New concussion guidelines could get athletes back to exercise, school earlier

American athletic trainers are getting behind guidelines that could allow students who sustain a concussion to return to class and physical activity sooner.

A statement published Tuesday in the Journal of Athletic Training encourages practitioners to consider the psychological effects on students if they are kept out of school while they recover.

“Current guidelines caution against returning students immediately to school, but this does not mean that they should remain at home for an extended period of time,” the statement says. “After a short period of cognitive rest (24–48 hours), student-athletes can begin the return-to-learn process by physically returning to school.”

The guidelines give a similar timeframe for a concussed athlete to resume light exercise — as long as their symptoms are stable and the effort does not make them much worse.

“When appropriately implemented, aerobic exercise that does not exacerbate symptoms more than mildly should be viewed as treatment or medicine for concussion,” the statement says.

Earlier guidance on concussions recommended total rest and minimal stimulation until symptoms went away. Researchers now fear that such isolation can be bad for mental health, especially for students. The 25 new recommendations from the National Athletic Trainers' Association are designed to take a more holistic approach to concussion management and how it affects patient care and outcomes.

“Concussion occurs not in a bubble, but to a person, in a context,” said Dr. Christina Master, a pediatrician and sports medicine specialist at Children’s Hospital of Philadelphia. “Concussion is something that is, on the one hand, serious and important to take seriously and address and identify and not ignore, but also eminently treatable, manageable, recoverable.”

In a webinar to discuss the paper, researchers said they hope the statement will empower athletic trainers when working with concussed athletes. Steven Broglio, a professor of athletic training and the director of the University of Michigan Concussion Center, said the guidelines track those adopted by the 2022 International Conference on Concussion in Sport in Amsterdam.

"It allows an athletic trainer to do, basically, what they knew to do anyway," said Dr. Stanley Herring, a founding member of the American Medical Society for Sports Medicine and former Seattle Seahawks team physician. “I think it will elevate care and give power to the athletic trainer in professional sports as well.”