Fighting to keep a sport safe: toward a structured and sport-specific return to play protocol

Concussion Management Among National Collegiate Athletic Association Swim Programs

The nuances of swimming make the application of traditional return-to-play progressions following concussion challenging. Our purpose was to describe athletic training services and concussion management protocols among National Collegiate Athletic Association swim programs and compare them between the National Collegiate Athletic Association divisions. We surveyed 228 athletic trainers assigned to or with knowledge of their institution’s swim programs from a convenience sample of 539 (response rate = 42.3%) athletic trainers. Athletic training services were provided to 98.6% (214/217) of the programs. Nearly 80% (164/207) of the programs administered baseline concussion testing to swimmers, with differences observed between divisions (p < .001). No differences (p = .108) in the number of concussions sustained by swimmers in the past academic year were noted between divisions. Specific return-to-swim protocols were reported by 51.8% (115/222) of respondents with no differences in the presence of a specific return-to-swim protocol between divisions (p = .790). While concussions are reported less frequently in swimming than other sports, appropriate medical care, including a specific return-to-swim protocol, is warranted and provided for future use.

Concussion management in combat sports: consensus statement from the Association of Ringside Physicians

Various organisations and experts have published numerous statements and recommendations regarding different aspects of sports-related concussion including definition, presentation, treatment, management and return to play guidelines. 1-7 To date, there have been no written consensus statements specific for combat sports regarding management of combatants who have suffered a concussion or for return to competition after a concussion. In combat sports, head contact is an objective of the sport itself. Accordingly, management and treatment of concussion in combat sports should, and must, be more stringent than for non-combat sports counterparts.The Association of Ringside Physicians (an international, non-profit organisation dedicated to the health and safety of the combat sports athlete) sets forth this consensus statement to establish management guidelines that ringside physicians, fighters, referees, trainers, promoters, sanctioning bodies and other healthcare professionals can use in the ringside setting. We also provide guidelines for the return of a combat sports athlete to competition after sustaining a concussion. This consensus statement does not address the management of moderate to severe forms of traumatic brain injury, such as intracranial bleeds, nor does it address the return to competition for combat sports athletes who have suffered such an injury. These more severe forms of brain injuries are beyond the scope of this statement. This consensus statement does not address neuroimaging guidelines in combat sports.