Athletes who suffer concussions are at risk of a delayed recovery if they return to the field too quickly. (Carolyn Kaster/Associated Press)Student athletes who return to sports quickly after a concussion appear to have a slower brain recovery than teens who stay off the field longer, a new study shows.
The report, from The Journal of Athletic Training, suggests that athletes who suffer from even mild concussions should slow down their return to the sports field. In fact, students with less severe injuries appeared to be those who return to sports the fastest. But resuming intense physical activity appeared to slow their recovery and even exacerbated their symptoms.
“By continuing with high levels of activity, they began to exhibit similar symptoms to those who initially experienced a more severe concussion,” said Jason P. Mihalik, an athletic trainer from the University of North Carolina and an author of the study.
The researchers tracked the medical records and activity levels of 95 student athletes, including 15 girls, who had suffered concussions in school sports. The students were evaluated using cognitive tests immediately after the concussion and in follow-up visits. The data showed that athletes who engaged in the highest level of activity soon after the initial injury tended to demonstrate the worst neurocognitive scores and slowest reaction times. Students fared better if they didn’t return immediately to their sport but instead simply engaged in normal school and home activities.
The study data reflect a general trend showing lower visual memory and reaction scores during the month following the injury among athletes who returned to their sports quickly after a concussion. But the data can’t be used to make specific recommendations about how long students should stay off the field after a concussion, which depends on the extent of the individual injury. However, the study does show that when it comes to concussions, the more time off to heal, the better.
Every year there are more than 300,000 sports-related concussions in the United States, and more than 60,000 cases occur among high school students. The study authors said that the results highlight the notion that concussion management may need to include recommendations regarding return to all activities, including school, work and daily chores, and not just sport-specific activities.
“Given the health issues associated with concussion, which may last longer than once thought, the decision on when and how to return an athlete not only to the playing field, but also to normal day-to-day activity, has begun receiving attention as a national health issue,” Mr. Mihalik said.
Part of the problem is that the culture of student athletics tends to reward students who stay on the field after a head injury, as reported in this Times story. The story is accompanied by this interactive graphic detailing numerous high school sports injuries.
And I recommend watching both of the following videos about what can happen when students suffer concussions on the field.
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12 Comments
It appears a jaw positioning procedure used by the N.E. Patriots may be the next focus of research by the concussion medical community. All other means of concussion research have been exhausted, in terms of innovative equiptment. Developed with Marvin Hagler and used by 70% of the N. E. Patriots for decades, it actually medically corrects a jaw problem, the Maher mouth guard has been responsible for the fact the Pats have had two concussions in the past two years. The Colts have had over twenty in the same time span, its worth a closer look, wouldn’t you think. http://www.mahercor has more info on the story
— SteveI could see why my school doesn’t want a baseball team.
— JasonI refused to allow my sons to play high school football because of short and long term injury issue.
(Stimulated by the NY Times recent articles on teh Lyric hearing devices got them a few days ago. Instantly restored my hearing to where it was almost 50 years ago before exposure to unprotected rifle and artillery fire in the army.)
— MARK KLEIN, M.D.Allow me to add to the above comment on the Lyric yet another reason to avoid Type II diabetes. The devices inserted in the ears can be worn for months. However, diabetics with vascular complications can have problems tolerating it because the skin inside the ear can break down under the tiny pressure the devices create to hold them in place.
— MARK KLEIN, M.D.I played soccer for a few years in my early adolescence, 10-13yrs of age, and suffered one major concussion after an on-field collision. I sat out the rest of that game, but was back on the field within days for practice. I still remember the nausea, dizziness and inability to focus that I experienced at that practice. I remember attributing my symptoms to the heat, but it appears something more serious was occuring. I think children could benefit from learning the warning signs of this type of brain trauma in their Health classes at school.
— SarahAs an adult, I returned to playing hockey after not lacing my skates for fifteen years. I can’t get enough of the game. I did suffer a decent concussion in which the acute symtoms lasted for a few days and the slow, non-agile, and general feeling of vulneralablity lasted for a couple weeks. It wasn’t until I had this concussion that I really knew what one felt like and realized that this was not the first. Remembering similiar symtoms from a prior collision that was much higher impact than the latter. This is consitant with what I’ve read and have been told by the doctors. Once one occurs the rest come easier and more severe. Initially I was unsure if I would feel comfortable playing again due to the lasting symptoms. Thanks to my wife, being concerned for my health and being the provider for our family, she wouldn’t let me return to playing for more than twice as long as recommended by doctors. I did however return to work right away and remember having trouble performing some of the duties at my physically demanding job. I think not returning to the game right away was a small sacrafice to pay as compared to the gains by allowing my brain to heal.
— JonMy son used Dr. Gerald Maher’s patent pending custom-fit mouth guard when he played football. It is designed to prevent the lower jaw bone from being driven into the skull by using a hard plastic that creates separation of the back teeth and gives a perfectly parallel bite. The nice thing about it is that players can talk more easily when they wear it compared with other mouth guards and can drink without having to take it out. It has helped prevent numerous concussions in many high school and pro football players as well as boxers like Marvin Hagler.
— Dr. Kip LaShotoI am a neuropsychologist who has been trying to interest high schools, among whose students long-term risk appears to be the highest, in ways of preventing premature return to play. The lack of interest is remarkable. I attribute this to the discomfort on the part of schools about alienating overzealous parents and alumni contributers by putting teams at a disadvantage, even at the risk to their students. As with the position that the Bush administration took on global warming, it may be easiest to pretend that the science isn’t settled. It suggests that there needs to be some, more stringent, national standard that would level the playing field (or a really good lawsuit) to trump the pecuniary motive.
— Frank A. Wolkenberg, Ph.D,As a former high school and national athlete that has over the course of the past 17 years had several concussions I cannot agree more with the premise of this article. Coaches and athletes alike need to be made more aware of the dangers of returning to sports after a possibly concussive incident. That being said, a change needs to happen in the world of professional sports if we want to see any change in how high school and college athletes and coaches behave. Professional athletes are pushed back onto the field after incidents because they are seen as investments made by mangers and owners, and a sidelined investment can’t make money. Look at the rash of former NFL, MLB, NHL athletes that have rapidly deteriorating health after retirement. If they had been allowed to rest and heal properly, they would have less health problems post career and young students would have a positive role model in terms of athletics. And this extends beyond athletics to dancers and other performers as well.
— Danglobal warming science has nothing to do with neuro sciences fact vs fiction
— msproppermdfacsAccurate understanding of the severity of brain concussive injury is essential to knowing how and when to be removed from activity. A company based in the US and Bosnia is leading the way to portable diagnostic tools. Brainscope.com.
— Geno - USAThere is a really good article on Concussion Management in Organized Sports at HeadBrainInjuries.com. It lists the specific guidelines of the American Academy of Neurology for keeping players with head injuries out of the game for a while.
— Stevehttp://www.headbraininjuries.com/concussion-management-sports