One of the main tenets of state concussion laws passed around the U.S. in the last decade has typically been mandatory removal from play for athletes following a suspected concussion. Now two studies published in the last year demonstrate one of the reasons why this is so important.
The first study, published in the Journal of Athletic Training last April, looked at NCAA Division 1 athletes and showed that those who were immediately removed from play after a concussion-causing event missed, on average, 5 fewer days following injury compared to those who were not immediately removed from play. Athletes with delayed removal from play were also 2.2 times as likely to suffer delayed recovery (defined as 8 or more days).
The second article studied younger athletes between the ages of 12-19 and was published in September
in the journal Pediatrics. It concluded that for those athletes who continued practicing or playing following a concussion, the mean number of days from injury until medical clearance was double that (44 vs 22 days) of athletes who were immediately removed from play. In addition, athletes who had delayed removal from play were 8.8 times more likely to suffer prolonged recovery, defined in this case as ≥ 21 days.
While both studies seem to show conclusively that continuing to participate in sports following concussion leads to delayed recovery, it is unclear why this is the case. Continuing to play certainly leads to increased exposure to further trauma and it’s possible those that were not removed from play suffered additional injury. Alternatively, there may be something about the metabolic or physiological impact of continued physical activity following concussion that adversely affects the athlete and his/her recovery.
These studies reinforce the importance of educating athletes, families, coaches, officials and health care professionals regarding concussion signs and symptoms and why it is necessary to remove from play any athlete with a suspected concussion. While often there is little that can be done to prevent concussions during sports, proper intervention following injury- starting with prompt removal from play, may shorten the course of recovery.