Evolving Treatment for Concussions

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Concussions are a major concern for athletes, sports organizations and parents. But what was customary for treating concussion symptoms in the past, and the requirements for permitting an athlete to return to play after a concussion, continue to evolve. This can lead to confusion, so let’s clear up some of the issues. The Centers for Disease Control and Prevention states, "A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth."

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A New Approach for Long-Term Recovery

Concussions are complicated and everyone who suffers one may experience a unique set of symptoms and effects. Medical providers need to update how concussions are treated—especially in athletes.

Historically, the "cocoon theory" was used for treating concussions in athletes. The basic premise was doctors advised an athlete to avoid all physical activity until all concussion symptoms resolved. Early on, rest certainly is within reason immediately following a concussion. However, the cocoon theory’s call for extended rest for long-term concussion recovery has fallen out of favor.

These days, guided by new research, experts consider early, graduated and monitored physical activity an ideal approach to concussion recovery. Monitoring is key: The athlete needs to be watched closely by a medical professional, ideally a neurologist or sports neurologist who has sports medicine experience.

Monitoring Is Crucial

The medical monitoring of athletes who have sustained a concussion is essential. It isn’t enough to have a concussion diagnosed in an emergency room and then allow the patient-athlete to go on about their business after a few days of rest. Because concussions are brain injuries, they require follow-up care. Patients should never decide on their own when it’s acceptable to return to play.

We, as clinicians, have spent decades evaluating concussions and brain injuries. This extensive work has enabled us to identify predictors of possible prolonged recovery from a concussion. The sooner we can evaluate and care for our patient-athletes—potentially employing medications and therapies known to help—the sooner we can help them return to the sports they love, healthy and free from concussion symptoms that can put them at further injury risk.