By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of, Orthopedic Surgery, Stanford University
Key Points:

  • More than a third of young athletes treated for concussions at a Texas sports clinic went back into the game after their injury despite safety recommendations
  • Whether the kids were unaware they had a concussion, or whether they intentionally withheld the injury from coaches or trainers is unknown
  • The study shows that there is still a need to educate players and coaches about the signs and symptoms of concussion, and to change the culture around reporting a possible concussion

By now everyone�??s heard what you need to do: if you suspect you might have a concussion P9250071you need to come out of the game immediately, and not play again until properly cleared by a medical professional skilled in sports concussion management. We�??ve been saying this in these pages for years; every major professional sports league has strict concussion protocols; every college does too. But a recently presented clinical study shows that kids playing sports still want to stay in the game after a possible concussion and many return to play in the same game or training session.
The research study, �??Same Day Return to Play After Pediatric Athletes Sustain Concussions,�?� was presented at the American Academy of Pediatrics (AAP) 2016 National Conference & Exhibition in San Francisco on Oct. 22. The study was conducted by clinicians at the Texas Scottish Rite Hospital for Children in Plano, Texas. Shane M. Miller, M.D., FAAP, a pediatric sports medicine specialist at Texas Scottish Rite Hospital for Children in Plano, Texas, noticed a significant number of his patients reported they returned to play after a concussion before being cleared by a medical professional, despite medical guidelines, state law and educational efforts.
38% of the players continued to play after the initial injury
The study authors analyzed records for 185 patients between the ages of 7 and 18 treated for concussion during a 10-month period in 2014. 71 (38 percent) reported returning to play on the same day as their initial injury. Patients who immediately returned to play after their injury reported less severe symptoms of dizziness and balance problems immediately after being hurt. The study doesn�??t address this specifically, but my feeling is that these kids probably didn�??t think their symptoms were enough for them to feel they had a concussion. By the time they were seen in the clinic, however, their symptoms had worsened.
What�??s going on? Either players are unaware of what a possible concussion feels like, or they are not reporting the injury to their coach or parents
Players want to keep playing. When it comes to injuries on the field, many injuries willssd.banner not be witnessed by the coach, referee, or even other players. The result is that many injuries require the injured players to report the injury themselves. Young players might not have knowledge about what a concussion feels like, the need for removal from play for proper recovery, and the risk of possible serious/permanent brain injury with a second concussion shortly after the first injury. We need to do better with our education. Also, players might know they have a concussion and intentionally withhold that information from coaches, trainers, or teammates. We need to do better about changing the culture around reporting.
Players, coaches, and parents must recognize a possible concussion and remove the player immediately
The study shows that we still have some work to do in changing the culture around play after possible concussion, and we also have some work to do in educating players, coaches, and parents about the signs and symptoms of a possible concussion. 38% is a big number, but perhaps even more kids were continuing play after concussion a decade ago. Let�??s keep working at making this number smaller.

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