student Athletes.”

This law only pertains to students in grades 5-12 who are participating in interscholastic or intramural sport. It is recommended that any student be removed from play and evaluated by a licensed health care provider whether they fall under the specific guidelines of this law or not.

In order for a person to be able to sign a written clearance for the athlete to return to play after a suspected concussion, the person must meet all three of the following criteria:

  • Must have a license given by a governmental agency that regulates a specific profession.
  • Must be listed in Indiana Code as a health care provider.
  • Must have training in the evaluation and management of concussions and head injuries.

A health care professional works under the care of a health care provider. Because a professional does not meet the criteria for the definition as a licensed health care provider, they are not allowed to write written clearance for a student athlete to return to play following a concussion. (

Concussion Management Guidelines

The ISCN directors have created guidelines for the appropriate treatment of concussions that are considered to be the gold standard in concussion care. Those guidelines can be found here.

Preseason Concussion Assessment

The Preseason Concussion Assessment is a test that is useful to gain a baseline assessment of various brain functions that may be affected should an athlete suffer a head injury. This test should be done prior to beginning athletic activity each new season. The test assesses memory, concentration, orientation and balance. (The current most commonly used baseline assessment is the Sideline Concussion Assessment Tool (SCAT 5) and is used at practice or competition for concussion assessment on the sidelines or in the locker room. Recent research also suggests that the Vestibular, Ocular Motor Screening (VOMS) enhances the sensitivity and specificity of accuracy to determine that a concussion has occurred.)