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Athletic Concussion Regulations

Amended: January 8, 2025

HOPKINTON PUBLIC SCHOOLS

ATHLETIC CONCUSSION REGULATIONS

INTRODUCTION 

A concussion is a type of brain injury that changes the way the brain normally works.  A concussion is caused by a blow to the head or body that causes the brain to move rapidly inside the skull. Concussions can also result from a fall or from players colliding with each other or obstacles on the playing field.  The two direct mechanisms of injury are coup-type and contrecoup-type. Coup-type injury is when the head is stationary and struck by a moving object such as another player’s helmet, a ball, or sport implement, causing brain injury at the location of impact.  Contrecoup-type injury occurs when the head is moving and makes contact with an immovable or slowly moving object as a result of deceleration, causing brain injury away from the sight of impact.  Indirect forces are transmitted through the spine and jaw or blows to the thorax that whip the head while the neck muscles are relaxed. 

Contrary to previous thought, an athlete does not have to be knocked unconscious in order to sustain a concussion.  A concussion - also known as a traumatic brain injury - changes how the cells in the brain normally work resulting in a variety of signs and symptoms (Appendix I). The immediate physiological effect of a concussion is a disruption of the sodium/potassium pump necessary for intracellular health. This leads to changes in glucose metabolism and altered cerebral blood flow which results in alterations in academic/cognitive and emotional well-being. 

Concussions are difficult to diagnose because the damage cannot be seen. An MRI or CT Scan cannot diagnose a concussion, but they can help rule out a more serious brain injury to a student athlete.  Understanding the way in which an injury occurred is vital in understanding and having a watchful eye for athletes who may exhibit symptoms of a concussion so these student athletes can receive the appropriate care.  Because concussions are difficult to detect, student athletes must obtain medical approval before returning to athletics following a concussion.

In recent years, there has been a significant amount of research into sports-related concussions in high school athletes. Returning a student athlete to play after a known or suspected concussion places the student at risk for long term health consequences, including serious injury or even death. In 2010, the Massachusetts Department of Public Health’s (MDPH) issued the new regulation 105 CMR 201.000 Head Injuries and Concussions in Extracurricular Athletic Activities (Appendix II), mandated by Chapter 166 of the Acts of 2010, An Act Relative to Safety Regulations for School Athletes (Appendix III). This regulation requires all public middle and high schools (serving grades 6 through high school graduation) to have policies and procedures governing the prevention and management of sport-related head injuries. Hopkinton Public Schools is committed to the safety of all our student athletes. 

The Hopkinton Public Schools seeks to provide a safe return to activity for all athletes after injury, particularly after a concussion. A team of school staff consisting of our Superintendent, School Nurses, Athletic Director (AD), Certified Athletic Trainer (ATC), School Physician, Team Physician, and other School Administrators has developed these Athletic Concussion Regulations for Hopkinton Public Schools in order to effectively and consistently manage these injuries. The intent is to aid in ensuring that concussed athletes are identified, treated and referred appropriately, receive appropriate follow-up medical care during the school day, including academic assistance, and are fully recovered prior to returning to activity. 

I. PERSONS RESPONSIBLE FOR THE IMPLEMENTATION OF SCHOOL POLICY 

The School Physician, School Nurses, Athletic Director (AD), Licenced and Certified Athletic Trainer (ATC), Coaches, and Administrators of the Hopkinton Public Schools will be responsible for the implementation of the policy and procedures which shall apply to all Hopkinton High and Hopkinton Middle School students, and shall apply to all students who participate in any extracurricular athletic activities. The associated responsibilities shall include but are not limited to: 

1. Supporting and enforcing the protocols, documentation, required training and reporting.

2. Assuring that all documentation is in place. 

3. Reviewing, updating and implementing policy every two years and including updates in annual training and student/parent handbooks. 

II. ANNUAL TRAINING REQUIREMENT 

The Commonwealth of Massachusetts requires annual safety training on sports-related concussion, including second impact syndrome. All student athletes and their parents/guardians must complete the MDPH approved online training annually. Proof of completion of training for parents/guardians and Students will be verified with the parent/guardian’s online signature through the student athlete’s FamilyID/ArbiterSports Registration. The following individuals from Hopkinton High School and Hopkinton Middle School will be responsible to participate in all required trainings: 

1. Coaches  (including volunteer coaches);

2. Certified Athletic Trainers; 

3. School Nurses;

4. School and team physicians;

5. Athletic Director and Assistant Athletic Directors;

6. Parents/ guardians of a child who participates in an extracurricular athletic activity;

7. Students who participate in an extracurricular athletic activity; 

8. Marching Band Director (if applicable).

III. DOCUMENTATION OF PHYSICAL EXAM 

All student athletes must pass a physical examination before participating in any athletic try-out, practice, conditioning, contest or event.  A physician or other qualified professional such as a Nurse Practitioner or Physicians Assistant must have examined all student athletes within 13 months prior to the date of participation.  Student athletes and parents are responsible for keeping the physical up to date and knowing when the physical will expire. A signed doctor’s note will not be accepted, only a physical examination.  The MIAA Rules & Regulations Section 56.1 mandates that all physicals must be up to date and current at all times to participate (within 13 months) or the student athlete will be ineligible (Appendix IV). The completed signed copy of the physical exam must be submitted to the Athletic Department by uploading it to the student athlete’s FamilyID/ArbiterSports Registration. It may also be delivered as a hard copy, mailed, or faxed. Instructions for how to upload a physical to the FamilyID/ArbiterSports Registration may be found on the Athletics Website.

IV. PRE-PARTICIPATION HEAD INJURY REPORTING SUBMISSION AND REVIEW 

The Massachusetts concussion law requires athletes and their parents to inform their coaches about prior head injuries at the beginning of each sports season. 

1. Reporting to the coaches and athletic department is done via the online FamilyID/ArbiterSports Registration questionnaire and should be completed by the student’s parent/guardian and the student. It must be submitted to the Athletic Department, prior to the start of each season a student plans to participate in an extracurricular athletic activity. This information provides a comprehensive history with up-to-date information relative to concussion history which includes specific and required questions to ensure that particular attention is paid to identifying athletes with a history of brain or spinal injuries. Until the student athlete’s FamilyID/ArbiterSports Registration is completed and signed by the parent/guardian and student and returned to the school prior to the start of every sports season, the student cannot participate in the extracurricular sports activity. 

2. In the event of a history of multiple concussions noted on FamilyID/ArbiterSports Registration: 

The decision to allow a player who reported a history of multiple concussions on her/his/their pre-participation form should be made only after consultation with the student’s physician or primary care provider; the sports medicine or concussion specialist, if involved; the neuropsychologist, if involved, and the appropriate school athletic staff and the parent. This decision may be submitted in the form of language on the student’s annual physical stating that the student athlete is cleared for participation without restrictions signed by the healthcare provider. Current evidence indicates that youth who have suffered one or more concussions are more likely to suffer a subsequent one. 

3. Hopkinton Public Schools has the FamilyID/ArbiterSports Registration available on the Hopkinton Athletics website. Students needing assistance with access to the online registration may reach out to the Athletic Department at (508) 497-9845. All of the information, included on FamilyID/ArbiterSports will be shared with school nurses, administrators, certified athletic trainers, and coaches as needed. 

V. MEDICAL/NURSING REVIEW OF PRE-PARTICIPATION FORMS 

At the start of each sports season, the Athletic Trainer for Hopkinton High School and Hopkinton Middle School (ATC)  will review all FamilyID/ArbiterSports Registrations. The School Nurse will also have access to all FamilyID/ArbiterSports Registrations. The certified athletic trainer and/or Athletic Director will be responsible for: 

1. Reviewing completed FamilyID/ArbiterSports Registration.

2. Communicate with coaches and administrators regarding the student’s concussion history and discussing concerns as needed. This may occur by including this information on the coach’s team roster.

3. Following up with parents and students as needed prior to the student's participation in extracurricular athletic activities. 

4. Sharing concussion related information with the school nurse. 

VI. PROCEDURE FOR REPORTING AND REVIEWING HEAD INJURIES TO SCHOOL NURSE AND/OR CERTIFIED ATHLETIC TRAINER DURING THE SEASON 

In order to ensure that students who experience concussion/head injury during practice or contest are safe to play and to ensure timely review of all reports of head injury forms, the following procedures will be followed when an athlete from Hopkinton Middle School or Hopkinton High School is suspected of receiving a head injury: 

1. In the event that any signs or symptoms of a concussion are reported or are observed after a suspected blow to the head, jaw, spine or body, they may be indicative of a concussion and the student athlete must be removed from play immediately. Athletes who experience signs or symptoms of a concussion should not be allowed to return to play whether in practice or contest. (Appendix I) 

2. The Certified Athletic Trainer will evaluate the athlete and make every effort to complete the Report of Head Injury During Sports Season form (Appendix V) as soon as possible. 

3. If the Certified Athletic Trainer is not available, the coach will make every effort to complete the Accident Report Form as soon as possible, or notify the ATC by other means, as soon as possible and the ATC will complete the Report of Head Injury During Sports Season form.

4. The Certified Athletic Trainer, coach, or school nurse will be responsible for communicating the student’s injury with parents/guardians, and providing them with a copy of the student athlete concussion packet as soon as possible.

5. The Certified Athletic Trainer will notify the Athletic Director and school nurse of reported head injury.

6. School nurse will contact the student athlete's teachers and guidance counselor. 

7. The ATC and/or school nurse will maintain documentation of the Report of Head Injury During Sports Season form in the student's health record. 

8. Parents/guardians are made aware of their responsibility for notifying the school nurse in the event of a head injury occurring outside of extracurricular athletic activity through written materials at the start of the sports season. Such forms must be submitted to the AD/Supervisor, ATC or coach at any time during the school year. 

VII. REMOVING ATHLETES FROM PLAY AND MEDICAL EVALUATION 

Acute Protocol:

1. In the event that any signs or symptoms of a concussion are reported or are observed after a suspected blow to the head, jaw, spine or body, they may be indicative of a concussion and the student athlete must be removed from play immediately.  The certified athletic trainer (or coach or team physician if the ATC is not present) will remove the student athlete from play and they will not be allowed to return to play whether in practice or contest that day. (Appendix I) 

2. The Certified Athletic Trainer will evaluate the athlete using either a symptom checklist, standardized assessment, VOMS testing, or other neurocognitive testing tool such as Sway Medical, or other assessment tool as the Certified Athletic Trainer deems appropriate. If the Certified Athletic Trainer is not present the student athlete should be removed from play and may not return to participation until they have been evaluated by the ATC or other qualified provider. 

3. If the athlete sustains a head injury at an away game, the athlete will be evaluated by the away team certified athletic trainer (if available) and the coach will fill out an accident report. The head injury is to be reported as per the protocols noted in Section VI as soon as possible, for medical assessment and management, and for coordination of home instructions and follow-up care. 

4. If the athlete is injured at an away event or if the certified athletic trainer is unavailable, the coaching staff is responsible for notifying the athlete’s parent/guardian of the injury and, if warranted, calls for emergency care. 

5. If a student athlete is suspected of having sustained a concussion the certified athletic trainer, coach, or school nurse will be responsible for communicating the student’s injury with parents/guardians, and providing them with a copy of the student athlete concussion packet as soon as possible. The concussion packet will contain educational information regarding signs and symptoms of deteriorating brain injury/function which would prompt immediate referral to a local emergency room, as well as the Post Sports-Related Head Injury Medical Clearance and Authorization form (Appendix VI) which is required for return to play. 

6. If a student athlete is suspected of having sustained a concussion the certified athletic trainer or school nurse will recommend the student see their primary care physician for further evaluation.  

7. When an athlete loses consciousness for any reason, the athletic trainer will start the Emergency Action Plan.  Any athlete who is removed from the contest or practice and begins to develop signs and symptoms of a worsening brain injury will be transported to the hospital immediately in accordance with the Emergency Action Plan. Worsening signs and symptoms requiring immediate physician referral can be found in Appendix I. 

8. The certified athletic trainer will report head injuries to the school nurse, coach, and Athletic Director. 

9. The School Nurse will notify the student’s guidance counselor and teachers.

10. The Certified Athletic Trainer will complete the Report of Head Injury During Sports Season form and keep the forms on file in the athletic training room office.

11. Follow-up evaluation will occur when asymptomatic (see below).

VIII. MEDICAL CLEARANCE FOR RETURN TO PLAY 

If an athlete is removed from play for a suspected concussion, they must be medically cleared and evaluated before returning to play/practice. 

1. If a student athlete is diagnosed with a concussion they must first be cleared to return to play/practice by their primary care physician or one of the individuals as authorized by 105 CMR 201.011 A (Appendix I). The student must then also receive final clearance from the certified athletic trainer. If there is a student needing assistance with access to healthcare, the school nurse or district social worker should be contacted.  

2. Medical clearance will be provided using the Post Sports-Related Head Injury Medical Clearance and Authorization form (Appendix VI) or equivalent form provided by the student athlete’s primary care physician. A copy will be kept in the student’s medical record in the athletic training room office. 

3. In a situation in which a student has been medically cleared but school staff has observed continuing symptoms, the school will make the final decision regarding a student’s return to play. If this situation arises, the Hopkinton Public School’s staff should communicate to the physician or healthcare provider who provided the clearance regarding the symptoms the school staff has observed to allow for reevaluation by the healthcare provider. If the athlete still has symptoms, the athlete should NOT return to play.

4. If a student athlete refuses to see their primary care physician following a suspected head injury, they will not be permitted to return to participation until they are asymptomatic and have completed a graduated return to play protocol supervised by the certified athletic trainer.

IX. DEVELOPMENT AND IMPLEMENTATION OF POST CONCUSSION GRADUATED REENTRY PLANS 

Students who are diagnosed with a concussion will have a written graduated reentry plan for return to academic and athletic activities. The plan shall be developed by the school nurse, certified athletic trainer, and other school personnel and healthcare providers as appropriate. Graduated reentry plans include gradual steps from physical and cognitive rest, gradual return to physical and academic activities, estimated time intervals for resumption of activities, and frequent assessments. The communication between the members of the student athlete’s team is critical. 

Progression of re-entry for both academics and extracurricular activities is individualized and will be determined on a case-by-case basis. Factors that may affect the rate of progression include: previous history of concussion, duration and type of symptoms, age of the athlete, and sport/activity in which the student participates. For example, an athlete with a prior history of concussion, one who has had an extended duration of symptoms, or one who is participating in a collision or contact sport may be progressing more slowly. 

1. Return to Academics:

The injured student may recover more quickly with rest, not only from physical exertion and athletic activity but also from the cognitive demands of academic work.  For academic re-entry the written plan may include but not be limited to: 

1. Physical and cognitive rest as appropriate. 

1. Cognitive rest may include avoiding or limiting excessive noise (including listening to music with headphones), bright lights, use of computers, texting, television, video games, and reading since these can provide too much stimulation to the brain and may exacerbate symptoms and delay healing. 

  2. Graduated return to classroom studies as appropriate. 

1. A student’s speed of processing information may be affected by a concussion. The student may learn more slowly, have impairment with memory and concentration, and staying organized. The effects of a concussion may interfere with listening in class, learning new skills, taking notes, and studying for and completing tests. Reading, even for pleasure, can sometimes worsen symptoms. 

2. Estimated time intervals for resumption of activities. 

3. Frequent assessment by the school nurse, and/or by the certified athletic trainer as appropriate. 

4. Periodic medical assessments until full return to classroom activities and extracurricular activities are authorized. 

5. Although not all students will require them, school accommodations may include: 

i. Time off from school; 

ii. Shortened school day; 

iii. Rest breaks in school; 

iv. Reduction in workload;

v. Extended time to complete coursework, assignments, and tests, especially in math, science, and foreign language classes; 

vi. Delaying the taking of standardized tests until symptoms have cleared; 

vii. For safety reasons, alternate transportation may need to be arranged by the parent if the student typically drives to school. 

6. The student should be reassessed frequently, with input from teachers and other involved staff members. Accommodations should then be adjusted according to the student’s abilities and progress. 

7. The written plan will be made available to all school personnel who are involved in the provision of the student’s academic services. 

2. Return to Athletic Participation

The certified athletic trainer is responsible for monitoring recovery and coordinating the appropriate return to play activity progression of the student athlete. The ATC responsibilities include, but are not limited to: 

1. The student must be completely symptom free and medically cleared as defined in 105 CMR 201.011 in order to begin graduated reentry to extracurricular athletic activities; 

2. Providing an initial assessment, followed by regularly scheduled assessments, that are individualized and relate to the student athletes previous history of concussion, duration and type of symptoms, age of the athlete, and sport/activity in which the student participates; 

3. Developing an individualized graduated re-entry plan that is a stepwise progression of activity as tolerated, and may include the following stages with approximately 24 hours between each stage: 

Graduated Return To Play For Concussion:

Specific activities for each stage may vary based on sport and position. For example, the Pediatric Sports Specific Return To Play Guidelines Following Concussion may be used when appropriate. (Appendix VII)

Stage 1. No Activity

Stage 2. Aerobic Exercise (This stage may take place as one or two separate days at the discretion of the certified athletic trainer.)

1. Light (up to approximately 40% max heart rate) 

2. Moderate (up to approximately 60% heart rate) 

Stage 3. Individual sport-specific exercise (up to approximately 80% max exertion)

Stage 4. Non-contact training (full intensity)

Stage 5. Full contact practice 

Stage 6. Return to competition 

4.  Monitoring the student’s recovery progression in collaboration with the school nurse and with the student’s healthcare provider; 

5.  Maintaining appropriate documentation regarding assessment and management of the injury.

6.  In a situation in which a student has been medically cleared but school staff has observed continuing symptoms, the school will make the final decision regarding a student’s return to play.  If this situation arises, the Hopkinton Public School’s staff should communicate to the physician or healthcare provider who provided the clearance regarding the symptoms the school staff has observed to allow for reevaluation by the healthcare provider. If the athlete still has symptoms, the athlete should NOT return to play.

3. Sway Medical 

Sway is used for a student’s baseline test as well as an assessment tool following a concussion. 

1. High School and Middle School Student Athletes participating in the following sports* must take the Sway baseline test prior to participating in scrimmages or contests for the following sports. The test is valid for one year.

1. Fall: Cheerleading, Football, Field Hockey, Soccer, and Volleyball

2. Winter: Alpine Ski, Basketball, Cheerleading, Ice Hockey, and Wrestling

3. Spring: Baseball, Lacrosse, Softball, and Volleyball

*Additional sports offerings may also be required to complete Sway baseline testing.

2. Sway testing will be administered as deemed necessary following a suspected head injury. Student athletes who have been diagnosed with a concussion should take the post-injury Sway test and demonstrate performance within normal limits of baseline prior to beginning a gradual return to play protocol. 

3. Students who sustain a suspected concussion in a non-athletic related manner may also participate in Sway post-injury concussion testing upon request. 

 

X. PROVIDING INFORMATION, FORMS AND MATERIALS TO PARENTS/GUARDIANS AND ATHLETES 

The Department of Public Health intends that all student athletes and adults who are on the field during practice or competition will be educated with the same basic information about the signs, symptoms, and risks of concussion. Communication between families, athletic staff, and health care providers is crucial to facilitate a student’s prompt removal from play and referral for medical care and full recovery following a concussion. 

1. Parental responsibility for completing the FamilyID/ArbiterSports online registration containing pre-participation health history questions and sign-off for completing CDC concussion education as described in Section II. 

2. The official Hopkinton High School & Middle School website under the Athletic Department tab has a page on sports concussion that also details these protocols and contains the CDC Heads Up Concussion Fact Sheet. (Appendix VIII) 

3. Parents/guardians and students can call the athletic department office at (508) 497-9845 or the school nurse's office at (508) 497-9816 to get further clarification or ask questions. At the beginning of every sports season, no student will be allowed to participate in athletic activities until the FamilyID/ArbiterSports Registration pre-participation questionnaire is signed, submitted by parent/guardian and student, and reviewed by designated staff annually. 

XI. INCLUSION OF SPORTS-RELATED HEAD INJURY POLICY IN THE STUDENT AND PARENT/GUARDIAN HANDBOOK 

Hopkinton High School and Hopkinton Middle School revise their Parent/Guardian/Student Handbooks annually and as such will include information regarding the regulation entitled 105 CMR 201.000 which references Head Injuries and Concussions in Extracurricular Athletic Activities, mandated by Chapter 166 of the Acts of 2010, An Act Relative to Safety Regulations for School Athletes. The handbooks and subsequent revisions will contain information concerning the school’s Concussion Management policy.

A link to this policy will be included in the Hopkinton High School and Hopkinton Middle School Parent/Guardian/Student handbooks. Hard copies of the Concussion Management Policy and Appendices will be available in the main offices, athletic offices, and nurse’s offices of the high school and middle school. 

XII. COMMUNICATING WITH PARENTS WITH LIMITED ENGLISH PROFICIENCY

Due to needing translation and/or interpretation, some parents/guardians may be reluctant to communicate with school personnel and may feel isolated from the school community. Hopkinton Public Schools is required to communicate in a language that parents/guardians understand. Our middle and high schools serve a linguistically diverse population and all website content offers web-based translation. All sports-injury related materials can be translated and made available by the Athletic Office, upon request. In the event a student sustains an injury or experiences a medical event, the Athletic Director’s office will notify the family in the appropriate language. Interpreters are available by contacting the Director of English Language Acquisition, Equity, and Access.

XIII. REQUIREMENTS THAT COACHES, ATHLETIC DIRECTORS, ATHLETIC TRAINERS AND VOLUNTEERS TEACH STRATEGIES THAT MINIMIZE SPORTS-RELATED HEAD INJURY AND PROHIBIT DANGEROUS PLAY: 

Coaches, Athletic Directors, Athletic Trainers and Volunteers of Hopkinton Public Schools should: 

1. Insist that safety comes first; develop, teach, implement, and enforce safety rules;

2. Promote good officiating of the existing rules; 

3. Emphasize to athletes and parents that playing with a concussion is dangerous; 

4. Promote safe use of equipment all year; require that sports participants use the right protective equipment during all practices and games and that all equipment, particularly helmets, are properly fitted; 

5. Maintain and improve the surfaces of playing fields; routinely conduct hazard assessments of the playground; walk the field regularly to check for divots, uneven surfaces, loose goal posts or other conditions that could affect play; Ensure that spaces and facilities for physical activity meet or exceed recommended safety standards for design, installation and maintenance; 

6. Check all school-issued equipment to ensure it is up to manufacturer standards of quality and care and does not exceed expiration date. Student-owned equipment remains the responsibility of the student athlete and his/her/their parents/guardians;

7. Make sure athletes wear the right protective equipment for their activity (such as helmets, padding, shin guards, mouth protectors, and eye and mouth guards). Protective equipment should fit properly, be well maintained and certified, not be expired, and be worn consistently and correctly;  

8. Discourage others from pressuring injured athletes to play. 

XIV. INFORMATION REGARDING POST CONCUSSION SYNDROME AND SECOND IMPACT SYNDROME

Post Concussion Syndrome is a poorly understood condition that occurs after a student athlete sustains a concussion. Student athletes who sustain concussions can have symptoms that last a few days to a few months, and even up to a full year, until their neurocognitive function returns to normal. Therefore, all school personnel must pay attention to and closely observe all student athletes for post concussion syndrome and its symptoms. Student athletes who are still suffering from concussion symptoms are not ready to return to play. More symptoms and information can be found on the Concussion Legacy Foundation Fact Sheet (Appendix IX)The signs and symptoms of post concussion syndrome may include but are not limited to:

• Dizziness

• Headache with exertion

• Tinnitus (ringing in the ears)

• Fatigue

• Irritability

• Frustration

• Difficulty in coping with daily stress

• Impaired memory or concentration

• Eating and sleeping disorders

• Behavioral changes

• Decreases in academic performance

• Depression

• Visual disturbances

Second Impact Syndrome is a serious medical emergency and a result of an athlete returning to play and competition too soon following a concussion. Second impact syndrome occurs because of rapid brain swelling and herniation of the brain after a second head injury that occurs before the symptoms of a previous head injury have been resolved. The second impact that a student athlete may receive may only be a minor blow to the head or it may not even involve a hit to the head. A blow to the chest or back may create enough force to snap the athlete’s head and send acceleration/deceleration forces to an already compromised brain. The resulting symptoms occur because of a disruption of the brain’s blood auto-regulatory system which leads to swelling of the brain, increasing intracranial pressure and herniation.

After a second impact, a student athlete usually does not become unconscious but appears to be dazed. The student athlete may remain standing and be able to leave the field under his/her/their own power. Within fifteen seconds to several minutes, the athlete’s condition worsens rapidly, with dilated pupils, loss of eye movement, loss of consciousness leading to coma and respiratory failure. The best way to handle second impact syndrome is to prevent it from occurring altogether. All student athletes who incur a concussion must not return to play until they are asymptomatic and cleared by an appropriate healthcare professional.

XV. SUMMARY OF RESPONSIBILITIES

The purpose of this section is to outline the responsibilities of students, parents/guardians, coaches,  the athletic director, certified athletic trainer, school nurse, and other school staff which may not have been listed in the aforementioned sections of this document, in addition to what has already been described in previous sections of this document. 

1. Student and Student Athlete Responsibilities

1. Complete Baseline Sway test prior to participation in athletics as required in Section IX.3.1.

2. Report accurate concussion history prior to participation in athletics through the questionnaire on the FamilyID/ArbiterSports Registration.

3. Participate in all concussion training and education and check off that the training was completed on the FamilyID/ArbiterSports Registration.

4. If you sustain a head impact and experience signs & symptoms of concussion remove yourself from play immediately.

5. Report all signs and symptoms of concussion to certified athletic trainer, coach, and/or school nurse.

6. Follow the recovery plan and rest as advised by a certified athletic trainer, school nurse, and healthcare provider.

7. Check in with the athletic trainer in person or by email before and after each step of the graduated return to play protocol. 

8. Avoid any high stimulating electronic devices such as smartphone use, video games, and television.

9. Avoid carrying books or backpacks that are too heavy.

10. Communicate with your teachers, guidance counselor, and school nurse about any difficulties completing academic work.

    1. See the school nurse for pain management.

    2. Follow gradual return to play guidelines.

    3. Return to sports only when cleared by the physician and the athletic trainer.

    4. Report any symptoms to the athletic trainer and/or school nurse and parent(s)/guardian(s) if any occur after return to play.

    5. Return medical clearance form to athletic trainer prior to return to play.

    6. Students who do not complete and return all required training, testing and forms will not be allowed to participate in sports.

2. Parent/Guardian Responsibilities

1. Report accurate concussion history prior to participation in athletics through the questionnaire on the FamilyID/ArbiterSports Registration.

2. Participate in all concussion training and education and check off that the training was completed on the FamilyID/ArbiterSports Registration.

3. Submit a valid physical as described in Section III.

4. If a student suffers a concussion outside of school, report it to the school nurse or certified athletic trainer as described in Section VI. 

5. Watch for changes in your child that may indicate that your child does have a concussion or that your child’s concussion may be worsening. Report to a physician. (Appendix I)
   Encourage your child to follow concussion protocol.

6. Enforce restrictions on rest, electronics, and screen time.

7. Reinforce the recovery plan.

8. Request a contact person from the school with whom you may communicate about your child’s progress and academic needs.

9. Observe and monitor your child for any physical or emotional changes.

10. Request to extend make up time for work if necessary.

11. Check all non school issued equipment to ensure it is up to manufacturer standards of quality and care and does not exceed the expiration date.  

12. Recognize that your child will be excluded from participation in any interscholastic athletic event if all forms are not completed and on file with the athletic department.

3. Coach & Band Director Responsibilities

1. Participate in concussion education and training as described in Section II on a yearly basis. Complete the certificate of completion and return it to the athletic director.

2. Remove from play any student athlete who exhibits signs and symptoms of a concussion or is suspected of sustaining a head injury.

3. Notify the certified athletic trainer of any head injuries, suspected head injuries, or students reporting signs & symptoms of a head injury as soon as possible. 

4. Complete an accident report form if their player suffers a head injury and the athletic trainer is not present at the athletic event.

5. Notify parent/guardian if a student sustains a head injury when the athletic trainer is not present.

6. Do not allow student athlete to return to play until cleared by a physician and athletic trainer.

7. Follow Gradual Return to Play Guidelines. Collaborate with the certified athletic trainer regarding student athletes with head injuries or suspected concussions, maintain discussion regarding student athletes’ progress with respect to their status in the Concussion Management (Return to Play) protocol, up to and including final authorization of full return to play. 

8. Refer any student athlete with returned signs and symptoms back to the certified athletic trainer.

9. Do not allow any student to participate who has not completed their FamilyID/ArbiterSports registration.

10. Do not allow any student to participate who has not submitted a valid physical from within 13 months of the participation date.

11. Review medical concerns and head injury history on FamilyID/ArbiterSports Roster before the start of the athletic season. Follow up with student athletes as needed and ask any questions about medical history to the school nurse or certified athletic trainer.

12. If the athlete loses consciousness or exhibits severe symptoms when the athletic trainer is not present the coach is responsible for calling EMS and following the emergency action plan;

13. Any coach, band instructor, or volunteer coach for extracurricular activities shall not encourage or permit a student participating in the activity to engage in any unreasonably dangerous athletic technique that unnecessarily endangers the health of a student athlete, including using a musical instrument, helmet, or any other sports equipment as a weapon.

14. Check all school issued equipment to ensure it is up to manufacturer standards of quality and care and does not exceed the expiration date.  

4. Athletic Director & Assistant Athletic Director Responsibilities

1. Provide parents, athletes, coaches, and volunteers with educational training concussion materials yearly.

2. Ensure that all educational training programs are completed and recorded.

3. Participate in concussion education and training as described in Section II on a yearly basis. 

4. Ensure that all students meet the physical exam requirements consistent with 105 CMR 200.000 and MIAA Rules and Regulations prior to participation in any interscholastic athletic activity.

5. Ensure that all students participating in interscholastic athletic activity have completed and submitted their FamilyID/Arbiter Sports Registration which includes health history and concussion history questionnaires.

6. Do not allow any student to participate who has not completed their FamilyID/ArbiterSports Registration.

7. Do not allow any student to participate who has not submitted a valid physical from within 13 months of the participation date.

8. Do not allow student athletes to return to play until cleared by a physician and athletic trainer.

9. Ensure that athletes are prohibited from engaging in any unreasonably dangerous athletic technique that endangers the health or safety of an athlete, including using a helmet or any other sports equipment as a weapon.

10. Ensure that all head injury forms are completed and are on file or delegate to appropriate personnel.

11. Inform parent/guardian(s) that, if all necessary forms are not completed, their child will not participate in interscholastic athletics. 

12. Maintain and submit annual statistics required by the DPH or delegate to appropriate personnel

5. School Nurse Responsibilities

1. Participate in and complete the CDC training course on concussions on a yearly basis as described in Section II.

2. Complete symptom assessment when a student enters the Health Office (HO) with a questionable concussion during school hours.

3. If symptoms are present, notify parent/guardian(s) and instruct parent/guardian(s) that the student must be evaluated by their primary care provider.

4. If symptoms are not present, the student may return to class and the parent will be notified.

5. Allow students who are in recovery to rest in HO when needed.

6. Develop a plan for students regarding pain management.

7. Communicate with guidance counselors and teachers to implement any accommodations and/or modifications with respect to academics, course requirements, homework, testing, scheduling, and other aspects of school activities consistent with the Return to Learn Strategies for a return to full academic and extracurricular activities after a student that has suffered a head injury or concussion.

8. Educate parents and teachers about the effects of concussion and returning to school and activity.

9. If the injury occurs during the school day, inform administrators and complete the accident/incident form.

10. Enter physical exam dates and concussion dates into the student information system.

 

6. Certified Athletic Trainer Responsibilities

1. In collaboration with the school nurses and the athletic director, will participate in the development and review of the policy and procedures.

2. Initial evaluation and documentation of any on-site head-injuries and potential concussions sustained by a Hopkinton Middle/High School or competing student athlete.

3. Removal from play of any student athlete, who during practice or competition, suffers a head injury or suspected head injury or exhibits signs and symptoms of a concussion. 

4. Contact the parent/guardian of a student athlete with a suspected head injury. Provide concussion packet and recommend seeing primary care provider for further evaluation.

5. Implement the Graduated Return to Play protocol as described in Section IX.

6. Review Pre-Participation Head Injury/Concussion Reporting for all students so as to identify those athletes who are at greater risk for repeated head injuries and make available to coaches through the FamilyID/ArbiterSports Rosters.

7. Administration of all Sway testing including preseason baseline testing, initial and subsequent post-injury testing and post-exertional testing.

8. Complete annual educational training as required by 105 CMR 201.008.

9. Collaborate with the Middle/High School Nurses regarding all matters of documented head injuries and concussions.

10. Collaborate with Middle/High School Coaches regarding student athletes with head injuries or suspected concussions, maintain discussion regarding student athletes’ progress with respect to their status in the Concussion Management (Return to Play) protocol, up to and including final authorization of full return to play. 

11. Maintain records including Report of Head injury During Sports Season, Post Sports-Related Head  Injury Medical Clearance and Authorization, and records related to the completion of graduated return to play.

7. School Responsibilities

1. Review and, if necessary, revise the concussion policy every 2 years.

2. The team will work with the student on organizing work assignments, making up work and giving extra time for assignments and tests/quizzes. 

3. After teachers are made aware of a student’s concussion, they will follow the Academic Post Concussion Accommodation Plan.

4. Educate staff on the signs and symptoms of concussions and the educational impact concussions may have on students. Teachers will read and follow the Academic Post Concussion Accommodation Plan.

5. Direct parents with limited English proficiency to the CDC website for educational materials concerning concussions.

6. Teachers & Guidance Counselors should cooperate with the implementation of accommodations and/or modifications with respect to academics, course requirements, homework, testing, scheduling, and other aspects of school activities consistent with a return to learn strategies for a return to full academic and extracurricular activities after a student has suffered a head injury or concussion. 

XVI. PENALTIES 

Hopkinton Public Schools takes the safety of student athletes seriously. All members of the school staff are expected to follow these policies and protocols to support the health and safety of student athletes. The underlying philosophy of these policies is “When in doubt, sit them out.” Failure to comply with the letter or spirit of these policies could result in progressive discipline for staff and/or forfeiture of games. If students or parents have concerns that the policies are being violated, they should contact the Superintendent and also place their complaint in writing with a request for resolution. 

Legal reference: 

105 CMR 201.000: Head Injuries and Concussions in Extracurricular Athletics 

S 2469, Chapter 166 of the Acts of 2010: An Act Relative to Safety Regulations for School Athletic Programs. 

Amended: January 8, 2025