Saying No To Return to Play

On a website with a tag line “About-From-For Physicians” a staff writer wrote an article about the troubles physicians have in returning athletes to play.  It is the job of a physician to protect the patient, but there are gray areas that toil with the mind.  Not unlike physicians, athletic trainers face the same situations, but with out an ‘MD’ behind their name.

But what about those gray areas? It’s the championship game, three points down in the fourth quarter with six minutes left on the clock at the 20-yard line. The star wide receiver receives a nasty tackle, and you know he’s suffered a minor concussion. As the professional team physician, you know what you must do, but the wide receiver is begging you to let him play, and the coach is breathing down your neck with threats and pleas. Or what about the senior high-school athlete whose only shot at a college education is to finish playing the game the university scout came to watch? Are you going to look the boy and his parents in the eyes and tell them, “Sorry, he’ll have to sit this one out”?

The fact is, these gray areas happen often and are some of the hardest calls to make. But at the end of the day, the physician’s job is to protect the wellbeing of the players — no matter the circumstances.

It is completely natural, in my opinion to understand and even sympathize with the ‘gray areas’ but physicians and athletic trainers alike should know and get solace in the FACT that it is a no-brainer.  The athlete should be OUT, not only for the 24 hour period that seems to be the “common practice” at this time, but much longer.

Would anyone consider putting a player with known broken tibia (non-displaced) back into play?  If there was a choice between the fractured tibia and concussion, the obvious choice is the leg being allowed to return.  However, doing that would set someone up for a MAJOR law suit.

The “Invisible Injury” of concussion is now being found to have long-term effects, regardless of how you understand or want to adapt to this issue, the fact remains that the player will sit.

One thought on “Saying No To Return to Play

  1. brokenbrilliant February 24, 2011 / 06:49

    Good post. I would also suggest that if everything is hingeing on one critical play or one critical player, there may be a larger issue, namely that there is not a sustainable foundation in place. Developing in many ways, so you can get to college, or developing a whole team rather than a few stars who carry the full load, are other ways of doing things. Obviously it is not always possible and the higher up you get, the more things can depend on individual excellence in isolated situations, but I do think this is worth considering. Are we unwittingly jeopardizing our best resources in some situations, because we put all our eggs in their basket?

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