Blog: 'New' Concussion Guidelines?

The American Academy of Neurology released an updated set of concussion guidelines this week, calling for athletes to be removed from play if a concussion is suspected and not be allowed to return until cleared by a medical professional.

Wait, what?

That was the reaction I had upon first reading the "updated" guidelines, a reaction shared by others in the AB office. For us, and I would guess many of our readers, such guidelines have been the status quo for years. Removing an athlete from play is part of the Centers for Disease Control's Lystedt Law, the country's first concussion legislation passed in May 2009.

Since that time, more than 40 states have enacted similar legislation mandating athletes suspected of a concussion be removed from play; cardio exercise's role in concussion recovery.

And the AAN is just now updating their 15-year-old policy to call for athletes to be removed from play after a traumatic hit?

"Better late than never," I wrote in an email sharing the news article. But in actuality, with how much headway has been made on concussion awareness and research, it's easy to forget just how much work is left to do. "We know more now than we've ever known and it's because it's become an issue in the big-time sports," says National Athletic Trainers' Association president Jim Thornton. "Athletic trainers have been managing concussions for years, but we've also got concussions that are being managed at 58 percent of our schools by coaches and other people who have no business managing those concussions."

The AAN's previous guidelines, developed in 1997, included a three-level grading system for concussions and permitted athletes to return to play once their symptoms cleared. That it has abandoned that system is actually a testament to the gains in concussion research and awareness over the years. "We need to make sure that our guidelines for care for injuries are up to date, researched and evidenced-based," says Thornton. "These recommendations come to us from research that has been done by the experts and we're in total support of it."

The National Athletic Trainers' Association was just one of many athletic or medical groups that have endorsed the AAN's new guidelines, along with the National Association of Emergency Medical Service Physicians, the Neurocritical Care Society, the American Football Coaches Association, the National Football League Players Association, the Child Neurology Society and the National Academy of Neuropsychology.

The guidelines may just be repeating what's been said before, but it's still a message worth repeating. And the organization did its due diligence before releasing its updated guidelines, resulting in another useful concussion information resource for parents, players and coaches.

"They undertook quite an exhaustive review of the world's concussion literature from 1955 through 2012 in coming up with these guidelines," says Dr. Robert Cantu of the Sports Legacy Institute. "I think these are good guidelines. The fact is that these guidelines are just echoing the choir but are nonetheless correct."