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New Rules for Football Concussions

NFL issues new rules about when players can return to the game after a concussion.
By
WebMD Feature
Reviewed by Louise Chang, MD

In late October, Philadelphia Eagles star running back Brian Westbrook suffered a concussion in a game against the Washington Redskins. He sat on the sidelines for two weeks, recovering -- but when he returned to play on Nov. 15 against the San Diego Chargers, Westbrook suffered yet another concussion, putting his season and possibly his career in doubt.

Westbrook's immediate re-injury raises the question: should he have been playing at all? And just how many football players are returning to play too soon after concussions, or not having the seriousness of their injuries recognized?

On Dec. 3, in the wake of much debate over the long-term damage concussions do to players, the National Football League (NFL) announced new rules governing concussion management. Players who've had a concussion will now only be allowed to return to the field after being cleared by an independent neurologist.

But concussion is not just an issue for the NFL. A study from the National Center for Injury Prevention found that 47% of high school football players say they suffer a concussion each season, with 37% of those reporting multiple concussions in a season. But according to the American College of Sports Medicine, some 85% of sports-related concussions go undiagnosed.

And even when they are diagnosed, more often than not, concussions in football and other sports aren't being managed properly. Guidelines from the American Academy of Neurology say that, for example, if an athlete's symptoms after a concussion -- such as dizziness or nausea -- last longer than 15 minutes, he should be benched until he's been symptom-free for a week. But a three-year study of play in 100 U.S. high schools found that nearly 41% of athletes were back on the field too soon.

Long-Term Impact

It's pretty clear that all those concussions can have devastating long-term impact on NFL players. Many former players, still young, report persistent headaches, fatigue, difficulty paying attention, memory problems, mood swings, and personality changes. Even a study commissioned by the football league itself found a higher rate of dementia among retired players than in the general population -- about six times as high in players over 50 compared to other men in the same age group. A New York Times analysis bolstered those findings.

But much less is known about how repeat concussions, especially those that are not properly managed, affect high school and college athletes over the long term. "The long-term effects of a few concussions on the young athlete is an incomplete book," says Mark Lovell, PhD, founding director of the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program. "We're just starting to scratch the surface. We're starting to study kids as young as five and follow them throughout their lives, but that takes years to do; 90% of what we know about concussion, we've learned in the last five years."

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