AAN: “A New Game Plan for Concussion”

The American Academy of Neurology has defined a more comprehensive stance when dealing with concussions.  The AAN released a position statement regarding the initial management of concussions, last November;

1. Any athlete who is suspected to have suffered a concussion should be removed from participation until he or she is evaluated by a physician with training in the evaluation and management of sports concussions.

2. No athlete should be allowed to participate in sports if he or she is still experiencing concussion symptoms.

3. Following a concussion, a neurologist or physician with proper training should be consulted prior to clearing the athlete for return to participation.

4. A certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk for concussion.

5. Education efforts should be maximized to improve the understanding of concussion by all athletes, parents, and coaches.

Neurology Now a publication for “healthy living for parents and their families” has published an article by Kate Gamble that takes a closer look at why the statement was made.  With the back drop of new and expanding research along with stories like Tommy Mallon Gamble interviews the likes of Dr. Julian Bailes and Dr. Jeffery Kutcher to explain why we need to readjust the stigma of concussions;

Dr. Kutcher is also chair of the Sports Neurology Section of the American Academy of Neurology (AAN), which the Associated Press recently dubbed “the most authoritative medical group when it comes to concussion.” The AAN drafted a position statement in November 2010 to help guide the management of athletes with suspected concussions. Although “the majority of concussions are self-limited injuries, catastrophic results can occur, and we do not yet know the long-term effects of multiple concussions,” Dr. Kutcher said in the position statement, adding that the neurology community owes it to athletes to “advocate for policy measures that promote high quality, safe care for those participating in contact sports.”

As for where the research is going;

More research needs to be done on the long-term consequences of concussions, says Dr. Bailes. He believes that future studies will also look at the ability to make a definitive diagnosis through neuropsychological testing and imaging. “We’re also looking into the field of biomarkers [indicators that may be used to determine how well the body responds to treatment], and at genetic testing,” he said, adding that “there may be a subset of the population that is genetically predisposed to concussions.

“We’re seeing not only more research and understanding, but also an acceptance of the fact that concussions are real and need to be managed appropriately,” Dr. Bailes says. “If we do so, I think all of our sports are going to be around for every one to enjoy for many years.”

What is clear by this article and the interviews is that concussions remain an injury that is misunderstood by the general public.  There are few professionals that truly understand the injury and how to handle a concussion from start to finish.  The article even highlights how athletic trainers are a leader in this area especially when dealing with initial evaluation and return to play decisions;

“Athletic trainers have the experience and the training to be able to block out all of the environmental distractions that exist during games and triage an injury,” says Dr. Kutcher, who is also a team physician for the University of Michigan and Eastern Michigan University athletic programs. And trainers are taught to be completely objective when evaluating athletes.

“While I would love to think that all parents, coaches, and teammates can have objective viewpoints on these injuries, the truth is, that’s hard to do. Athletic trainers accept that responsibility, and they’ve developed the skills to not let the person’s position of importance to the team—for example, the starting quarterback—affect their clinical judgment.”

We are fully on board with what was written, now to get this information out to everyone.  (Thanks to Glenn Beckmann for passing this along)

6 thoughts on “AAN: “A New Game Plan for Concussion”

  1. brokenbrilliant April 6, 2011 / 07:44

    Great news about this. Now, if we can get more docs properly trained and aware, and we can have more education that’s factual and presented in a way that gives people the tools to recognize and respond appropriately… AND we can get more info on long-term consequences, that will be great.

    I think one of the issues around long-term consequences, is that a lot of folks who have sustained (one or more) concussions in their past may have a lot to lose, should it be known that they have a history of head injury. The public ignorance and prejudice is still pretty bad. But we can start following people now and watch them over the long term.

    Also to consider — in our urgency to impress upon people the seriousness of concussion, are we perhaps unconsciously encouraging people to remain injured, to prove that they had an injury? This is one of the real pitfalls of public education — on the one hand, you don’t want people to take it lightly, but in the name of proving the seriousness of brain injury, do we perhaps inhibit the recovery that’s possible, for fear that it might detract from the perceived seriousness of the damage?

    Just asking…

    • Dustin Fink April 6, 2011 / 12:28

      Very good questions BB… I think it is a fine line, but the information and stigma of TBI is so backwards that the pressing, I feel must be done. I also really like your point about the “a lot to lose” with letting that information out. I can tell you I feared this A LOT… But when I came clean with everyone, I came clean with myself. I know this is not possible for everyone but it made me feel better about me.

  2. Ron Hutchins April 6, 2011 / 08:12

    I don’t understand why being in the classroom isn’t being addressed. Our concussion policy states we don’t want our kids in school until symptom free. Cognitive stimuli is an obstacle as well as physical exertion in the way of having someone get symptom free. I scratch my head every time concussions are talked about in the adolescent population and people say don’t exercise but say nothing about cognitive rest.

    • Dustin Fink April 6, 2011 / 12:25

      Thank YOU Ron!!! I agree in the strongest terms… Cognitive activity is just as bad or could be worse than physical activity in regards to recovery!!!!

  3. Jackie Dooley June 3, 2011 / 19:11

    How do you know when your 13 year old daughter is ready to return to sports and activity after a mild concussion? How can we teach girls to “hit the floor” or “fall”? In basketball they seem to always fall/flop back on their heads.

    • Dustin Fink June 4, 2011 / 07:58

      As a parent you will “know” when she is back to normal. What should be monitored is any symptoms that come back. We need to remember that a concussion does not resolve in a linear fashion like other injuries, it is up and down. One day is a good day the next is not so good.
      Your second point is a valid one, I have seen more and more concussions from girls due to this issue. It just seems – observationally – that girls have problems falling gracefully. A great question…

      Thanks for asking, tell Jenni I say hi…

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