Return-to-Play Guidelines in Concussion: A Closer Look at the Literature

Abstract

Traumatic brain injuries that occur during sports have gained significant attention in the literature. Despite improved education and research on proper identification, risk management, and treatment, standardized methods for returning an athlete to play after a concussion are lacking in universal applicability. Current return-to-play guidelines are considered appropriate for the majority of athletes who recover within a few weeks. However, applicability of such guidelines becomes difficult when treating those athletes who experience prolonged symptoms or do not have the resources available to adequately manage complex presentations of concussions. Understanding the guidelines with consideration to special populations will assist the treating physician in providing an appropriate and individualized evaluation and treatment plan to safely return an athlete with a concussion back to play without compromising his or her health.

Comparative analysis of state-level concussion legislation and review of current practices in concussion

“…26 Certain situations warrant special consideration in concussion management, such as individuals with multiple concussions, younger athletes, and persons with prolonged symptoms after concussion. 57 Athletes with prolonged symptoms tend to have a higher referral pattern to physicians for evaluation, 51 so it is not unreasonable to infer that these more complex cases are more frequently seen by physicians, further reinforcing the importance of physician education, especially in more complex presentations.…”