Concussions in athletes have gotten considerable attention in recent years, but some misconceptions remain among parents and coaches about concussion, or mTBI (mild traumatic brain injury). These injuries occur when the brain is jarred, usually by an impact to the head or other part of the body.

Most coaches at the high school level and above should be aware of Wisconsin Act 172. That law specifies that athletes suspected of having a concussion may not return to play until they are without symptoms and cleared by a health care provider. Coaches of younger children in sports such as recreational soccer or basketball, and many parents, may not know about these details.

Many people do not fully understand that the impact or striking force does not need to be directly to the head. It might not be from the biggest hit or even in a helmeted sport. And in more than 90 percent of high school student-athletes who suffer concussion, there is no loss of consciousness.

The most common concussion symptom athletes report is a headache. They may also know an answer to a question you ask them, but cannot verbalize it.

Athletes are notorious for wanting to stay in a game, so it's often up to others to notice signs of a concussion. Teammates may see a change in personality or confusion in a teammate; a wide receiver in football may run the wrong route even though the intended play was just discussed in a huddle.

Be aware that teammates are not necessarily reliable and can apply peer pressure. If an athlete breaks an arm, people recognize it when they see the cast. A concussion is not visible. They may ask 'What's wrong with you?' if a seemingly healthy athlete isn't playing.

Parents must advocate for their children. Watch for signs of a sudden change in academic performance or mood and discuss it with the child's teachers.

Keep in mind that we're talking about the athlete's future life. Understand that symptoms may develop later, such as depression and long-term cognitive effects. The team physician must take care of the injured athlete at the time of injury, but also be aware of potential effects on learning, memory, mood and interpersonal relationships many years later.