Strict Rest Slows Recovery after Sports-Related Concussions

ACSM, Five Sports Medicine Organizations Publish New Guidance for Team Physicians

Nearly 1.8 million sports-related concussions happen annually in youth under age 18 in the U.S. Accurate diagnosis and treatment are key for recovery and long-term athlete health. The Team Physician Consensus Conference (TPCC), a project-based alliance among ACSM and five other professional sports medicine organizations, published new guidance to help team physicians effectively manage sports-related concussions in youth and athletes of all ages.

“If you’ve seen one concussion, you’ve only seen one concussion,” said Margot Putukian, M.D., FACSM, one of the lead authors and an executive committee member of the TPCC alliance. “Each concussion is unique and needs a thorough history and physical examination.”

The three primary takeaways for team physicians include:NFL sees concussion rates drop, fewest since 2014 - Global Sport Matters % %

  1. Sports-related concussions are treatable, and most athletes recover fully within two to four weeks. Symptom-directed management includes appropriate rest, introducing aerobic exercise, sleep hygiene, as well as proper nutrition and hydration.
  2. Prolonged, strict rest after sports-related concussions slows recovery. While an initial period of physical and relative cognitive rest is recommended, in most cases introducing medically supervised graded activity after two to three days aids recovery.
  3. Persisting symptoms need to be thoroughly evaluated and may require more comprehensive treatment. It is important to first make sure the brain injury has been diagnosed and treated correctly and then to assess for pre-existing, co-existing and/or resulting biopsychosocial factors that may be present and contribute to ongoing symptoms. A symptom-targeted treatment, which may involve a multi-disciplinary team, is often beneficial.

“Concussions are treatable and most resolve within a month,” adds W. Ben Kibler, M.D., FACSM, who is an orthopedic surgeon, team physician and another lead author of the paper. “If your athlete has persisting symptoms, seek treatment. Don’t give up!”

ACSM collaborated with the American Academy of Family Physicians, the American Academy of Orthopaedic Surgeons, the American Medical Society for Sports Medicine, the American Orthopaedic Society for Sports Medicine and the American Osteopathic Academy of Sports Medicine to develop this statement. It is the newest of 22 papers published by the six professional associations since 2000.

The alliance meets annually to review evidence-based research on a select medical issue related to athlete care. The resulting paper provides practical information for team physicians and other medical professionals to use when caring for athletes of all ages. Other topics addressed include return to play, sideline preparedness, injury and illness prevention, pain management and the team physician.

“For two decades, these papers have raised the call to keep athletes, especially our kids, safe,” added Dr. Putukian. “The papers serve as a trusted resource for coaches, administrators, athletes and parents.”

Selected Issues in Sport-Related Concussion (SRC | Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement” published online in the British Journal of Sports Medicine. It will also publish in the August 2021 issue of ACSM’s Current Sports Medicine Reports.

All team physician consensus statement documents can be found online at acsm.org.