Return to Contact Sports

2014 ◽  
pp. 117-120
Author(s):  
David L Brody
Keyword(s):  
Exercise Test ◽  
Physical Therapist ◽  
Return To Play ◽  
Return To School ◽  
Moderate Exercise ◽  
Contact Sports ◽  
Moderate Exercise Test ◽  
Specific Management

Published guidelines on return to play apply to simple concussions: (1) No return to play in the same 24-hour period as the concussion. (2) Graded, stepwise increases in activity guided by symptoms over 6–10 days. (3) No difference in return to play for elite versus nonelite athletes. (4) Brief convulsions or posturing at the time of concussion does not indicate higher than normal risk of seizures and requires no specific management. For more complex concussions, discourage the patient from returning to contact sports until all of the following are true: The symptoms are all in the mild range or resolved, the collateral source verifies that the patient’s behavior is back to normal, the patient has been able to successfully return to school or work, balance is back to normal, and the patient passes a physical therapist-directed moderate exercise test.

Return to Contact Sports

2019 ◽  
pp. 169-174
Author(s):  
David L. Brody
Keyword(s):  
Interpersonal Relationships ◽  
Physical Therapist ◽  
Well Being ◽  
Return To Play ◽  
Return To School ◽  
Moderate Exercise ◽  
Contact Sports ◽  
Moderate Exercise Test ◽  
Specific Management

Published guidelines on return to play apply to simple concussions: (1) No return to play in the same 24-hour period as the concussion. (2) Graded, stepwise increases in activity guided by symptoms over approximately 6 to 10 days. (3) No difference in return to play for elite versus nonelite athletes. (4) Brief convulsions or posturing at the time of concussion does not indicate higher than normal risk of seizures and requires no specific management. After 2 weeks in adults and 4 weeks in children, more rest is not likely to help. At that point, it is reasonable to start active interventions. For more complex concussions, discourage the patient from returning to contact sports until all of the following are true: The symptoms are all in the mild range or resolved, the collateral source verifies that the patient’s behavior is back to normal, the patient has been able to return to school or work (for nonprofessional athletes), balance is back to normal, and the patient passes a physical therapist-directed moderate exercise test. Many complex concussion patients will decide not to return to contact sports at all if their long-term well-being depends more on their work and interpersonal relationships than on their athletic performance.

Outcomes After Anterior Cervical Discectomy and Fusion in Professional Athletes

Neurosurgery ◽  
2013 ◽  
Vol 73 (1) ◽  
pp. 103-112 ◽  
Author(s):  
Joseph C. Maroon ◽  
Jeffrey W. Bost ◽  
Anthony L. Petraglia ◽  
Darren B. LePere ◽  
John Norwig ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Full Range ◽  
Anterior Cervical Discectomy ◽  
Return To Play ◽  
Professional Athletes ◽  
Adjacent Segment ◽  
Contact Sports ◽  
Cervical Discectomy ◽  
Imaging Results ◽  
Increased Risk

Abstract BACKGROUND: Significant controversy exists regarding when an athlete may return to contact sports after anterior cervical discectomy and fusion (ACDF). Return-to-play (RTP) recommendations are complicated due to a mix of medical factors, social pressures, and limited outcome data. OBJECTIVE: The aim of this study was to characterize our diagnostic and surgical criteria, intervention, postoperative imaging results, and rehabilitation and report RTP decisions and outcomes for professional athletes with cervical spine injuries. METHODS: Fifteen professional athletes who had undergone a 1-level ACDF by a single neurosurgeon were identified after a retrospective chart and radiographic review from 2003 to 2012. Patient records and imaging studies were recorded. RESULTS: Seven of the 15 athletes presented with neurapraxia, 8 with cervical radiculopathy, and 2 with hyperintensity of the spinal cord. Cervical stenosis with effacement of the cerebrospinal fluid signal was noted in 14 subjects. The operative level included C3-4 (4 patients), C4-5 (1 patient), C5-6 (8 patients), and C6-7 (2 patients). All athletes were cleared for RTP after a neurological examination with normal findings, and radiographic criteria for early fusion were confirmed. Thirteen of the 15 players returned to their sport between 2 and 12 months postoperatively (mean, 6 months), with 8 still participating. The RTP duration of the 5 who retired after full participation ranged from 1 to 3 years. All athletes remain asymptomatic for radicular or myelopathic symptoms or signs. CONCLUSION: After a single-level ACDF, an athlete may return to contact sports if there are normal findings on a neurological examination, full range of neck movement, and solid arthrodesis. There may be an increased risk of the development of adjacent segment disease above or below the level of fusion. Cord hyperintensity may not necessarily preclude RTP.

scholarly journals Adolescents With ADHD Do Not Take Longer to Recover From Concussion

2021 ◽  
Vol 8 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson ◽  
Bruce Maxwell ◽  
Ross Zafonte ◽  
Paul D. Berkner
Keyword(s):  
Recovery Time ◽  
Return To Play ◽  
Return To School ◽  
Prior History ◽  
Return To Sports ◽  
Full Time ◽  
Recovery Times ◽  
Concussion History ◽  
Concussion Recovery ◽  
Medication Status

The objective of this study was to determine whether adolescents with attention-deficit/hyperactivity disorder (ADHD) have prolonged return to school and sports following concussion compared to those without ADHD and whether medication status or concussion history is associated with recovery time. We hypothesized that having ADHD would not be associated with longer recovery time. This prospective observational cohort study, conducted between 2014 and 2019, examined concussion recovery among school sponsored athletics throughout Maine, USA. The sample included 623 adolescents, aged 14–19 years (mean = 16.3, standard deviation = 1.3 years), 43.8% girls, and 90 (14.4%) reported having ADHD. Concussions were identified by certified athletic trainers. We computed days to return to school (full time without accommodations) and days to return to sports (completed return to play protocol) following concussion. Adolescents with ADHD [median days = 7, interquartile range (IQR) = 3–13, range = 0–45] did not take longer than those without ADHD (median days = 7, IQR = 3–13, range = 0–231) to return to school (U = 22,642.0, p = 0.81, r = 0.01; log rank: χ12 = 0.059, p = 0.81). Adolescents with ADHD (median days = 14, IQR = 10–20, range = 2–80) did not take longer than those without ADHD (median days = 15, IQR = 10–21, range = 1–210) to return to sports (U = 20,295.0, p = 0.38, r = 0.04; log rank: χ12 = 0.511, p = 0.48). Medication status and concussion history were not associated with longer recovery times. Adolescents with ADHD did not take longer to functionally recover following concussion. Recovery times did not differ based on whether adolescents with ADHD reported taking medication to treat their ADHD or whether they reported a prior history of concussion.

scholarly journals Concussion Symptom Characteristics and Resolution in 20 United States High School Sports, 2013/14-2017/18 Academic Years

Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. 573-583
Author(s):  
Avinash Chandran ◽  
Zachary Y Kerr ◽  
Patricia R Roby ◽  
Aliza K Nedimyer ◽  
Alan Arakkal ◽  
...  
Keyword(s):  
United States ◽  
High School ◽  
The United States ◽  
Return To Play ◽  
Health Concern ◽  
Loss Of Consciousness ◽  
Chi Square ◽  
Convenience Sample ◽  
Contact Sports ◽  
Symptom Prevalence

Abstract BACKGROUND High school (HS) sport-related concussions (SRCs) remain a public health concern in the United States. OBJECTIVE To describe patterns in symptom prevalence, symptom resolution time (SRT), and return-to-play time (RTP) for SRCs sustained in 20 HS sports during the 2013/14-2017/18 academic years. METHODS A convenience sample of athletic trainers reported concussion information to the HS RIOTM surveillance system. Symptom prevalence, average number of symptoms, and SRT and RTP distributions were examined and compared by event type (practice, competition), injury mechanism (person contact, nonperson contact), sex, and contact level (collision, high contact, and low contact) with chi-square tests and Wilcoxon rank-sum tests. RESULTS Among all SRCs (n = 9542), headache (94.5%), dizziness (73.8%), and difficulty concentrating (56.0%) were commonly reported symptoms. On average, 4.7 ± 2.4 symptoms were reported per SRC. Overall, 51.3% had symptoms resolve in <7 d, yet only 7.9% had RTP < 7 d. Differential prevalence of amnesia was seen between practice and competition-related SRCs (8.8% vs 13.0%; P < .001); nonperson-contact and person-contact SRCs (9.3% vs 12.7%; P < .001); and female and male SRCs in low-contact sports (5.8% vs 17.5%; P < .001). Differential prevalence of loss of consciousness was seen between practice and game-related SRCs (1.3% vs 3.2%; P < .001); and female and male SRCs in high contact sports (1.2% vs 4.0%; P < .001). Differential longer SRT (>21 d) was seen between new and recurrent SRCs (9.4% vs 15.9%; P < .001). CONCLUSION Headache was the most commonly reported symptom. Notable group differences in the prevalence of amnesia, loss of consciousness, and SRT may be associated with more severe SRCs, warranting further attention.

Return to play guidelines following repair of bony facial fracture in contact sports

2019 ◽  
Vol 57 (10) ◽  
pp. e93-e94
Author(s):  
James Fitton ◽  
Alice Cameron ◽  
Richie Gill ◽  
Serryth Colbert
Keyword(s):  
Return To Play ◽  
Facial Fracture ◽  
Contact Sports

scholarly journals Sternal non-union in a professional hockey player: considerations for return to play

2009 ◽  
Vol 1 (1) ◽  
pp. 6 ◽  
Author(s):  
Samuel Mark Sanders ◽  
John Richardson, Jr ◽  
William Hartrich ◽  
Leslie J Bisson
Keyword(s):  
Case Report ◽  
Return To Play ◽  
Professional Athlete ◽  
Contact Sports ◽  
Non Union ◽  
Orthopedic Surgeons ◽  
Hockey Player ◽  
Aortic Root Surgery ◽  
Professional Hockey ◽  
Work Up

We describe a healthy 40-year old professional hockey player with an asymptomatic sternal non-union following aortic root surgery. The purpose of this case report is to make orthopedic surgeons aware of the possibility of this complication following sternotomy, and to discuss the considerations involved in return to play in contact sports. We will discuss our work-up, evaluation, and management of a sternal non-union in a professional athlete. Patient’s consent has been obtained.

Physical Therapy Management of Adults with Mild Traumatic Brain Injury

2019 ◽  
Vol 40 (01) ◽  
pp. 036-047 ◽  
Author(s):  
Deborah Diaz ◽  
Carolyn Moore ◽  
Ashley Kane
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Exercise Program ◽  
Semicircular Canals ◽  
Return To Play ◽  
Home Exercise ◽  
Motion Sensitivity

AbstractRehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibular and balance system that are best addressed by professionals with specific training in vestibular rehabilitation, most commonly physical therapists. Benign paroxysmal positional vertigo is a condition in which otoconia particles in the inner ear dislodge into the semicircular canals, resulting in severe vertigo and imbalance. This condition frequently resolves in a few sessions with a vestibular physical therapist. In conditions such as gaze instability, motion sensitivity, impaired postural control, and cervicogenic dizziness, improvement is more gradual and requires longer follow-up with a physical therapist and a home exercise program. In all of the above-stated conditions, it is essential to consider that a patient with protracted symptoms of mTBI or postconcussion syndrome will recover more slowly than others and should be monitored for symptoms throughout the intervention.

scholarly journals Is Golf a Contact Sport? Protection of the Spine and Return to Play After Lumbar Surgery

2021 ◽  
pp. 219256822098329
Author(s):  
Ram Haddas ◽  
William Pipkin ◽  
Dan Hellman ◽  
Leonard Voronov ◽  
Young-Hoo Kwon ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Treatment Options ◽  
High Impact ◽  
Return To Play ◽  
Lumbar Spine Surgery ◽  
Contact Sport ◽  
Contact Sports ◽  
Spine Pathology ◽  
Modern Era

Study Design: Narrative review. Objective: To address the gap in the literature on specific return to play protocols and rehabilitation regimens for golfers undergoing lumbar spine surgery with a high impact swing. Methods: This review did not involve patient care or any clinical prospective or retrospective review of patient information and thus did not warrant institutional review board approval. The available literature of PubMed, Medline, and OVID was utilized to review the existing literature. Results: Studies have shown that the forces through the lumbar spine in the modern-era golf swing are like other contact sports. Methods of protecting the lumbar spine include proper swing mechanics, abdominal and paraspinal musculature strengthening and flexibility as well as physical fitness. There are a variety of treatment options available to treat lumbar spine pathology each with a different return to play recommendations from doctors in the field. Conclusions: With the introduction of a high impact, modern-era swing to the game of golf, the pathology is seen in the lumbar spine of both young, old, professional, and amateur golfers with low back pain are similar to other athletes in contact sports. Surgery is effective in returning athletes to a similar level of play even though no protocols exist for an effective and safe return. There have been many studies conducted to determine appropriate treatment and return to play for these injuries, but there is a gap in the literature on specific return to play protocols and rehabilitation regimens for golfers undergoing lumbar spine surgery with a high impact swing. As return to competitive play is important, especially with professional golfers, studies combining the use of swing mechanics changes, rehabilitation regimens and the type of surgery performed would be able to provide some insight into this topic now that golf may begin to be considered a contact sport.

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