TORONTO – If coaches on the field suspect that their player is showing symptoms of a concussion, that player should be pulled out of the game immediately, according to the latest update to American guidelines on handling the head injury.
The updated rules list football and rugby as the sports with the greatest risk of concussion, followed by hockey and soccer.
The new guidelines replace recommendations made in 2007 by the American Academy of Neurology. They were released Monday in the journal Neurology.
Athletes showing signs of concussion shouldn’t return to the sport until they’re assessed by a doctor, these firm guidelines dictate.
“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,” co-lead author Dr. Christopher Giza said in a statement.
“There is no set timeline for safe return to play.”
Read more: Panel finds helmets, mouth guards don’t prevent concussions
It’s estimated that more than a million athletes in the U.S. experience a concussion each year. The symptoms include:
• Headache and sensitivity to light and sound
• Changes to reaction time, balance and coordination
• Changes in memory, judgment, speech and sleep
• Loss of consciousness or a “blackout” (happens in less than 10 percent of cases)
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The guidelines are endorsed by the National Football League Players Association, the American Football Coaches Association, the Child Neurology Society and a handful of other nationwide groups. In an effort to crack down on head injury in sports, these organizations have poured funding into researching brain injury, its long-term implications and treatment.
Other statements in the guidelines, according to a press release, include:
• An athlete who has a history of one or more concussions is at greater risk for being diagnosed with another concussion.
• The first 10 days after a concussion appears to be the period of greatest risk for being diagnosed with another concussion.
• There is no clear evidence that one type of football helmet can better protect against concussion over another kind of helmet. Helmets should fit properly and be well maintained.
• Licensed health professionals trained in treating concussion should look for ongoing symptoms (especially headache and fogginess), history of concussions and younger age in the athlete. Each of these factors has been linked to a longer recovery after a concussion.
• Risk factors linked to chronic neurobehavioral impairment in professional athletes include prior concussion, longer exposure to the sport and having the ApoE4 gene.
In these guidelines, doctors spent thousands of work hours scouring scientific studies to come to a consensus on concussion research. At least two authors independently analyzed and graded each study.
International guidelines warn of helmets, mouth guards in sports
The U.S. guidelines come on the heels of an international report on concussion in sports.
In an updated consensus statement, about 30 doctors from around the world say that even the most advanced protective equipment, such as helmets and mouth guards, don’t necessarily prevent a concussion.
These findings were co-chaired by Canadian experts at the University of Calgary’s Brain Injury Initiative.
Their new guidelines, updated for the fourth time since they were first issued in 2001, also offers advice on how to diagnose and treat concussion during recovery.
The international panel also suggested that absolute rest isn’t a good idea for players – they should ease into adding school, extracurricular activities and even light exercise into their daily lives. Once they get the green light from a doctor, they can return to sports again.
Read the American guidelines here.
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