Posted April 2, 2024

In the realm of youth sports in Minnesota, the topic of concussions has garnered increasing attention over the recent years. With mounting concern for athletes' well-being, discussions around concussion protocols and their long-term implications have become commonplace. All of these concerns are valid and as the research progresses, we will have more answers to what future risks children might be facing from suffering from concussions. In the meantime, JAG Health can answer some of your questions right now.

In considering the consequences of multiple concussions, we often heard the statement “If she suffers a third concussion she won’t be able to play sports again.” We hear this from parents, physicians, athletic trainers, coaches, and the athletes themselves. Among the many misconceptions surrounding sports-related concussions is the notion that athletes must hang up their jerseys after enduring three of these mild traumatic brain injuries. However, it's time to debunk this myth once and for all. Bottom line: Minnesota has no known laws or regulations in place at any level (state, city, league, organization, team, school, etc.) that forces a child to stop playing sports due to multiple concussions.

The Myth

The myth that athletes should cease participating in sports after sustaining three concussions likely stems from a well-intentioned desire to prioritize their health and safety. In the 1950’s there was some thought that suffering three concussions was a reason to stop playing the sport. Back then a concussion was only diagnosed by loss of consciousness. But with advancement in medical research those definitions have changed and so have the treatment approaches. It's easy to understand why some may have adopted such a rule in the past – three concussions sound severe, and the cumulative effects could be presumed to be significant. Yet, the reality is far more nuanced.

Understanding Concussions

First and foremost, it's essential to grasp the nature of concussions. These brain injuries occur when a forceful impact or rapid movement of the head causes the brain to bounce or twist within the skull. Symptoms may include headache, dizziness, confusion, memory problems, difficulty focusing and concentrating, balance difficulties, and others. While some symptoms may dissipate relatively quickly, others can persist for weeks or even months. Children are at greater risk to experience prolonged recovery following a concussion, but even so the prognosis is still quite favorable with most kids recovering within 4 weeks.

Individual Variation

One of the critical factors challenging the "three concussion rule" is the vast variability among individuals in how they respond to and recover from concussions. No two concussions are exactly alike, and factors such as age, genetics, overall health, and prior history of brain injury can significantly influence an individual's recovery trajectory.

Evolving Understanding and Protocols

The field of sports medicine is continually evolving, and so too are our understandings of concussions and their management. While protocols regarding concussion assessment and return-to-play guidelines have undoubtedly become more stringent in recent years, there is no universally agreed-upon threshold at which an athlete must retire due to a certain number of concussions.

Case-by-Case Evaluation

Rather than adhering to a rigid "three strikes and you're out" mentality, JAG Health emphasizes the importance of individualized assessment and care. Each concussion should be evaluated on a case-by-case basis, taking into account factors such as the severity of the injury, the frequency of previous concussions, the nature of the sport, and the athlete's overall health and well-being. There might very well be a reason to stop playing a sport after suffering a third concussion. There might be a reason to stop after 1. But this decision can be made based on the athlete’s unique circumstances, and this decision should be made by the parents and athletes with input from the medical providers. These families are not at the mercy of an arbitrary “3 strikes” rule.

Risk Mitigation and Prevention

While it's crucial to approach concussions with caution and respect, it's equally vital to recognize the steps that can be taken to mitigate the risk of sustaining these injuries in the first place. This includes proper education and training for athletes, coaches, and officials, implementing rule changes to reduce high-risk behaviors, ensuring the availability of appropriate protective equipment, and promoting a culture of safety and transparency within sports organizations. New training programs that have shown the ability to significantly reduce risk of suffering concussions, along with reducing upper and lower body injuries. JAG Health can help you implement these programs for your athlete or your teams.

We don’t want our young athletes to avoid reporting a suspected concussion or head injury because they are worried it might cause them to give up the sport they love. They need to report those injuries so they can be treated and managed well and so they can keep playing the sports they love. While concussions are undoubtedly serious injuries that require careful attention, there is no one-size-fits-all rule governing how many concussions are too many. Instead, a nuanced and individualized approach to assessment, management, and prevention is essential to safeguarding the health and well-being of athletes at all levels of competition. JAG Health can provide telehealth concussion management services and help keep young athletes in the game.