The USHA Concussion Protocol is formally presented here on our web site.  A form of it is incorporated into our rule book as Rule 4.10 TIMEOUTS C.2) Concussion.

In the aftermath of any physical incident in which a player’s head may have been impacted the referee or the player or any bystander shall immediately inform the Tournament Director.  The Tournament Director shall immediately engage Medical Control to determine if a concussion Risk Assessment, comprised of assessment of commonly accepted medical concussion symptoms and signs, should be performed on the affected player.  Medical Control shall be staffed with at least a Trained Health Care Provider, defined as, but not limited to, a medical doctor, a physician assistant, licensed physical trainer, EMT, or any person formally trained in Risk Assessment of concussion symptoms and signs.  Medical Control shall always confer with the host facility if they have their own Trained Health Care Provider and their own state-approved concussion protocol, and shall abide by the host facility’s decisions.  The Tournament Director shall appoint Medical Control, and the Tournament Director shall be Medical Control in the absence of a formal Medical Control or in the absence of a host facility protocol.  In such a case the Tournament Director should apply the generally accepted symptoms and signs as listed in the USHA Concussion Protocol posted on line at  The Tournament Director’s determination of a need for Risk Assessment shall be based on good faith and is expected to err on the side of caution.

Upon referral to Medical Control the player shall not be charged a time out nor assessed injury time out minutes for the duration.  The player may not refuse to cooperate in this procedure under penalty of forfeit of match.  If Medical Control determines there is no need for a Risk Assessment, the player may return to the match.  If Medical Control performs a Risk Assessment and determines concussion symptoms and signs are not present, the player may return to the match.  If Medical Control determines concussion symptoms and signs are present, the player must be referred to a proper medical facility for a formal concussion diagnosis. The player will not be allowed further participation and the match shall be forfeited.  If the player is required to leave the premises at any time for any part of this procedure the match shall be forfeited.  For any player not cleared by Medical Control further participation will require written permission from a medical doctor or other authorized evaluator prior to any match.  Otherwise, all succeeding matches shall be forfeited.  This includes any player who forfeited a match due to non-cooperation in this procedure.

Signs may include the following:

  • Appears dazed
  • Vacant facial expression
  • Confused about singles/doubles match
  • Forgets the score
  • Is unsure of game, score, or opponent
  • Slurred speech
  • Shows behavior or personality changes
  • Can’t recall events prior to incident
  • Can’t recall events after incident
  • Seizures or convulsions
  • Moves clumsily or uncoordinated
  • Answers questions slowly
  • Any change in typical behavior or personality
  • Loses consciousness

Symptoms may include the following:

  • Headaches
  • “Pressure in head”
  • Nausea or vomiting
  • Neck pain
  • Balance problems or dizziness
  • Blurred, double, or fuzzy vision
  • Sensitivity to light or noise
  • Amnesia
  • “Don’t feel right”
  • Fatigue or low energy
  • Sadness
  • Nervousness or anxiety
  • Irritability
  • More emotional
  • Feeling sluggish or slowed down
  • Feeling foggy or groggy
  • Drowsiness
  • Change in sleep patterns
  • Confusion
  • Concentration or memory problems
    (forgetting game plays)
  • Repeating the same question/comment