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 “This was one of the first studies to tie-in a recovery consequence
to staying in the game and playing with a concussion,” said lead
author Robert J. Elbin of the University of Arkansas in
Fayetteville.
Continuing to play with a concussion may worsen the injury, and now
there’s evidence that it also keeps you from returning to play for a
longer period.
The researchers studied 95 athletes, including boys and girls aged
12 to 19 who sought care for a sport-related concussion at a
specialty clinic in the fall of 2014. In interviews, the athletes,
who were playing football, soccer, hockey, volleyball or basketball
when injured, reported their own medical history, injury-related
information and how quickly they had been removed from play after
the concussion.
They also underwent a battery of neurocognitive tests at the clinic,
one to seven days after the concussion, and again eight to 30 days
later. Researchers followed-up to determine how many days it took
for each player to be cleared to return to their sport.
Being cleared to return meant having no symptoms, either at rest or
after physical exertion.
The researchers compared 35 teens who were removed from play
immediately to 34 who continued to play, on average for another 19
minutes, before sitting out.
Those who kept playing took an average of 44 days to return to the
sport, compared to 22 days for those who were removed, according to
the results in Pediatrics.
Those who kept playing also had more severe neurocognitive symptoms
and a greater number of symptoms than those who were removed, as
well as being nearly nine times more likely to have a protracted
recovery period of more than 21 days.
“All post-concussion guidelines recommend immediate removal from
play to avoid risk of worsened injury,” said Dr. Christopher C. Giza
of UCLA Brain Injury Research Center, who was not involved in the
new findings.
It’s not clear if the continued physical exertion made recovery time
longer, or if some athletes may have sustained additional head
impacts after the concussion when they continued playing, Elbin told
Reuters Health.
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“Also, it is possible that some athletes not immediately removed
from play may be underreporting symptoms so as not to miss playing
time, but eventually if the symptoms are severe enough they then
report in a delayed fashion,” Giza said by email.
Another study published in April in the Journal of Athletic Training
found similar patterns of delayed return to play among athletes in
National Collegiate Athletic Association (NCAA) Division 1sports who
played through a concussion.
Sitting out for a short time after a concussion, with a concussion
that is properly diagnosed and managed, may ultimately help an
athlete recover more rapidly, miss less school and miss less of
their sport, Giza said.
“Since sometimes a concussed athlete may actually not be fully aware
of their impediments very early after concussion, teammates should
look out for each other,” Giza added. “If they see a team member who
shows impairment – earlier removal from play may stop a repeat
injury and/or may help with more rapid recovery,” he said.
“For youth athletes that present with a head injury, it’s
recommended that they’re immediately removed from play and seek
medical evaluation,” Elbin said. “Unfortunately 50 percent of
concussions go unreported.”
Players may not want to let their team down by sitting out, but
staying in the game appears to mean that you miss twice as much
actual playing time, he said.
“According to these data, continuing to play will let the team down
more,” Elbin said.
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