Sports and Concussions: What Are the Recommendations?

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When it comes to making recommendations, doctors' organizations tend to come late to the game, calling press conferences to state the obvious. The American Academy of Neurology states that "any athlete who is suspected to have suffered a concussion should be removed from participation until he or she is evaluated by a physician with training in the evaluation and management of sports concussions." The Academy's position also includes an educational component to increase concussion education for parents, athletes, and coaches; and reminds us that players should not return to competition until they had recovered from their injury.

It took a little while for common sense to return to the halls of neurology academia; their last position paper from 1997 allowed players with concussions to return to play immediately if they were deemed to be asymptomatic with normal neurologic assessment at rest and with exercise. It was routine to see players running on the sideline after a head injury, as part of their evaluation to determine if concussion symptoms could be provoked.

While unintentional head injuries occur in sports and daily life, there are sports in which the head is a target, and winning happens when a concussion occurs and the player is knocked unconscious. The Academy has a 2008 position paper on sports that promotes intentional trauma to the brain. One would think that it would be to demand a ban. Instead, while concluding that sports like boxing and mixed martial arts are a serious threat to brain function and even with protective gear can cause "measurable and persistent damage to the brain," the recommendations are muted: Try to decrease the number of blows to the head, educate potential participants about the damage, and work on prevention, especially for kids younger than 16 years of age.

Medically Reviewed by a Doctor on 11/15/2013