Preventing and Managing Traumatic Brain Injury in Contact Sports

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• Understanding Sports Concussions and Long-Term Risks
• The Dangers of Repetitive Brain Injury
• Essential Prevention Rules for Coaches and Parents
• The Critical Return-to-Play Protocol
• When to Seek a Neurological Specialist
• Building Trust with Athletes to Prevent Injury Hiding
• Spinal Injury Risks in Contact Sports

Understanding Sports Concussions and Long-Term Risks

Traumatic brain injury in sports is a significant public health concern that extends far beyond professional athletes. Dr. Arthur Day, MD, a neurosurgeon with extensive experience in sports medicine, clarifies that a concussion is not a minor, transient event. He states that the brain is not OK after a concussion, even if it appears to be, and returning to play too soon creates a major risk for more serious injury.

This type of sports-related head injury is a frequent cause of long-term health deterioration. The interview with Dr. Anton Titov, MD, highlights that the nervous system is vulnerable anytime the body is subjected to the high-impact stresses common in contact sports like American football, ice hockey, and rugby.

The Dangers of Repetitive Brain Injury

The most devastating consequences arise from repetitive traumatic brain injury. Dr. Arthur Day, MD, explains that catastrophic outcomes can occur if an athlete does not fully recover between concussions. This can lead to a slowly progressive deterioration in mental faculties, a condition neurologically similar to Alzheimer's disease.

Dr. Arthur Day, MD, emphasizes that athletes with a history of multiple concussions have a demonstrably higher chance of developing serious nervous system degeneration later in life. This underscores the critical importance of tracking the number of concussions and the duration of symptoms after each event to fully understand an athlete's risk profile.

Essential Prevention Rules for Coaches and Parents

Prevention of traumatic brain injury starts with strict adherence to safety protocols. Dr. Arthur Day, MD, advises that athletes must always wear appropriate protective gear as outlined for their sport. However, equipment alone is not enough.

The most crucial rule is the immediate removal of any athlete suspected of having a concussion from sports play. A team overseer, such as a coach or administrator, must be fully aware of the consequences of head injury and empowered to enforce this rule without exception. This proactive approach is the first and most important step in mitigating severe damage.

The Critical Return-to-Play Protocol

A mandatory and non-negotiable recovery period is essential after a concussion. According to Dr. Arthur Day, MD, an athlete must be out of contact sports for a minimum of one week. Furthermore, they cannot return to play until they have been completely symptom-free for that entire seven-day period.

This return-to-play protocol is designed to ensure the brain has adequate time to heal before being subjected to further potential trauma. Rushing this process significantly increases the risk of a subsequent, more severe concussion and accelerates the potential for long-term neurological decline discussed by Dr. Anton Titov, MD.

When to Seek a Neurological Specialist

It is vital to recognize when a head injury is more serious than a standard concussion. Dr. Arthur Day, MD, stresses the importance of sending an athlete to a neurological specialist for evaluation if symptoms are severe, unusual, or linger longer than expected.

A specialist like a neurologist or neurosurgeon can perform necessary diagnostic workups, such as a CT scan, to rule out more serious intracranial pathology. Obtaining a medical second opinion can confirm a diagnosis and ensure that the treatment plan for a traumatic brain injury is the most appropriate and effective course of action.

Building Trust with Athletes to Prevent Injury Hiding

A critical cultural component of injury prevention is building an atmosphere of trust. Dr. Arthur Day, MD, points out that athletes often feel pressure to hide injuries to keep playing. The best team coach or overseer is someone who fosters open communication.

Athletes must trust this person enough to report a concussion or other head injury immediately without fear of negative repercussions. Creating this environment is as important as establishing the physical safety rules themselves, ensuring that hidden injuries do not lead to unseen, long-term damage.

Spinal Injury Risks in Contact Sports

While the focus is often on the brain, contact sports also present a significant risk for spinal injuries. As Dr. Arthur Day, MD, notes, athletes can injure their back, pinch a nerve, or even break their neck during play.

These catastrophic spine injuries require their own set of strict guidelines for removal from play, immobilization, and specialist evaluation. The same principles of caution, immediate action, and specialist consultation that apply to head injuries are equally critical for protecting an athlete's spinal cord and long-term neurological function.

Full Transcript

Traumatic brain injury in sports happens not just to professional athletes. What are simple crucial rules to prevent traumatic brain injury in sports? How to prevent devastating consequences of brain trauma? A leading neurosurgeon with special interest in brain and spine trauma in athletes shares his wisdom.

Traumatic brain injury in football can affect high school players and amateur athletes. Repetitive brain injury causes brain degeneration. Recurrent traumatic brain injury causes Alzheimer's type of chronic neurological disease.

Sports related head injury is the most frequent cause of long-term deterioration of health and active life in athletes. How long should an athlete stay away from sports after concussion? How to develop trust in the sports team? Athletes should not hide brain injury from team overseer or coach.

Dr. Anton Titov, MD: When should one seek a neurologist or neurosurgeon's evaluation of an athlete?

A video interview with a leading expert in cerebrovascular neurosurgery and minimally invasive neurosurgery. A medical second opinion confirms that chronic traumatic brain injury diagnosis is correct and complete. Medical second opinion also confirms that treatment for chronic traumatic brain injury is required.

Dr. Anton Titov, MD: Medical second opinion helps to choose the best treatment for traumatic brain injury. Get a medical second opinion on traumatic brain injury and be confident that your treatment is the best.

Dr. Arthur Day, MD: Sports medicine is one of your career-long interests. You were a neurosurgeon for an American football team in Florida. Traumatic brain injury is discussed often, especially in contact sports.

Dr. Anton Titov, MD: What are common traumatic brain injuries among athletes? How to prevent brain injuries of athletes in the field? What are advances in treatment of traumatic brain injury in athletes?

You also co-authored textbooks "Neurological Sports Medicine: A Guide for Physicians and Athletic Trainers" in 2001 and "Handbook of Neurological Sports Medicine: Concussion and Other Nervous System Injuries in the Athlete" in 2014.

Dr. Arthur Day, MD: Certainly the nervous system is in danger from anything that causes the body to move under stress. The public has recently become aware of and concerned about concussion during contact sports play. It is American football, ice hockey, rugby.

Catastrophic brain injury can happen if the brain injury becomes repetitive. If an athlete does not fully recover between one concussion and the next concussion, or slowly progressive deterioration in mental faculties can happen. It is similar to Alzheimer's disease.

Brain function deterioration happens when traumatic brain injury in an athlete becomes repetitive, or when recovery time between concussions is insufficient.

Dr. Arthur Day, MD: Impact of traumatic brain injury has been highlighted for some well known ice hockey players. Brain injury in football players, mainly American football players, is well known.

We now know that concussion is a real phenomenon. Concussion is not just something that is a physiological normal phenomenon. The brain did not work for a minute, but then it's OK. Brain is not OK after concussion, even though the brain looks OK.

We have to make sure that we don't return the athlete to sports play before they fully recover from the concussion. Otherwise they might be at risk of serious traumatic brain injury.

Sometimes an athlete had several brain injuries (concussions). We know that athletes with repetitive traumatic brain injury have a higher chance of getting some serious degeneration in the nervous system later in their lives.

Clarification of events that resulted in concussion is important. Counting the number of concussions is important. Keeping track of duration of symptoms that an athlete had after each concussion has become a major concern in sports injury in the United States.

Also you have to make sure that an athlete has recovered fully before returning to sports play. We are not talking only about professional athletes. We want our children to participate in sports. We want our population to be healthy.

We as neurosurgeons need to define which activities are safe and which are not, so that we can all stay physically active during our lives. Because we don’t want to worry about consequences of repetitive traumatic brain injuries.

Athletes can also injure their back. They can pinch a nerve or break their neck. So it's important to have rules that specify when an athlete can return to play. Also when and what something should be done about the injury an athlete had during sports play.

Dr. Anton Titov, MD: Sometimes a parent watches this interview and has a teenager who plays contact sport (ice hockey, football, or rugby, for example). What can parents do to minimize the risks of traumatic sports-related brain injury in their child?

Dr. Arthur Day, MD: I think they need to obviously wear protective gear as outlined. But there has to be a team overseer (coach, administrator). Coach has to be aware of the consequences of head injury in sports.

Sometimes an athlete has a concussion or other traumatic head injury. Then this overseer should remove the athlete from sports play. Sports team overseer should not let the athlete return to play until the athlete recovers from concussion or other head injury.

Whenever an athlete has a concussion, the athlete has to be out of contact (out of active sports play) for a week at least. Athlete should not return to play until the athlete has been symptom-free for that full week.

Best team coach or overseer is someone who doesn't have any problems with communication with the athlete. Coach must find out when the athlete is injured. Athletes should trust this person and not hide their sports head injury so they can keep playing.

That is a kind of atmosphere of trust that team coach or overseer has to create. But we also need to have very strict guidelines about when athletes have to stop playing sports. We need rules when they have concussion or other head injury.

Also we have to establish strict rules when they can return to play. Obviously in addition we have to recognize when it's more than just a concussion. So that an athlete can be sent to a neurologic specialist for head CT scan or other diagnostic workup.

Dr. Anton Titov, MD: A neurosurgeon must ensure that there is nothing more serious going on other than a concussion. Traumatic brain injury in sports. Short and long-term consequences of brain injury in sports. Concussions, spine injury. How to prevent injury in sports.