The Complicated Issue of Benching Young Athletes With Concussions


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As sports-related concussion education and awareness increases, it is becoming quite apparent that there are other issues preventing child-athletes and their parents from following the best advice for their health.

It is highly common for athletes to hide symptoms from brain injuries, and parents are often supportive of the decision to ignore doctors’ recommendations to avoid returning to play until brain injury symptoms are entirely gone, or to cut back on schoolwork.

It has been proven that both strategies help to speed recovery, and more importantly, returning to play and risking another hit to the injured brain greatly increases the risk of long-term problems but emotions often get in the way. According to a position paper released by the American Academy of Neurology this week, those tendencies highlight the need for doctors to remain strong in the face of patient and family pressure.

“Sometimes what will happen is that an athlete will come to you and they’ll be a few days out from their concussion,” says Dr. Matthew Kirschen, a pediatric neurologist at Children’s Hospital of Philadelphia and lead author of the committee that wrote the position statement, which was published in Neurology.

“They’ll be a few days out from their concussion, and they’ll still be symptomatic. They’ll still have deficits on their neurocognitive testing,” Kirschen told NPR. “And they’ll say, ‘Yes but I really want to play. There’s a big game Saturday. There will be a recruiter there.’ And the parents say they’re OK with them playing.

“The physician has to sit back and say, ‘The risks are too great. You can’t go back in,’ ” Kirschen says.

Education of parents and students, as well as coaching and health staff of teams, helps with making the right choices easier, but even the most informed patients and parents aren’t always willing to choose the safer strategy, especially if they feel a big game of scholarship is on the line.

This is made even worse by the fact that doctors can’t talk with schools or coaches about a child’s injury due to health privacy laws. Some patients and parents are willing to sign waivers that would let doctors share that information, but they aren’t in wide use currently and they are not mandatory.

With their hands tied, the logical voice often gets drowned out by emotions and the desires to “get back to normal.”

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