Protecting Athletes from Concussion an Ethical Obligation

Statement calls on doctors to make education a priority

Brain Scan

Doctors have an ethical obligation to educate and protect athletes from sports concussion, says a new position paper from the American Academy of Neurology (AAN).

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The AAN, the largest professional association of neurologists, released the statement today.

The position paper calls on doctors to make protecting the future mental and physical health of young athletes a top priority. Physicians should educate athletes, their parents and their families about the dangers of concussions in all relevant sports, the statement says.

Doctors also should work to identify the various risk factors related to concussion and the number of head injuries that could cause irreversible brain damage, the statement says.

In addition, the statement calls for:

  • Increased use of baseline cognitive testing
  • More concussion training in neurology residency programs
  • Development of a national concussion registry with mandatory reporting

Traumatic brain injury

A concussion is a mild traumatic brain injury caused by a bump, jolt, or blow to the head. The sudden movement causes the brain to bounce around or twist inside the skull. This leads to stretching and damaging of brain cells and chemical changes in the brain.

A jolt to the body also can cause a concussion if the impact is strong enough to cause the head to forcefully jerk backwards, forwards, or to the side.

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A concussion is classified as “mild” because it is not usually life-threatening. However, the effects from a concussion can be serious and last for days, weeks, or even longer.

Football, rugby, hockey and soccer are the high school sports with the greatest risk of concussion, the AAN says.

The Centers for Disease Control and Prevention (CDC) estimates that anywhere from 1.6 million to 3.8 million sports-related concussions occur each year. Nearly half of athletes (47 percent) who suffer concussive blows don’t report their symptoms, the CDC says.

Up to speed

Sports health physician Richard Figler, MD says primary care physicians in particular should take note of the AAN statement.

Dr. Figler did not work on developing the statement, but treats athletes with concussions at Cleveland Clinic. He is the co-medical director of Cleveland Clinic Concussion Center.

“The root of this is going to be education for the primary care doctor and all licensed health care providers who take care of concussions,” Dr. Figler says. “Depending on the practice, they may only see concussions every once in a while. We all need to make sure we are up to speed on everything we can to do to make sure the athlete’s brain is protected – not just when the athlete is injured, but in the future as well.”

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The AAN released guidelines in 2013 that said players showing signs of concussion should be immediately removed from a game or practice. These athletes should not return to play or practice until they have been assessed by a licensed health care professional trained in concussion.

Proper recovery critical

A proper recovery time from concussion is critical, Dr. Figler says. The brain’s ability to heal is impaired if the athlete takes another hit within the period of recovery. This period of recovery can range from immediately after the first hit to until the symptoms are completely resolved, Dr. Figler says.

The issue is of particular importance for young athletes, Dr. Figler says

“These young developing brains may have a little bit more to lose because they’re being injured at a key developmental stage,” Dr. Figler says. “We need to protect these athletes from further injury by not sending them back too soon.”

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