Return to Play

If it was up to Dr. Lester Mayers, young athletes who suffer sports concussions would be not be allowed to return to play (RTP) for 4 to 6 weeks after injury, a significant departure from current concussion guidelines which allow RTP 1 to 2 weeks after an athlete's concussion signs and symptoms clear, both at rest and during exercise.

The SCAT3 is a standardized method of evaluating injured athletes for concussion ages 13 years and older. Although designed for use by medical and health professionals, it includes advice for athletes and parents about signs to watch for in the first 24 to 48 hours after suspected concussion and a list of other important points, including the need for rest and avoiding strenuous activity, and not training or playing sport until medically cleared.

Baseline and post-concussion neuropsychological (NP) testing is now recommended for all athletes in sports with a high risk of concussion (e.g. football, lacrosse, hockey, soccer, basketball), regardless of age or level of performance, but the timing and type of testing may need to be adjusted for children and adolescents.

The question of when it is safe for your child to return to the playing field after suffering a concussion is largely a matter of clinical judgment on an individualized basis, but some hard and fast rules do apply.

The last five to ten years have seen a dramatic increase in the number of reported cases of second impact syndrome (SIS) which occurs when an athlete who sustains head trauma, i.e. a traumatic brain injury - often a concussion or worse injury, such as a cerebral contusion (bruised brain) - sustains a second head injury before signs of a concussion with the first have cleared.

Parents should have the right to expect, if their child is playing contact or collision sports, that he or she undergo pre-season baseline and post-injury neuropsychological testing as the current consensus statement on concussions recommends for athletes in such sport, regardless of age or competitive level.

Less than half of U.S. high schools have an athletic trainer on staff.  Given their key role in assessing sports concussions and return to play decisions, every school should have one.

The AT is an invaluable member of the sports medicine team, particularly when an athlete suffers a concussion, because they have specialized training, and see athletes on a daily basis.  Because they are trusted by athletes, they can encourage the honest self-reporting that is key to avoiding delayed recovery or catastrophic injury.