Safely returning teens to sports after a concussion

Many parents wonder how soon after their child suffers a concussion is it safe to let their child play sports.

Doctors at the University at Buffalo may have discovered a testing process to safely allow athletes back in the game sooner. And along the way, they found some results that might scare some parents.

Nearly 120 Western New York high school athletes took part in the potentially ground-breaking study. It had a 100 percent success-rate returning athletes to their sport without any symptoms, but along the way, doctors discovered students still having problems in school.

“I’m on the ice like five times a week. It’s my life,” 15-year-old James Panzarella said.

His love for the game matches countless Western New York teens before him.

“I definitely wouldn’t know what to do if I didn’t play hockey,” James said.

But James brings a medical history threatening his future in the sport with him onto the ice.

“2009 I think was the first one. Then, 2010 or 11 was the second one,” James said.

Three concussions by age 15, the third happening just weeks ago on just a normal hockey play.

“Guy came from the other side. I didn’t see him coming and he hit me,” James said. “I went to practice the next day, tried skating, and that was probably one of the worst headaches I’ve ever had.”

His mother, Dr. Karen Panzarella-Brodie said, “So now I’m anxious watching him. And hoping he doesn’t get hit.”

Karen doesn’t want to take away from her son the sport he loves so much, unless she absolutely has to. But it was important to her that he sat out until he was fully cleared to play. She took him to the University at Buffalo, where doctors just finished a study testing return-to-play guidelines.

They developed a treadmill test, which they say makes certain concussion symptoms are fully gone before athletes return to their sport. Because some are so dedicated, they’d do almost anything to keep playing.

“We can make sure, number one, the athlete’s not lying about feeling better. So, if they are still symptomatic from a concussion, but telling us they’re feeling better for example, we’ll put them on a treadmill test and the symptoms will come rushing back 10 times worse. So they can’t fake it, in other words,” said Dr. Scott Darling, who led the study at UB.

Doctors say the treadmill test gave them better results than the more commonly used-test.

Parents might be familiar with the computerized testing used to give athletes “baseline test,” but doctors say the computerized tests were unpredictable and did not show them when an athlete was ready to return.

“Results just did not predict outcome,” said Dr. Barry Willer, University at Buffalo.

As for the treadmill test, the doctors say it had a 100 percent success rate. All 117 high school athletes in the study returned to play without symptoms.

But doctors found a much bigger concern. Returning to sports is one thing, but returning to school is another. At least one-third of the students who returned to sports without any concussion symptoms still had problems in the classroom.

“I would try to read a book and I would only be able to get through a couple pages before I would be like, what did I just read? I wouldn’t be able to focus on it exactly,” James said.

James goes to St. Joseph’s Collegiate Institute, which his mother says was understanding in helping him transition back to a full workload of school work.

“It is something that we weighed,” according to Dr. Panzarella. “And we did reduce his school time the first week to accommodate for that. But you really don’t have any good protocols yet for how long to do that and what to do,”

That’s something James’ mother, and many others, would like to see more research on.

In the meantime, now that James has gone through the testing and is completely symptom-free, they hope he continues to thrive in the sport he loves without any future scares.

If another brain injury is to happen, their family could have a very difficult decision to make.

When asked what would happen if he suffered another concussion, James said, “If it were more than just a mild concussion, I would probably have to stop playing hockey, unfortunately. Which, I don’t know how I would be able to do that. But that’s what would have to happen.”

The UB doctors say the research article that will be published next month in the Clinical Journal of Sports Medicine has a large implication. They say it could safely shorten the return-to-play time of the most common guidelines used nationwide.

As for return-to-school guidelines, the doctors say this is something that needs to researched. They found those problems during the follow-up questions in the study they were performing. But they say definitely warrants a study of its own, and it is something they might start working on there.

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