May 02, 2013
By Andy Hyland
More than one million athletes experience a concussion in the United States each year, and now a national group of neurologists are recommending that any athlete who shows signs of a concussion should be immediately removed from play.
Gary Gronseth, M.D., a professor of Neurology at the University of Kansas Medical Center, was on the American Academy of Neurology panel that wrote a new set of guidelines for athletes, released earlier this year.
"On the field, if there's any doubt, take them out," Gronseth says. "Let them be fully evaluated by someone who is skilled in evaluating concussion. And if they have a concussion, keep them out until the signs and symptoms of a concussion go away."
Gronseth and his colleagues reviewed more than 10,000 research citations and hundreds of academic papers published on the subject through June 2012 to ensure the guidelines were as up-to-date as possible. The guidelines are available online.
The researchers found that the blame for why players will go back too soon more often rests on the players themselves than on coaches or medical staff.
"They want to get back in there," Gronseth says.
Among all sports the group studied, football and rugby posed the highest risk for concussion, followed by hockey and soccer.
For young women and girls, the risk of concussion is greatest in soccer and basketball, according to the research.
The available research on the topic shows no evidence that one type of football helmet provides better protection against concussions than other helmets.
"We're definitely not saying that helmets aren't a good idea," Gronseth says. "But you can't claim that one helmet is better than another."
The brain essentially floats in a fluid inside the skull, Gronseth says. The fluid acts as a cushion to protect the brain from injury. Often, concussions are the result of rapid rotational movement of the head when the brain strikes the sides of the skull. In those cases, a helmet can't always offer protection.
The group also looked at factors that place players at risk for a concussion. The highest risk factor was whether a person had a previous concussion. The risk for another concussion was highest in the 10 days after the initial concussion, Gronseth says.
A tougher decision for athletes can be the choice to stop participating in sports completely.
"The more concussions you're getting, the more you're going to get," Gronseth says. "If you see any permanent cognitive decline, you shouldn't be back on the field."
Several sports associations — including the National Football League Players Association — and medical groups have endorsed the new guidelines, but Gronseth says more education is needed.
"Entities responsible for organized sports — and parents and athletes — need to be counseled about the risks of concussions," he says. "I think we assume they know, but many times they don't."