The toughest decisions

A recent article by  a staff writer at MDNews.com (and was also commented on by D. Fink at The Concussion Blog) does a great job of expressing the difficulty that both physicians and athletic trainers often face when deciding whether or not to return a kid to play safely or not.  The article points out that while a clinician's exam should lead the AT or physician to a reasonable idea of what is going on, it isn't always the only factor influencing the decision.  Often, there are great pressures brought by parents, coaches, and the players themselves to try to get the athlete back into play.  It is often very easy to sit from the sideline and assess whether or not the right thing was done, especially several hours after the incident has occurred.  (A familiar idiom often used in athletics comes to mind about hindsight being 20/20.) The other issue that everyone need to keep in mind is that not all TBI symptoms appear immediately at the time of injury.  Occasionally, it takes a few minutes to half an hour for the symptoms to become detectable.  While there are always those hits that everyone cringes about and it is obvious something is wrong, that isn't always the case.  To further complicate things, sports like wrestling give the AT or physician only a minute and a half to perform their evaluation and come to a conclusion.  This is where the rules need to change BADLY.  This is a near impossibility in most cases to be able to determine if the athlete has suffered a TBI or not in such a short amount of time.  Hopefully, this will be addressed in this upcoming off season.

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