Hold That Thought: A Practical Concussion Guide for Parents and Coaches

Have you ever been that parent or coach standing on the sideline, trying to decide whether this is one of those moments when you have to step in?

Some Practical Guidance on Identification of Head Injuries

This decision comes with a mix of fear, responsibility, and urgency. You want to protect the athlete, but you also don’t want to over-react and with concussion symptoms so often subtle or delayed. The decision can feel impossible.

The good news is that new research is giving parents and coaches clearer signs to watch for and a deeper understanding of what’s really happening inside the brain.

SHAAKE: Spontaneous Headshake After A Kinematic Event.

One of the most important developments is the identification of a new visible sign of concussion called the SHAAKE, the “Spontaneous Headshake After a Kinematic Event.” In simpler terms: if an athlete takes a hit or falls and then, within seconds, shakes their head quickly side-to-side as if trying to “clear the cobwebs,” that movement may actually be an early neurological response to brain stress.

Studies show that this head shake occurs in a large portion of athletes who end up being diagnosed with concussion, and when it appears, there is a strong likelihood that the brain has been affected. For parents and coaches, the value is huge: it’s something you can see immediately, without equipment, and without needing the athlete to admit anything. If you notice it, it’s a reason to pull the player aside for a proper evaluation.

New Research Points to Multiple Recovery Paths

At the same time, concussion research is moving beyond the idea that all concussions look the same. Scientists now understand that there are multiple “subtypes,” depending on which parts of the brain are affected. Some athletes primarily experience vestibular symptoms like dizziness, balance problems, or room-spinning sensations. Others struggle with oculomotor issues - difficulty focusing their eyes, tracking motion, or reading. Some have cognitive symptoms, like slower thinking or trouble concentrating. This matters because treatment is shifting from generic rest to targeted rehabilitation.

A player with balance issues may benefit from vestibular therapy, while someone with visual problems may need oculomotor exercises.For families and coaches, this means recovery should be tailored, not one-size-fits-all.

Blood Biomarkers are also Being Studied

Another important area of research involves blood biomarkers, molecules released into the bloodstream when brain cells are stressed or injured. Studies in adolescents show that levels of certain proteins can differ depending on sex and can be linked to specific types of symptoms.For example, some markers are associated with worse emotional symptoms in girls, while others correlate with physical symptoms in boys. Although these tests aren’t yet available on the sidelines, they point to a future where doctors may have more objective ways to diagnose concussion and track recovery. This reinforces something parents and coaches often sense instinctively: recovery isn’t the same for every athlete, and girls and boys may not heal at the same pace.

Take Time with Recovery

Perhaps the most sobering finding and the one that most affects families is that the brain’s full recovery often lags behind the visible signs of improvement. Athletes may feel normal and pass basic tests long before deeper structures of the brain have healed. Research also highlights that the real danger isn’t only the number of diagnosed concussions, but the accumulation of repeated head impacts, even those that don’t cause symptoms. These smaller, repetitive jolts can still trigger microscopic changes in brain tissue over time. For young athletes whose brains are still developing, this makes early recognition and cautious management even more crucial.

All of this points to a larger truth: the sideline decisions you make as a parent or coach matter profoundly. When you remove an athlete after a suspected concussion, you aren’t being dramatic- you’re protecting their long-term health. When you listen to a child who says, “I just don’t feel right,” or when you insist on a gradual return to school and sport, you’re giving their brain the time it needs to truly heal. When you watch closely for signs like the SHAAKE, confusion, balance issues, or emotional changes, you’re acting as the first line of defense in a situation where minutes can make a difference.

For an easy way to navigate this moment, refer to the poster below for step-by-step guide to recognising symptoms and making this decision.

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