AthleticsAthletics““Interscholastic athletics have a vital place in the total educational program when they areeffectively planned, organized, administered, supervised, and evaluated. Through school athletics, many of the interests and needs of young people can be served better than through any other channel.”

State Board of Education 1987

MS ATHLETIC REGULATIONSMS ATHLETIC REGULATIONS• General Statute 115C-47(4) makes it the General Statute 115C-47(4) makes it the

responsibility of the local board of education to responsibility of the local board of education to regulate extracurricular activities, including regulate extracurricular activities, including athletics. This statute reads as follows:athletics. This statute reads as follows:

• "Local boards of education shall make all rules and "Local boards of education shall make all rules and regulations for the conducting of extracurricular regulations for the conducting of extracurricular activities under their supervision, including a activities under their supervision, including a program of athletics...provided that all program of athletics...provided that all interscholastic athletic activities shall be interscholastic athletic activities shall be conducted in accordance with rules and conducted in accordance with rules and regulations prescribed by the State Board of regulations prescribed by the State Board of EducationEducation." ."

General Statute 115C-47General Statute 115C-47

AGEAGE•STUDENT MAY NOT STUDENT MAY NOT

PARTICIPATE IF HE/SHE PARTICIPATE IF HE/SHE BECOMES 15 YEARS OF BECOMES 15 YEARS OF AGE ON OR BEFORE AGE ON OR BEFORE AUGUST 31, 2012.AUGUST 31, 2012.

ATTENDANCEATTENDANCE• MUST BE IN ATTENDANCE 85% MUST BE IN ATTENDANCE 85%

(CANNOT MISS MORE THAN 13.5 (CANNOT MISS MORE THAN 13.5 DAYS IN THE PREVIOUS 90-DAY DAYS IN THE PREVIOUS 90-DAY SEMESTER).SEMESTER).

• THIS INCLUDES ALL ABSENCES THIS INCLUDES ALL ABSENCES (EXCUSED AND UNEXCUSED)(EXCUSED AND UNEXCUSED)

ATTENDANCEATTENDANCE• ATTENDANCE IS REGULATED BY ATTENDANCE IS REGULATED BY

LOCAL LEA POLICY IN TERMS OF LOCAL LEA POLICY IN TERMS OF LENGTH OF DAY REQUIRED TO BE LENGTH OF DAY REQUIRED TO BE COUNTED IN ATTENDANCE.COUNTED IN ATTENDANCE.

• LOCAL ATTENDANCE POLICY MAY BE LOCAL ATTENDANCE POLICY MAY BE MORE STRINGENT IN TERMS OF MORE STRINGENT IN TERMS OF COUNTING/EARNING CREDIT FOR COUNTING/EARNING CREDIT FOR COURSES.COURSES.

• SUMMER SCHOOL DOES NOT COUNT SUMMER SCHOOL DOES NOT COUNT TOWARDS ATTENDANCE.TOWARDS ATTENDANCE.

ATTENDANCEATTENDANCE• A student must, at any time of any game A student must, at any time of any game

in which he or she participates, be a in which he or she participates, be a regularly enrolled member of the school’s regularly enrolled member of the school’s student body, according to local policy. student body, according to local policy.

• If there is not local policy, “regularly If there is not local policy, “regularly enrolled” is defined as enrolled for at least enrolled” is defined as enrolled for at least one-half of the “minimum load.” one-half of the “minimum load.”

• It is recommended the student be in It is recommended the student be in school the day of the contest.school the day of the contest.

ACADEMICSACADEMICS• STUDENTS IN GRADES 7 AND 8, STUDENTS IN GRADES 7 AND 8,

MUST PASS AT LEAST ONE LESS MUST PASS AT LEAST ONE LESS THAN THE NUMBER OF REQUIRED THAN THE NUMBER OF REQUIRED CORE COURSES EACH SEMESTERCORE COURSES EACH SEMESTER

ANDAND• MEET PROMOTION STANDARDS MEET PROMOTION STANDARDS

ESTABLISHED BY THE LEA.ESTABLISHED BY THE LEA.

ACADEMICSACADEMICS• AN ATHLETE BECOMES ELIGIBLE OR AN ATHLETE BECOMES ELIGIBLE OR

INELIGIBLE ON THE FIRST DAY OF INELIGIBLE ON THE FIRST DAY OF THE NEW SEMESTER.THE NEW SEMESTER.

• STUDENTS ENTERING THE 7TH STUDENTS ENTERING THE 7TH GRADE FOR THE FIRST TIME ARE GRADE FOR THE FIRST TIME ARE AUTOMATICALLY ACADEMICALLY AUTOMATICALLY ACADEMICALLY ELIGIBLE FOR FIRST SEMESTER.ELIGIBLE FOR FIRST SEMESTER.

ACADEMICSACADEMICS• SUMMER SCHOOL WORK THAT IS SUMMER SCHOOL WORK THAT IS

USED TO MAKE UP PART OF THE USED TO MAKE UP PART OF THE ELIGIBILITY REQUIREMENT, MUST BE ELIGIBILITY REQUIREMENT, MUST BE APPLIED TO THE MOST RECENT APPLIED TO THE MOST RECENT SEMESTER.SEMESTER.

ENROLLMENT/ENROLLMENT/RESIDENCERESIDENCE

• STUDENT MUST BE A REGULARLY STUDENT MUST BE A REGULARLY ENROLLED MEMBER OF THE ENROLLED MEMBER OF THE SCHOOL’S STUDENT BODY.SCHOOL’S STUDENT BODY.

• STUDENT MUST PARTICIPATE AT THE STUDENT MUST PARTICIPATE AT THE SCHOOL TO WHICH HE/SHE IS SCHOOL TO WHICH HE/SHE IS ASSIGNED BY THE LOCAL BOARD OF ASSIGNED BY THE LOCAL BOARD OF EDUCATION.EDUCATION.

ENROLLMENT/ENROLLMENT/RESIDENCERESIDENCE

• SCHOOL ASSIGNMENT IS BASED ON SCHOOL ASSIGNMENT IS BASED ON THE RESIDENCE OF THE PARENT OR THE RESIDENCE OF THE PARENT OR LEGAL CUSTODIAN (COURT ORDERED LEGAL CUSTODIAN (COURT ORDERED CUSTODY, CUSTODY, NOTNOT GUARDIAN) WITHIN GUARDIAN) WITHIN THE ADMINISTRATIVE UNIT. THE ADMINISTRATIVE UNIT.

• STUDENT MUST LIVE WITH THE STUDENT MUST LIVE WITH THE PARENTS OR LEGAL CUSTODIAN.PARENTS OR LEGAL CUSTODIAN.

ENROLLMENT/ENROLLMENT/RESIDENCERESIDENCE

• A A “LEGAL CUSTODIAN”“LEGAL CUSTODIAN” IS A PERSON OR IS A PERSON OR AGENCY AWARDED LEGAL, COURT-AGENCY AWARDED LEGAL, COURT-ORDERED CUSTODY OF A CHILD.ORDERED CUSTODY OF A CHILD.

• A STUDENT MAY NOT HAVE TWO A STUDENT MAY NOT HAVE TWO RESIDENCES FOR ELIGIBILITY PURPOSES. RESIDENCES FOR ELIGIBILITY PURPOSES. “RESIDENCE” AS USED FOR ATHLETIC “RESIDENCE” AS USED FOR ATHLETIC PURPOSES IS DEFINED AS THE EQUIVALENT PURPOSES IS DEFINED AS THE EQUIVALENT OF THE TERM “DOMICILE” AS APPLIED BY OF THE TERM “DOMICILE” AS APPLIED BY THE COURTS OF NORTH CAROLINA.THE COURTS OF NORTH CAROLINA.

ENROLLMENT/ENROLLMENT/RESIDENCERESIDENCE

• TRANSFERS WITHIN THE SAME TRANSFERS WITHIN THE SAME ADMINISTRATIVE UNIT MAY BE GOVERNED ADMINISTRATIVE UNIT MAY BE GOVERNED BY THE LOCAL BOARD OF EDUCATION.BY THE LOCAL BOARD OF EDUCATION.

• A STUDENT TRANSFERRED FROM ONE A STUDENT TRANSFERRED FROM ONE ADMINISTRATIVE UNIT TO ANOTHER BY ADMINISTRATIVE UNIT TO ANOTHER BY MUTUAL AGREEMENT IS IMMEDIATELY MUTUAL AGREEMENT IS IMMEDIATELY ELIGIBLE, FOR ATHLETIC PARTICIPATION IN ELIGIBLE, FOR ATHLETIC PARTICIPATION IN THE RECEIVING UNIT, IF ELIGIBLE IN ALL THE RECEIVING UNIT, IF ELIGIBLE IN ALL OTHER RESPECTS.OTHER RESPECTS.

MEDICAL REQUIREMENTSMEDICAL REQUIREMENTS• STUDENT MUST RECEIVE A MEDICAL STUDENT MUST RECEIVE A MEDICAL

EXAMINATION ONCE EVERY 365 DAYS BY A EXAMINATION ONCE EVERY 365 DAYS BY A DULY LICENSED PHYSICIAN, NURSE DULY LICENSED PHYSICIAN, NURSE PRACTITIONER, OR PHYSICIAN’S ASSISTANT.PRACTITIONER, OR PHYSICIAN’S ASSISTANT.

• STUDENTS ABSENT FROM ATHLETIC STUDENTS ABSENT FROM ATHLETIC PRACTICE FOR FIVE (5) OR MORE DARYS PRACTICE FOR FIVE (5) OR MORE DARYS DUE TO ILLNESS OR INJURY SHALL RECEIVE DUE TO ILLNESS OR INJURY SHALL RECEIVE A MEDICAL RELEASE BY A PHYSICIAN A MEDICAL RELEASE BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE BEFORE LICENSED TO PRACTICE MEDICINE BEFORE RE-ADMITTANCE TO PRACTICE OR PLAY.RE-ADMITTANCE TO PRACTICE OR PLAY.

SEMESTER RULESEMESTER RULE• NO STUDENT MAY BE ELIGIBLE TO NO STUDENT MAY BE ELIGIBLE TO

PARTICIPATE AT THE MIDDLE PARTICIPATE AT THE MIDDLE SCHOOL LEVEL FOR A PERIOD SCHOOL LEVEL FOR A PERIOD LASTING LONGER THAN FOUR (4) LASTING LONGER THAN FOUR (4) CONSECUTIVE SEMESTERS, CONSECUTIVE SEMESTERS, BEGINNING WITH THE STUDENTS BEGINNING WITH THE STUDENTS FIRST ENTRY INTO SEVENTH GRADE.FIRST ENTRY INTO SEVENTH GRADE.

ELIGIBILITY LISTSELIGIBILITY LISTS

ELIGIBILITY LISTS SHALL BE ELIGIBILITY LISTS SHALL BE CERTIFIED WITH THE SIGNATURE CERTIFIED WITH THE SIGNATURE OF THE PRINCIPAL AND FILED OF THE PRINCIPAL AND FILED WITH THE LOCAL WITH THE LOCAL SUPERINTENDENT (OR DESIGNEE) SUPERINTENDENT (OR DESIGNEE) PRIOR TO THE FIRST GAME OR PRIOR TO THE FIRST GAME OR CONTEST IN THAT SPORT.CONTEST IN THAT SPORT.

OFF SEASON SKILL OFF SEASON SKILL DEVELOPMENTDEVELOPMENT

• Off-season skill development sessions are allowed Off-season skill development sessions are allowed during the school year for seventh and eighth during the school year for seventh and eighth graders. Skill development sessions shall not be held graders. Skill development sessions shall not be held during any tryout period of an in-season sport. during any tryout period of an in-season sport.

• All skill development sessions must be voluntary and All skill development sessions must be voluntary and open to all athletically eligible students. At no time open to all athletically eligible students. At no time may a coach require of any student off-season skill may a coach require of any student off-season skill development sessions as a measure of potential or development sessions as a measure of potential or continued participation on a team. continued participation on a team.

• Skill development sessions are restricted in number Skill development sessions are restricted in number of participants to one less than a team, on a daily of participants to one less than a team, on a daily basis. basis.

OFF SEASON SKILL OFF SEASON SKILL DEVELOPMENTDEVELOPMENT

• Any team practice or game environment Any team practice or game environment created in an off-season skill development created in an off-season skill development session is prohibited during the 180-day session is prohibited during the 180-day school calendar. The primary focus of off-school calendar. The primary focus of off-season skill development should be on season skill development should be on individual student athletes, not team. individual student athletes, not team.

• During the summer, working with During the summer, working with individuals, including rising and eligible individuals, including rising and eligible seventh and eighth graders will be seventh and eighth graders will be allowed, as long as it is not required. allowed, as long as it is not required.

OFF SEASON SKILL OFF SEASON SKILL DEVELOPMENTDEVELOPMENT

• NOTE:NOTE: Seventh and eighth graders are not Seventh and eighth graders are not permitted to participate in high school open permitted to participate in high school open facility or skill development sessions during facility or skill development sessions during the school year. the school year. 

• NOTE: The maximum number of participants NOTE: The maximum number of participants on a daily basis is: football (21), basketball on a daily basis is: football (21), basketball (4), baseball (8), volleyball (5), tennis (4), (4), baseball (8), volleyball (5), tennis (4), soccer (10), golf (3), softball (8), wrestling soccer (10), golf (3), softball (8), wrestling (8), track (6), and cross country (4), lacrosse (8), track (6), and cross country (4), lacrosse men (9), and lacrosse women (11)men (9), and lacrosse women (11)

DPI/LEA REGULATIONSDPI/LEA REGULATIONS• NO 6TH GRADER IS ALLOWED TO NO 6TH GRADER IS ALLOWED TO

PARTICIPATE IN THE ATHLETIC PROGRAM, PARTICIPATE IN THE ATHLETIC PROGRAM, PRACTICE OR PLAY.PRACTICE OR PLAY.

• MANAGERS MAY BE 6MANAGERS MAY BE 6THTH GRADERS AND DO GRADERS AND DO NOT HAVE TO MEET THE ELIGIBILITY NOT HAVE TO MEET THE ELIGIBILITY REQUIREMENTS (LEA DECISION). REQUIREMENTS (LEA DECISION). MANAGERS MAY NOT PRACTICE AS A MANAGERS MAY NOT PRACTICE AS A PLAYER.PLAYER.

NCDPI/ LEA REGULATIONSNCDPI/ LEA REGULATIONS• A STUDENT MAY NOT DRESS FOR A A STUDENT MAY NOT DRESS FOR A

GAME OR SCRIMMAGE WHEN HE/SHE GAME OR SCRIMMAGE WHEN HE/SHE IS NOT ELIGIBLE TO PARTICIPATE IN IS NOT ELIGIBLE TO PARTICIPATE IN THE GAME. THE GAME.

• CHEERLEADING IS A LOCAL DECISION CHEERLEADING IS A LOCAL DECISION ACTIVITIY.ACTIVITIY.

NCDPI/LEA REGULATIONSNCDPI/LEA REGULATIONS• TO MAINTAIN AMATEUR STATUS, A TO MAINTAIN AMATEUR STATUS, A

STUDENT MUST NOT ACCEPT MONEY STUDENT MUST NOT ACCEPT MONEY OR AWARDS HAVING UTILITARIAN OR AWARDS HAVING UTILITARIAN VALUE (GOLF BALLS, CLUBS, TENNIS VALUE (GOLF BALLS, CLUBS, TENNIS RACKETS, ETC.) FOR PARTICIPATION RACKETS, ETC.) FOR PARTICIPATION IN ATHLETICS.IN ATHLETICS.

• LOAN EQUIPMENT AND SUPPLIES ARE LOAN EQUIPMENT AND SUPPLIES ARE PROHIBITED ITEMS. PROHIBITED ITEMS.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS• EVENING CONTESTS AND/OR GAMES EVENING CONTESTS AND/OR GAMES

SHALL START NO LATER THAN 7:00 SHALL START NO LATER THAN 7:00 PM WHEN FOLLOWED BY A SCHOOL PM WHEN FOLLOWED BY A SCHOOL DAY.DAY.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS• THE LOCAL BOARD OF EDUCATION OR THE LOCAL BOARD OF EDUCATION OR

THE CONFERENCE OF WHICH THE THE CONFERENCE OF WHICH THE SCHOOL IS A MEMBER SHALL HAVE SCHOOL IS A MEMBER SHALL HAVE THE AUTHORITY TO SET ASIDE THE THE AUTHORITY TO SET ASIDE THE EFFECT OF ANY EFFECT OF ANY (OTHER THAN AGE)(OTHER THAN AGE) ELIGIBILITY RULE UPON THE ELIGIBILITY RULE UPON THE INDIVIDUAL STUDENT WHEN IN ITS INDIVIDUAL STUDENT WHEN IN ITS OPINION THE RULE FAILS TO OPINION THE RULE FAILS TO ACCOMPLISH THE PURPOSE FOR ACCOMPLISH THE PURPOSE FOR WHICH THE RULE IS INTENDED OR WHICH THE RULE IS INTENDED OR CAUSES UNDUE HARDSHIP UPON THE CAUSES UNDUE HARDSHIP UPON THE STUDENT.STUDENT.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS

• INSURANCE COVERAGE - STUDENT INSURANCE COVERAGE - STUDENT ATHLETES SHOULD HAVE PROPER ATHLETES SHOULD HAVE PROPER INSURANCE COVERAGE. INSURANCE COVERAGE. CATASTROPHIC LIABILITY INSURANCE CATASTROPHIC LIABILITY INSURANCE IS AVAILABLE THROUGH THE IS AVAILABLE THROUGH THE NCHSAA.NCHSAA.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS

• IT IS RECOMMENDED THAT THE IT IS RECOMMENDED THAT THE HEAD COACH ATTEND THE NC HEAD COACH ATTEND THE NC COACHES ASSOCIATION/NCHSAA COACHES ASSOCIATION/NCHSAA STATE CLINICS IN THE SPORT HE/SHE STATE CLINICS IN THE SPORT HE/SHE COACHES.COACHES.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS

• EJECTIONS ARE GOVERNED BY THE EJECTIONS ARE GOVERNED BY THE LOCAL SCHOOL BOARD AND LOCAL SCHOOL BOARD AND CONFERENCE. THE MINIMAL CONFERENCE. THE MINIMAL REQUIREMENTS FOR EJECTIONS ARE:REQUIREMENTS FOR EJECTIONS ARE:

• FIRST OFFENSE - REPRIMANDED AND FIRST OFFENSE - REPRIMANDED AND SUSPENDED FOR NEXT GAME AT SUSPENDED FOR NEXT GAME AT LEVEL OF PLAY AND ANY LEVEL OF PLAY AND ANY INTERVENING GAMES AT EITHER INTERVENING GAMES AT EITHER LEVEL.LEVEL.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS• SECOND OFFENSE - PLACED ON SECOND OFFENSE - PLACED ON

PROBATION AND SUSPENDED FOR PROBATION AND SUSPENDED FOR THE NEXT TWO GAMES AT THAT THE NEXT TWO GAMES AT THAT LEVEL OF PLAY AND FOR ANY LEVEL OF PLAY AND FOR ANY INTERVENING GAMES AT EITHER INTERVENING GAMES AT EITHER LEVEL;LEVEL;

• THIRD OFFENSE - THE PERSON THIRD OFFENSE - THE PERSON SHALL BE SUSPENDED FOR ONE SHALL BE SUSPENDED FOR ONE CALENDAR YEAR.CALENDAR YEAR.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS• A COACH WHO IS SUSPENDED AT A COACH WHO IS SUSPENDED AT

ANY LEVEL OF GRADES 7-12 MAY ANY LEVEL OF GRADES 7-12 MAY NOT COACH IN ANY OTHER GRADE NOT COACH IN ANY OTHER GRADE LEVEL DURING THE PERIOD OF LEVEL DURING THE PERIOD OF SUSPENSION.SUSPENSION.

• PENALTIES ARE CUMULATIVE FROM PENALTIES ARE CUMULATIVE FROM SPORT TO SPORT AND FROM SPORT SPORT TO SPORT AND FROM SPORT SEASON TO SPORT SEASON.SEASON TO SPORT SEASON.

DPI/LEA REQUIREMENTSDPI/LEA REQUIREMENTS• SPORTS SEASONSSPORTS SEASONS

– FALL - BEGINNING OF FALL TO NOV. 15FALL - BEGINNING OF FALL TO NOV. 15– WINTER - OCTOBER 15 - MARCH 1WINTER - OCTOBER 15 - MARCH 1– SPRING - FEBRUARY 1 UNTIL END OF SPRING - FEBRUARY 1 UNTIL END OF

SCHOOL.SCHOOL.

NCHSAA Sports Medicine NCHSAA Sports Medicine InformationInformation

• On the remaining slides are Sports On the remaining slides are Sports Medicine information taken from the Medicine information taken from the NCHSAA Eligibility PowerPoint for NCHSAA Eligibility PowerPoint for High Schools. This includes High Schools. This includes concussion, neck injuries, heart concussion, neck injuries, heart issues, respiratory issues/asthma, issues, respiratory issues/asthma, heat illness, and skin infections.heat illness, and skin infections.

SPORTS MEDICINE:SPORTS MEDICINE:CONCUSSIONSCONCUSSIONS

• A concussion is a traumatic injury to the brain and presents a wide A concussion is a traumatic injury to the brain and presents a wide variety of signs and symptomsvariety of signs and symptoms– HeadacheHeadache– ConfusionConfusion– Amnesia (not remembering events before or after the injury)Amnesia (not remembering events before or after the injury)– Vision changesVision changes– Loss of consciousnessLoss of consciousness– DizzinessDizziness– Irritability/emotional changes (inappropriate or atypical crying, Irritability/emotional changes (inappropriate or atypical crying,

laughing, etc)laughing, etc)– Nausea/vomitingNausea/vomiting– Fatigue/feeling sluggish/slow/’foggy’Fatigue/feeling sluggish/slow/’foggy’– Having “bell rung’ Having “bell rung’ – Excessive fatigue/drowsinessExcessive fatigue/drowsiness

• ANY sign/symptom after a blow to the head is a concussion until ANY sign/symptom after a blow to the head is a concussion until proven otherwiseproven otherwise

SPORTS MEDICINE:SPORTS MEDICINE:CONCUSSIONCONCUSSION

• A middle or high school athlete A middle or high school athlete should NEVER return to play on the should NEVER return to play on the day they suffer a concussionday they suffer a concussion– Returning an athlete to play before Returning an athlete to play before

complete resolution of symptoms complete resolution of symptoms can lead to recurrent concussion, can lead to recurrent concussion, prolonged post-concussion prolonged post-concussion symptoms, OR even ‘Second symptoms, OR even ‘Second Impact Syndrome’ (which is often Impact Syndrome’ (which is often fatal)fatal)

SPORTS MEDICINE:SPORTS MEDICINE:Gfeller-Waller Concussion Gfeller-Waller Concussion LawLaw• An athlete with suspected concussion cannot return to play An athlete with suspected concussion cannot return to play

until he/she is cleared by a licensed medical physicianuntil he/she is cleared by a licensed medical physician• The Return to Play Form must be presented prior to practicing The Return to Play Form must be presented prior to practicing

and/or playing againand/or playing again• Athletes, parents, coaches and all involved with program must Athletes, parents, coaches and all involved with program must

receive education regarding signs and symptoms of receive education regarding signs and symptoms of concussionsconcussions

• All must sign a form indicating the education session has been All must sign a form indicating the education session has been conductedconducted

• All schools must develop and post an Emergency Action Plan All schools must develop and post an Emergency Action Plan (EAP)(EAP)

• Note: This information, along with the necessary forms are Note: This information, along with the necessary forms are available on NCHSAA web siteavailable on NCHSAA web site

SPORTS MEDICINE:SPORTS MEDICINE:CONCUSSIONSCONCUSSIONS

Managing concussions is difficult even for well-Managing concussions is difficult even for well-trained and experienced medical providers. trained and experienced medical providers.

Coaches, you Coaches, you do notdo not want this responsibility (or want this responsibility (or liability).liability).

Take home pointTake home point: At the end of the day, it’s not : At the end of the day, it’s not an athlete’s knee, ankle, or elbow… it’s his or an athlete’s knee, ankle, or elbow… it’s his or her brain and you cannot get this one wrong…her brain and you cannot get this one wrong…

• ““WHEN IN DOUBT, SIT THEM OUT.”WHEN IN DOUBT, SIT THEM OUT.”

SPORTS MEDICINE: SPORTS MEDICINE: CONCUSSIONSCONCUSSIONSAn online coach education course – “An online coach education course – “Concussion in Concussion in

Sports – What You Need to Know “ Sports – What You Need to Know “ is now is now available from the National Federation of State available from the National Federation of State High School Associations (NFHS) at High School Associations (NFHS) at www.nfhslearn.com. .

The course provides a guide to understanding, The course provides a guide to understanding, recognizing, and properly managing concussion recognizing, and properly managing concussion in middle and high school sports. The course is in middle and high school sports. The course is FREE, but you must register at FREE, but you must register at www.nfhslearn.com..

The Centers for Disease Control (CDC) has The Centers for Disease Control (CDC) has endorsed the course and has provided many endorsed the course and has provided many useful resources.useful resources.

SPORTS MEDICINE:SPORTS MEDICINE:HEART ISSUESHEART ISSUES

• Sudden cardiac death occurs in young athletes for a Sudden cardiac death occurs in young athletes for a variety of reasons:variety of reasons:– Most are due to genetic abnormalities of heart Most are due to genetic abnormalities of heart

rhythms or heart anatomyrhythms or heart anatomy– Drugs can trigger cardiac arrest (cocaine, stimulants, Drugs can trigger cardiac arrest (cocaine, stimulants,

anabolic steroids, and ephedrine are common anabolic steroids, and ephedrine are common culprits)culprits)

– Heat stroke can lead to cardiac arrestHeat stroke can lead to cardiac arrest– Viral illnesses can cause ‘myocarditis’ (infection of Viral illnesses can cause ‘myocarditis’ (infection of

the heart muscle) which can cause sudden cardiac the heart muscle) which can cause sudden cardiac arrestarrest

– Sickle cell trait makes athletes more likely to have Sickle cell trait makes athletes more likely to have sudden cardiac arrest (more common in African-sudden cardiac arrest (more common in African-Americans)Americans)

SPORTS MEDICINE: SPORTS MEDICINE: HEART ISSUESHEART ISSUES

There are red flags which can tip us off to There are red flags which can tip us off to undiagnosed heart problems:undiagnosed heart problems:

• Chest pain with exertionChest pain with exertion• Passing out/fainting from exertion Passing out/fainting from exertion – this is – this is

not normal or due to being ‘out of shape’not normal or due to being ‘out of shape’• Family history of a sudden cardiac death Family history of a sudden cardiac death

or unexplained death before age 50or unexplained death before age 50Take home pointTake home point: : AnyAny athlete who passes athlete who passes

out or has chest pain with exertion needs out or has chest pain with exertion needs a medical evaluationa medical evaluation

SPORTS MEDICINE:SPORTS MEDICINE:RESPIRATORY RESPIRATORY ISSUES/ASTHMAISSUES/ASTHMA• Asthma attacks remain a leading cause of Asthma attacks remain a leading cause of

death among young peopledeath among young people• Be aware of common asthma triggers:Be aware of common asthma triggers:

– Respiratory infectionsRespiratory infections– Both extreme heat/humidity and cold/dry Both extreme heat/humidity and cold/dry – Pollen & other allergensPollen & other allergens

Take home pointTake home point: Know who your asthmatic : Know who your asthmatic athletes are & make sure they have athletes are & make sure they have

accessible inhalersaccessible inhalers

SPORTS MEDICINE: SPORTS MEDICINE: HEAT ILLNESSHEAT ILLNESS

Death from heat illness is preventableDeath from heat illness is preventableHydration is only one part of the solutionHydration is only one part of the solutionKnow who is at increased riskKnow who is at increased risk–Obese, out of shape athletesObese, out of shape athletes–Athletes with fever or recent stomach or Athletes with fever or recent stomach or respiratory infectionsrespiratory infections

–Athletes with sickle cell traitAthletes with sickle cell trait–Athletes with history of prior heat illnessAthletes with history of prior heat illness–Athletes on illicit drugs, ADD meds, or Athletes on illicit drugs, ADD meds, or supplements w/ stimulantssupplements w/ stimulants

SPORTS MEDICINE:SPORTS MEDICINE:HEAT ILLNESSHEAT ILLNESS

• Prevention is keyPrevention is key• Be aware of heat index (see handbook/website)Be aware of heat index (see handbook/website)

– General Rules when using WBGT Index:General Rules when using WBGT Index:• < 80 F: Unlimited activity; cautious with new or < 80 F: Unlimited activity; cautious with new or

unconditioned athletesunconditioned athletes• 80 – 84.9 F: Normal practice; closely monitor all if extreme 80 – 84.9 F: Normal practice; closely monitor all if extreme

exertionexertion• 85 – 87.9 F: New & unconditioned athletes should not 85 – 87.9 F: New & unconditioned athletes should not

practice; frequent rest for all otherspractice; frequent rest for all others• 88 – 89.9 F: Constant observation of all; remove pads and 88 – 89.9 F: Constant observation of all; remove pads and

equipmentequipment• >89.9 F: >89.9 F: SUSPENDSUSPEND practice practice

• Practice at cooler times when feasible (mornings, evenings) Practice at cooler times when feasible (mornings, evenings)

SPORTS MEDICINE:SPORTS MEDICINE:HEAT ILLNESSHEAT ILLNESS

• Allow athletes/teams to acclimate and Allow athletes/teams to acclimate and become accustomed to heat over timebecome accustomed to heat over time

• Allow regular breaks for cooling and hydrationAllow regular breaks for cooling and hydration• A “Kiddie” pool on the sidelines is strongly A “Kiddie” pool on the sidelines is strongly

recommendedrecommended• Monitor body weight pre/post practiceMonitor body weight pre/post practice• Recognize early and initiate cooling Recognize early and initiate cooling

immediatelyimmediately– confusion, collapse, nausea/vomitingconfusion, collapse, nausea/vomiting

SPORTS MEDICINE:SPORTS MEDICINE:NECK INJURIESNECK INJURIES

Cervical spine injuries are typically caused by Cervical spine injuries are typically caused by contact with a forward flexed neck contact with a forward flexed neck

–‘‘spearing’ positionspearing’ positionAny numbness/tingling in BOTH arms is suspicious Any numbness/tingling in BOTH arms is suspicious

for a cervical spine injury for a cervical spine injury –a ‘stinger’ a ‘stinger’ nevernever causes burning in both arms causes burning in both arms

Take Home PointTake Home Point: Any suspected cervical spine : Any suspected cervical spine injury should be immobilized and evaluated by injury should be immobilized and evaluated by

medical personnelmedical personnel

SPORTS MEDICINE:SPORTS MEDICINE:SKIN INFECTIONSSKIN INFECTIONS

• Skin infections are common in contact Skin infections are common in contact sportssports

• Most skin infections are relatively minor and Most skin infections are relatively minor and self-limitedself-limited

• Resistant staph infections (MRSA) have Resistant staph infections (MRSA) have become quite common and can be severebecome quite common and can be severe

• Skin infections are spread by skin-to-skin Skin infections are spread by skin-to-skin contact, sharing pads/equipment/work-out contact, sharing pads/equipment/work-out gear, dirty equipmentgear, dirty equipment

• Any boil or abscess needs medical Any boil or abscess needs medical evaluationevaluation

SPORTS MEDICINE:SPORTS MEDICINE:SKIN INFECTIONSSKIN INFECTIONS

Take home pointTake home point: the vast majority of skin infections : the vast majority of skin infections can be prevented by good hygienecan be prevented by good hygiene

– Shower right after every practice & gameShower right after every practice & game– Do not share equipment, pads, work-out clothes, Do not share equipment, pads, work-out clothes,

towels, etctowels, etc– Wash hands frequently with soap/water or anti-Wash hands frequently with soap/water or anti-

bacterial towels/gelsbacterial towels/gels– Wash equipment, mats, clothes, towels, etc Wash equipment, mats, clothes, towels, etc

regularlyregularly

DPI MIDDLE SCHOOL ATHLETIC DPI MIDDLE SCHOOL ATHLETIC MANUAL ONLINE SITEMANUAL ONLINE SITE•http://www.ncpublicschools.org/curric

ulum/healthfulliving/athletics/