AAP Updates Guidelines On Sport-Related Concussion

Athletes often joke about "getting your bell rung" after taking a hit on the playing field, but adolescent concussions can cause serious long-term injury or death, and should always be taken seriously. The American Academy of Pediatrics (AAP) is publishing a new clinical report, "Sport-Related Concussion in Children and Adolescents," in the September 2010 print issue of Pediatrics (published online Aug. 30). Young athletes are more susceptible to the effects of a concussion because their brains are still developing, and appropriate management is essential for reducing the risk of long-term complications.

Although preventing all concussions is unlikely, there are several ways to reduce the risk, including protective gear (such as helmets and mouth guards), adhering to the rules of the sport, identifying athletes at risk, and educating parents, teachers, athletes, school administrators and trainers about the dangers of concussions. Football has the highest incidence of concussion, but girls have higher concussion rates than boys in similar sports. Better understanding of the symptoms and risk of long-term complications have prompted the following recommendations from the AAP:

- Children or adolescents who sustain a concussion should always be evaluated by a physician and receive medical clearance before returning to play.

- After a concussion, all athletes should be restricted from physical activity until they are asymptomatic at rest and with exertion. Physical and cognitive exertion, such as homework, playing video games, using a computer or watching TV may worsen symptoms.

- Symptoms of a concussion usually resolve in 7 to 10 days, but some athletes may take weeks or months to fully recover.

- Neuropsychological testing can provide objective data to athletes and their families, but testing is just one step in the complete management of a sport-related concussion.

- There is no evidence proving the safety or efficacy of any medication in the treatment of a concussion.

- Retirement from contact sports should be considered for an athlete who has sustained multiple concussions, or who has suffered post-concussive symptoms for more than three months.




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