Tougher Concussion Rules for Athletes

Concussion guidelines suggest young injured athletes be removed from play

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Coaches and trainers will no longer think twice about pulling an athlete out after a severe smack to the head.

Young athletes suspected of having a concussion are to be pulled from play immediately and undergo more strict and thorough testing for the injury, according to revised guidelines published today by the American Academy of Neurology.

Athletes must be properly cleared by a licensed medical professional before being allowed back in the game, especially high school level athletes and younger.

"Play it safe and get your head checked."

Under the updates, athletes cannot return to play until they are completely cleared of a concussion by a licensed healthcare professional trained in concussions.

The academy found that younger athletes take longer to recover than college athletes. Athletes who are in high school or younger grades should be managed more conservatively before getting back on the field or court. 

In addition, athletes who have had concussions in the past are likelier to be diagnosed with another concussion. Any athlete who sustains a concussion, according to the guidelines, is likely to get another concussion within the first 10 days after being injured.

The academy had several aims behind their revisions to the original guidelines that were first released in 1997, including determining what increases or decreases concussion risk and identifying the best tools to diagnose concussions and more severe conditions linked to head injury.

Researchers also aimed to see what interventions can speed up the recovery process and find out what increases the risk for severe or prolonged early post-concussion impairments.

For football players, there's no one helmet that works better than another. All should fit well and be properly maintained, according to the guidelines.

After the athlete has returned to play, the academy recommended that licensed health professionals continue to look for ongoing concussion symptoms, particularly fogginess and headaches. Professionals should keep in mind athletes' age and history of concussions.

Other concussion signs include sensitivity to light and sound, and changes in the athlete's balance, coordination, reaction time, memory, judgment, speech and sleep patterns. More serious signs include loss of consciousness and blackouts.

The updates to the original guidelines were developed after reviewing all available studies and research on concussions published through last June.

“Among the most important recommendations the Academy is making is that any athlete suspected of experiencing a concussion immediately be removed from play,” said co-guideline author Christopher Giza, MD, from the David Geffen School of Medicine and Mattel Children’s Hospital at UCLA and member of the AAN, in a press release. 

“We’ve moved away from the concussion grading systems we first established in 1997 and are now recommending concussion and return to play be assessed in each athlete individually. There is no set timeline for safe return to play,” he said.

The risk of concussion is highest in football, rugby, hockey and soccer, according to the guidelines. For women and young girls, risk is greatest in soccer and basketball.

Funding for the research, which was published March 18 in the journal Neurology, was provided by the American Academy of Neurology.

The guideline is endorsed by the National Football League Players Association, the American Football Coaches Association, the Child Neurology Society, the National Association of School Psychologists, the National Association of Emergency Medical Service Physicians, the National Athletic Trainers Association and the Neurocritical Care Society.

Reviewed by: 
Review Date: 
March 17, 2013
Last Updated:
March 18, 2013