Kids and Concussions: Guidelines Stir Controversy

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Brain-injury experts are split over new guidelines on concussion care, with some worried that the stricter recommendations will ultimately put young athletes at greater risk of injury, according to the New York Times.

Updated recommendations in the May issue of The British Journal of Sports Medicine, said that athletes 18 or younger believed to have sustained a concussion during play should not be allowed to return to the playing field that day. Previously, an international panel of neurologists said the injured athletes could return if cleared by a doctor or certified athletic trainer. Now, they believe that such same-day determinations are too difficult to make.

"So many bad decisions are made when trying to assess whether a player is symptomatic or not," said Dr. Robert Cantu, an author of the guidelines and a director of the Neurological Sports Injury Center at Brigham and Women's Hospital in Boston. "We know that an unacceptable number of kids are being sent back while symptomatic, and sometimes with devastating effects. The majority believe that the bullet should be bitten, and not let a kid go back into the same contest."

But Dr. Bob Sallis, a past president of the American College of Sports Medicine, said he disagrees. "More kids will be hurt seriously because of this, either by players not admitting they might have gotten a concussion or coaches encouraging them not to be up front about their symptoms, whether subtly or overtly," Sallis said.

In the 2007-2008 school year, high school athletes in nine primary sports sustained about 137,000 concussions, according to the Center for Injury Research and Policy at Nationwide Children's Hospital in Ohio.

The panel also stressed the need for cognitive rest, not just physical rest, following a concussion, teens saying should be kept from schoolwork, computers and even text messaging until recovered from a concussion.