Removal from Play After Concussion Shortens Recovery Time

The New York Times reported on a new study that states high school athletes who are removed from play after a concussion recover twice as quickly as those who keep playing.


A new study shows that adolescents who are removed from play immediately after a concussion recover twice as fast than those who keep playing.

“The goal was to compare recovery times and clinical outcomes between athletes that stayed in the game and those who were immediately removed following their injury,” said lead author Robert Elbin, who is also an assistant professor of exercise science at the University of Arkansas.

The results of the study were published in the journal Pediatrics. Medical guidelines call for benching the player immediately after a head injury to avoid potentially long-term consequences and the devastating effects of a second hit, which could result in the potentially fatal second impact syndrome.

Quoting the CDC, Elbin said, “It’s better to sit out one game than the rest of the season.” Another phrase he used: “When in doubt, sit them out.”

Sometimes the culture around sports encourages playing through the pain. We’ve all heard the phrases “no pain, no gain” and “walk it off.” Sometimes high school players are looking for scholarships or feel pressure from their coach or parent to keep playing. However, removing players from play immediately after a head injury is the first step to lessen prolonged sports-related concussion recovery.

“This sends a powerful message not only to physicians and clinicians, but also sends a powerful message to parents, coaches, and even the athletes themselves,” Elbin said.

The study included 69 high school players who visited the University of Pittsburgh Medical Center Sports Medicine Concussion Program after suffering head injury during a contact sport, such as football, ice hockey, volleyball, field hockey, basketball, wrestling, and rugby. The athletes ranged from 12 to 19 years old. According to the program, five to eight percent of high school football players will suffer a concussion this year.

In this study, there were 35 athletes who were removed immediately from the game after a sports-related concussion, and 34 athletes who continued to play. The researchers measured neurocognitive performance, symptoms, and recovery time. The study found that those who were removed immediately from play took 22 days to recover, and those who kept playing took 44 days to recover, twice as long. Also, the group who played showed worse neurocognitive performance and greater symptoms than the group who was removed.

Recovery happens when the athlete’s symptoms or impairments return to their pre-injury, baseline levels, Elbin said. They will gradually try to return the athlete to play, starting with exercise and symptom monitoring. As part of the concussion protocol, the athletes will often have domains measured before the season starts to be used as baseline.

“This research is important because this is one of the first studies who examined athletes who weren’t removed from play,” Elbin said. “It underscores the importance of immediate removal from play.”

Although this study was small, researchers say that it still shows the importance of physical and cognitive rest immediately following a concussion. The study will help bolster the opinion of doctors that resting immediately following a concussion will allow more play time, not less. Resting immediately after a concussion allows brain cells to heal faster so athletes get back to playing more quickly.

“It shows the athlete that reporting the concussion is the best chance to getting back to play,” Elbin said.

There are up to 3.8 million sports-related concussions every year, according to a study. A concussion occurs when the soft brain bounces around in the hard skull, stretching and damaging brain cells. Dizziness, confusion, nausea, and sensitivity to light are among the possible symptoms.

A younger age makes people more prone to complications from concussion and prolonged recovery because the brain is still developing, which makes it more vulnerable.

Even though there is more awareness about concussions, a large portion of concussions go unreported, according to the New York Times. The sports mindset is often to play through the pain. However, concussions can cause problems like pain, trouble sleeping, and trouble in school. Awareness varies depends on the resources available at the school.

The study did not report if the players who stayed in the game suffered another impact or just continued physical exertion. In the future, researchers should look into why being removed from play shortens recovery time.

All in all, this study can be a tool for doctors to point to empirical evidence that shows resting after a concussion will cut recovery time by half.


Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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