The Institute of Medicine and National Research Council on Wednesday called for a national system to track sports-related concussions and start answering those questions.
Despite a decade of increasing awareness of the seriousness of concussions, the panel found young athletes still face a “culture of resistance” to reporting the injury and staying on the sidelines until it’s healed.
“Concussion is an injury that needs to be taken seriously. If an athlete has a torn ACL on the field, you don’t expect him to tape it up and play,” said IOM committee chairman Dr. Robert Graham, who directs the Aligning Forces for Quality national program office at George Washington University.
“We’re moving in the right direction,” Graham added.
But the panel found evidence, including testimony from a player accused by teammates of wimping out, that athletic programs’ attention to concussions varies.
Reports of sports concussions are on the rise, amid headlines about former professional players who suffered long-term impairment after repeated blows.
Recent guidelines make clear that anyone suspected of having a concussion should be taken out of play immediately and not allowed back until cleared by a trained professional.
Although millions of U.S. children and teens play school or community sports, it’s not clear how many suffer concussions, in part because many go undiagnosed.
But Wednesday’s report said among people 19 and younger, 250,000 were treated in emergency rooms for concussions and other sports-or recreation-related brain injuries in 2009, up from 150,000 in 2001.
It’s not always easy to spot a concussion – symptoms might not be obvious right away – yet most young athletes practice and play without routine access to a professional trained to check them, the panel said. That can leave the decision to bench players up to coaches and parents.
That’s especially true before high school and in community leagues.
Without training, people might not realize you can have a concussion without losing consciousness, or that you can still have symptoms despite a clean CT scan.
Typically, youth athletes recover from a concussion within two weeks. But in 10 percent to 20 percent of cases, symptoms can persist for weeks, months, and occasionally even longer, the report found. A second blow before full recovery is especially dangerous.
Nor is the concern only about physical activity.
The American Academy of Pediatrics this week said teachers might need to ease students back into learning after a concussion.
There’s increasing evidence that too much mental activity can prolong recovery, too. Sensitivity to light, headaches or memory difficulties might require breaks or extra time on assignments when the student returns to class, the pediatricians’ policy says.
The IOM report also said:
• Youths who’ve already had a concussion are at higher risk for subsequent ones.
• Calls for a “hit count” to limit the number of head impacts in a week or a season make sense, but there’s no evidence to say what that number should be.
But the report shouldn’t scare parents into pulling their kids out of sports, injury experts stressed.