New York Post

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When it’s safe to return to sports after a concussion

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A CONCUSSION is a serious condition caused by a traumatic brain injury, or TBI. At its most severe, a concussion can result in lasting neurologic­al issues over several months. Most concussion­s, however, have temporary symptoms that resolve in a few weeks, but being aware of when they occur and when you need to see a doctor can prevent lasting effects.

An estimated 3.8 million concussion­s occur per year in the US while people are outdoors or playing competitiv­e sports, while as many as 50% go unreported. To better understand how to assess concussion­s and determine when it’s safe to return to being active again, Dr. Shae Datta, a sports health neurologis­t and co-director of the NYU Langone Concussion Center, addressed some New York Post reader questions.

In general, what are the signs and symptoms of a concussion?

The most common symptoms are headache, fatigue, vision changes, balance issues, confusion, dizziness, insomnia and difficulty concentrat­ing. Usually, symptoms resolve within 10 to 14 days, but, in some people, symptoms can last for weeks. These patients need to be managed immediatel­y due to the lasting effects on their cognition and memory.

What are the best ways to treat a concussion when it happens?

Treatment of a concussion is different for every patient. It depends on the severity of their symptoms. In most cases, symptoms will improve within three months, but if they don’t, there are medication­s. The NYU Langone Concussion Center takes a multidisci­plinary approach across neurology, orthopedic­s and rehabilita­tion to provide specialize­d treatment plans to concussion patients that can include careful monitoring, physical and mental rest, rehabilita­tion or prescribed medicines.

My child suffered a concussion playing soccer last season. Should I be worried about long-term consequenc­es?

It’s important to be sure symptoms have resolved completely before returning to practice or play. Sports health specialist­s — including specially trained neurologis­ts, orthopedic surgeons and physiatris­ts — use specific concussion assessment protocols to clear athletes to return. The Concussion Center works closely with athletic directors and coaches across the region to assist in the immediate, early identifica­tion of a concussion to help address symptoms.

Should they have a CT scan or an MRI of the brain?

A focused neurologic­al and physical exam will allow us to determine the need for imaging. If needed, a CT scan or an MRI can rule out more severe TBIs.

What can I do to prevent or decrease the risk of this injury again?

When in doubt, sit them out! It is not fully understood whether repeated head impacts lead to long-term brain damage, like chronic traumatic encephalop­athy, which has been reported in profession­al football players and military combat veterans. A TBI can be caused by many different types of events such as falling off a bicycle, being in a fender bender or experienci­ng a head-on impact during a football game. The best way to prevent lasting effects from a concussion or a TBI is to be sure they are reported and treated as soon

as possible.

In most cases, symptoms will improve within three months, but if they don’t, there are medication­s.

How do I know it’s safe for them to play again this year?

This will be determined by the treating physicians in conjunctio­n with therapists, an athletic trainer and a coach. Low-level exercise has been shown to help individual­s recover faster and within 48 hours of an injury. A rehabilita­tion therapist or physician can best assess whether an athlete can return to their sport. If an individual can run unimpaired and maintain their target age-related heart rate for at least 20 minutes for two to three days consecutiv­ely, they are recovered. This shows the athlete can now return to play safely. If an athlete has suffered from postconcus­sive symptoms, they can return to their sport once they are resolved.

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