One of the challenges with doctors and athletic trainers diagnosing a concussion is an athlete who continues to play. Sometimes athletes intentionally withhold symptoms in order to stay in the game. A lack of understanding of the signs and symptoms of sport-related concussion could explain other athletes who continue to play.
Does continuing to play after a sport-related concussion affect recovery?
Playing with a concussion and recovery time
A recent study published in the journal Pediatrics attempts to answer that question. R.J. Elbin, PhD and other researchers compared the duration of symptoms, recovery time and neurocognitive performance of 35 young athletes with a mean age of roughly 15 immediately removed from play after a concussion to 34 athletes who continued to play after a concussion.
The authors of this study observed some important differences between young athletes removed from play and those who continued to play:
• Athletes who continued to play had significantly longer recovery times. They were medically cleared to play at an average of 44 days after concussion, while athletes removed immediately were medically cleared at 22 days.
• 80% of athletes who continued to play experienced prolonged recoveries – 21 days or longer. Only 31% of the athletes removed immediately had protracted recoveries.
• Athletes removed from play had significantly fewer symptoms than those who continued to play after a sport-related concussion.
• At 1 to 7 days after the concussion, athletes who continued to play exhibited worse outcomes for reaction time, processing speed and verbal and visual memory. At 8 to 30 days after the injury, athletes who continued to play still had worse visual and verbal memory and processing speed than did athletes removed immediately.
Take home message about recovery and playing after a concussion
This study clearly demonstrates the risk of continuing to play after young athletes suffer concussions in sports. They are going to have more symptoms for longer periods of time and overall longer recoveries. They will ultimately be out of sports for longer than if they were removed right away.
This information is crucial for athletes, parents and coaches. Education, not only of these risks for prolonged recoveries, but also of the signs and symptoms of concussions, can help encourage athletes to report their symptoms. Then medical professionals can remove them from the game or practice and begin formal evaluation and treatment of the injury. Coaches can also recognize that pushing the kid to play through the concussion could lead to that athlete missing much more time with the team.
How can we encourage athletes to report symptoms of a concussion? How can doctors and athletic trainers encourage them to be treated and medically cleared prior to return to play? Please share your ideas below!
Elbin RJ, Sufrinko A, Schatz P, French J, Henry L, Burkhart S, Collins MW, Kontos AP. Removal From Play After Concussion and Recovery Time. Pediatrics. 2016 Sep;138(3).