What state concussion laws require
All 50 states and DC have youth sports concussion laws, starting with Washington's Lystedt Law in 2009. Nearly all share three elements: education for coaches, parents and athletes (often a signed information sheet); immediate removal from play when a concussion is suspected; and written clearance from a licensed health care provider before return Sourced.
Many laws were written for school sports, but a long list of states explicitly reach recreational and non-school leagues, including Arkansas, California, Colorado, Delaware, DC, Georgia, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nebraska, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Tennessee, Utah and Wisconsin, and several more apply when you use school or government property Sourced.
| State | Rule |
|---|---|
| Indiana | 24-hour wait |
| New Mexico | At least ten days out |
| California | Graduated return of at least seven days under licensed supervision |
Verify your own statute, because the best available 50-state summary dates to 2018.
The protocol, in seven steps
This is the minimum a serious league runs. Put it in writing, put it in every coach packet, and brief your officials on it.
- Train every coach before the first practice. The CDC HEADS UP course for youth sports coaches is a free online course with a certificate; check whether your parks department accepts it as its required training Sourced. Keep certificates on file with dates.
- Collect a signed information sheet from every parent at registration, every season.
- Remove on suspicion. Any athlete showing signs or symptoms after a hit or fall comes out and does not return that day. Officials are briefed to stop play and alert the coach on any head contact. Coaches do not diagnose.
- Notify the parent the same day and complete an incident report (see the incident report template).
- Require written clearance from a qualified provider before any return to activity: an MD or DO everywhere, and athletic trainers, nurse practitioners and physician assistants in many states.
- Follow the six-step return to sport in the next section, one step at a time.
- Document everything: the removal, the clearance letter, and a daily return-to-play log. Keep the records until the player reaches majority plus your state's statute of limitations.
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Book a 20-minute call →The six-step return to sport
The CDC progression starts only after written clearance. Each step lasts at least 24 hours. Advance only if the player is symptom-free, and drop back a step if symptoms return Sourced.
| Step | Activity |
|---|---|
| 1 | Back to regular non-sport activities |
| 2 | Light aerobic activity for 5 to 10 minutes |
| 3 | Moderate activity |
| 4 | Heavy non-contact drills |
| 5 | Full practice |
| 6 | Competition |
At 24 hours per step, the minimum is about five to six days Sourced. Some states set a longer minimum; your statute wins. Track it on a return-to-play log.
What the data says about flag
A 2023 Journal of Athletic Training study of 1,939 players ages 6 to 12 at three tournaments, with athletic trainers recording injuries, found 5.1 injuries per 1,000 athlete exposures (boys 4.3, girls 12.8), only one concussion, head, face and neck as the most common region (31.9 percent), contusions as 55 percent of injuries, and roughly three quarters from direct impact. Comparable tackle studies ranged from 4.3 to 36.2 per 1,000 exposures Sourced.
An earlier 2017 cohort study produced the headline that flag may be "no safer" than tackle on overall injury rate, but its concussion difference was not statistically clear and it relied on coach-reported data.
- Concussion protocols are fully warranted in flag.
- The girls' injury rate argues for coaching technique on flag pulls and falls in girls divisions.
Concussion checklist
- State concussion statute identified; rec-league applicability confirmed
- CDC HEADS UP (or the state course) for every coach before practice one
- Signed concussion information sheet from every parent at registration
- Written remove-on-suspicion, clearance and six-step return-to-play policy
- Incident report and return-to-play log in every coach packet
- Officials briefed to stop play on any head contact
The same season plan covers heat, lightning and medical emergencies: see the emergency action plan and heat policy and WBGT. Screening the adults around your players is in background checks and child safety.