1 in 3 Athletes Returns to Sports Same Day as Concussion

Concussion protocols for youth sports in all states discourage athletes from returning to the game if they show signs of a concussion after a head hit, but a recent study indicates that most youth athletes, their coaches and the leagues in which they play aren’t exactly following these protocols.

In the study, researchers at Texas Scottish Rite Hospital for Children reviewed the medical records of 185 patients between the ages of 7 and 18 who had been treated for a concussion at a pediatric sports clinic over a 10-month period. Seventy-two percent of these patients were male, 47 percent of the 185 patients got a concussion playing football, while 16 percent sustained a concussion playing soccer.

Researchers discovered that 38 percent of these patients got back on the field the same day following their concussion. These patients didn’t have severe balance problems or issues with dizziness when they returned to play, but when they were finally seen by a medical professional their symptoms had worsened. They had severe nausea, dizziness, balance issues, sensitivity to light and noise, a feeling of pressure in the head, sleep problems, confusion and lack of concentration.

Gender, age, type of sport, location of the initial injury and the athlete’s initial symptoms didn’t result in any statistical differences in the study between athletes who returned to play on the same day and those who didn’t, researchers said.

“When in doubt, sit them out” — that was the main principle of the new concussion guidelines issued a few years ago. Based on the study above,  it appears that athletes, coaches and youth sports leagues aren’t abiding by it. This is putting youth athletes at risk, especially during a key time in their cognitive development.

It’s clear we need more objective methods to accurately determine when an athlete is concussed, shouldn’t re-enter the game and should seek further medical intervention. In my work as an emergency physician at Orlando Regional Medical Center, I see head injuries and concussions far too often. I’ve spent more than 15 years researching concussions — before it became a hot-button issue in sports — so I truly understand the long-term risks of these head injuries.

Sometimes the scans and physical exams don’t really tell us what’s going on when someone comes in with a concussion. But something else might: a blood test. Over four years, from 2010-2014, we examined nearly 600 patients — about half of whom had head injuries as a result of car accidents, falls, sports and other incidents — and found that those with brain injuries often had two proteins in their blood, GFAP and UCH-L1 measurable within an hour of injury. UCH-L1 appeared and decreased very quickly but GFAP lasted for up to a week after injury and indicated a concussion. The amount of these proteins present in the blood also indicated the severity of the brain injury and whether a patient needed neurosurgery. Previous research we’ve done in children shows that a blood test is 94 percent accurate in detecting brain injury compared to a CT scan even in very young children.

If patients are waiting to get treatment after a concussion, this blood test could help us identify the concussion early and give them the treatment they need immediately. This blood test is a few years away from being implemented, but it also could be applied on the field in real-time, further helping concussed athletes and preventing them from returning to play and possibly suffering another — or even worse — injury.

I understand that athletes are fierce competitors at heart and it’s part of the reason they’re eager to return to play, but in many instances the potential risks are just too great for them to do so. About 2.5 million people visit the ER every year because of concussions and other brain-related trauma, according to the Centers for Disease Control and Prevention (CDC). With more objective tests like these — and by following concussion protocols more closely — we can keep more youth athletes safe and prevent them from suffering brain injuries that may impact them for the rest of their lives.