Pre-Season Baseline Testing for Young Athletes: Prepare Before an Injury Happens
Learn why pre-season baseline testing, gives coaches and parents a critical “before” picture to guide safer return-to-play decisions if an injury happens during the season.
BASELINE TESTING
Shan Patel, PsyD
8/9/20263 min read
One of the most common questions parents ask about youth sports safety is: what can actually be done before something happens? When it comes to concussions, there's a clear answer, baseline testing.
Concussions don't show up on a CT scan or an MRI. That's what makes them one of the more difficult injuries to manage, and it's exactly why pre-season baseline testing has become a standard part of concussion care for young athletes.
What Baseline Testing Is
A concussion baseline test measures how an athlete's brain functions in a normal, healthy state, before any injury occurs. The most widely used tool is ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), a computerized test developed by concussion experts and now used by sports medicine programs around the world, including UPMC Sports Medicine Concussion Program, one of its original pioneers. The test takes about 20-30 minutes and measures verbal and visual memory, along with brain processing speed and reaction time, producing a score at the end.
It's important to understand what this test is not: ImPACT does not diagnose a concussion. It's a comparison tool. If an athlete is later evaluated for a suspected concussion, they take the test again, and the results are compared against their pre-season baseline. That comparison helps a provider decide how to treat the athlete, what recovery should look like, and when it's safe to return to sport.
Why Timing Matters
Baseline tests should be scheduled before the season starts, when an athlete is symptom-free and not dealing with any suspected injury. Once symptoms are present, the "before" picture is gone, and the opportunity to capture a truly clean baseline is lost.
This is also how the most effective community testing programs are structured. HeadsUP Pittsburgh, a partnership between UPMC Sports Medicine and the Pittsburgh Penguins Foundation, has baseline tested more than 33,000 young athletes across 39 sports since 2010, and provided concussion education to nearly 65,000 parents, coaches, referees, and teachers. That kind of scale is only possible because testing happens proactively, on a predictable seasonal schedule, rather than reactively after an injury. This level of care can now be available in most states via PCI - Learn more
What Gets Measured
A baseline test evaluates concentration, memory, and reaction time, along with symptoms that can overlap with concussion, such as headaches or sleep issues, so providers know what's genuinely normal for that specific athlete, not just for athletes in general. This distinction matters: baselines aren't about comparing one child to another. They're about establishing what's normal for that individual.
What Happens Without a Baseline on File
Not every young athlete is tested before an injury occurs, and that doesn't leave them without options. Even without baseline data, clinicians can still build a full, customized care plan after an injury, a missing baseline is never a reason a child doesn't receive proper care. It simply means the provider is working with less comparison data, which experienced clinicians account for in evaluation and treatment.
Practical Recommendations for Parents and Coaches
- Schedule baseline testing before the season, not during it. This is the single biggest factor in getting a clean, useful result.
- Know the age bracket. Testing looks different for ages 6–11 versus 12 and up.
- Follow a consistent retest schedule. Annually under age 13, every two years from 13 on.
- Look into community testing options. Many regions run free or low-cost seasonal baseline programs modeled on efforts like HeadsUP Pittsburgh, local youth leagues or hospital sports medicine departments are good places to start.
- Don't wait for symptoms to start planning. If an athlete already has concussion symptoms, that calls for a direct medical evaluation, not a baseline test.
Giving every young athlete a genuine "before" picture is one of the simplest, most effective steps a family can take, so if the moment comes when it's needed, there's no guessing involved.
References
1. UPMC Sports Medicine. "ImPACT® Concussion Baseline Testing." https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/concussion/baseline
2. UPMC Sports Medicine. "HeadsUP Pittsburgh Partnership." https://www.upmc.com/services/orthopaedics/services/sports-medicine/about/partnerships-sponsorships/headsup
3. UPMC Washington / Herald-Standard. "UPMC brings free concussion baseline testing to Washington," June 2026. https://www.heraldstandard.com/news/local_news/2026/jun/03/upmc-brings-free-concussion-baseline-testing-to-washington/
4. Pittsburgh Penguins Foundation & UPMC Sports Medicine. "Open Enrollment for Heads UP Baseline Concussion Testing." Yahoo Sports, 2024. https://sports.yahoo.com/concussion-baseline-testing-offered-free-172149286.html
5. CDC. "HEADS UP: Concussion Training and Resources." https://www.cdc.gov/heads-up/
This article reflects general concussion baseline testing protocols consistent with those used by leading sports medicine concussion programs. Individual testing recommendations should always be confirmed with a provider, as protocols can vary by patient and program.
About the author:
Shan Patel, PsyD, is a neuropsychologist and concussion specialist who completed his fellowship through the UPMC Sports Medicine Concussion Program. He is the Owner and CEO of the Patel Concussion Institute (PCI), a telehealth-based practice serving patients nationally via PSYPACT, and serves as Clinical Director of the University Orthopedic Care, Concussion Program, and Integrative Behavioral Health Program, overseeing operations across 14 hospital-based clinics in Florida.
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