Researchers found that in the first weeks of play after time off for
a concussion, major league players performed worse than players
coming back from non-medical leaves of absence.
“One of the things we’re always trying to understand is what is the
impact of concussion on anything someone does,” said Dr. Jeffrey
Bazarian, the study’s senior author and a concussion expert at the
University of Rochester in New York.
Unlike other sports and activities where concussions are common,
Bazarian told Reuters Health in a phone interview that baseball
provides researchers with a unique opportunity.
“The thing that’s nice about baseball is that there are so many
statistics kept on each player,” he said, adding that they can see
how a player performs before and after a leave of absence.
For the study, published in the American Journal of Sports Medicine,
the researchers used information on Major League Baseball (MLB)
players from a performance database and disabled list records. They
found 66 concussions from 2007 through 2013 after eliminating
players with missing data, repeat injuries or leaves longer than 35
days. There were 68 times players took bereavement or paternity
leave.
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Players with concussions were off the field for an average of about
11 days, compared to an average of about five days for those out on
bereavement or paternity leave.
After accounting for the players’ performance before their leaves,
their playing positions and the time they spent off the field, the
researchers found that players with concussions performed worse in
the two weeks following their return, compared to those out on
leave.
For example, the batting average, which is the number of hits a
player has divided by their number of times at bat, was 0.235 for
players returning from concussion, compared to 0.266 for players
returning from bereavement or paternity leave.
“We would speculate that the concussion affects a few brain pathways
involved with the skill of hitting a ball coming at you at 90 miles
per hour,” Bazarian said, adding that it may affect tracking the
ball and upper body and head coordination.
MLB’s current concussion protocol includes neurological testing for
athletes before the season to compare with test results after
concussions. It also includes a seven-day disabled list for
concussions and protocols for allowing players to return to play.
“We feel that the fact that the rate of concussion is very low in
Major League Baseball and most people don’t return to the disabled
list after they’ve been clear is pretty good,” said Dr. Gary Green,
MLB’s medical director. “We also track these people when they return
to play to make sure they’re not experiencing any symptoms.”
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Green, who was not involved in the new study, also pointed out
several issues that may affect the study’s results, including vast
differences between the two groups in the number of days missed and
the positions played. Also, he said, the databases used for the
study may not accurately capture what is and is not a concussion.
“The problem with the paper is it has major mythological flaws that
prevent it from having a whole lot of value,” said Green, who is
also a sports medicine expert at the University of California, Los
Angeles.
He also said that it’s in the teams’ best interest to make sure
their players are delivering their best performances.
“Why would a team put a guy out there if they’re not going to be
performing at their highest level,” he noted.
Bazarian and his colleagues suggest in their paper that current
tests may not be sensitive enough to pick up lingering issues that
affect accuracy on the field.
“This is a great example where we think people are recovered and
they may not be,” Bazarian said.
The researchers can’t say whether the players, if they are not fully
recovered, are harmed by returning to the field with some lingering
problems stemming from the concussion.
“That’s really the implication for not just Major League Baseball,
but college baseball and high school baseball,” Bazarian said. “We
need to do more research to figure that out.”
SOURCE: http://bit.ly/1FKeBVz American Journal of Sports Medicine,
online March 17, 2015.
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