New guidance on sports related concussion

A new consensus statement on sports-related concussion is outlining the best course of action and the factors linked to persisting symptoms.

Sport-related concussion is a common injury usually managed by team physicians. The new statement by the Team Physician Consensus committee, comprised of six major US professional associations, updates guidance published in 2011.

It is based on US emergency department visits and doctors’ appointments and appears today in the British Journal of Sports Medicine.

It states: "The diagnosis of sport-related concussion remains a challenge due to non-specific symptoms and lack of objective biomarkers".

However, this is a treatable condition, and the number and severity of initial symptoms is the best predictor of how long recovery will take.

The authors weighed up the current evidence and believe that strict rest after concussion slows recovery and increases the probability of prolonged symptoms.

They explain that most athletes recover within a typical timeframe of two weeks for adults and up to four weeks for children.

Symptoms which continue beyond this time are referred to as persisting symptoms after sports-related concussion and are likely to be caused by a number of pathologic processes, "an interaction of postinjury symptoms that are complicated by pre-existing, coexisting and/or resulting biopsychosocial factors".

The management of disabling persisting symptoms often requires a multidisciplinary approach, the authors add.

Dr Margot Putukian, a committee member of the Team Physician Consensus Conference, said: “Most athletes who have been concussed will get better, and will be able to return to play. Each injury is unique and will have its own timeline. But athletes should take comfort in knowing that there are treatments out there, and there are steps they can take to aid their own recovery."

Herring, S. et al. Consensus statement: Selected issues in sport-related concussion (SRC mild traumatic brain injury) for the team physician: a consensus statement. British Journal of Sports Medicine 16 June 2021; doi: 10.1136/bjsports-2021-104235

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