Concussion Management: When to return to training
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In combat sports where repeated head trauma is common, when is it safe to return to training?
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Concussions are mild traumatic brain injuries that result from acceleration of the brain that creates a shearing force. This causes a metabolic energy crisis in the brain. The brain is vulnerable to worsening injury if further head trauma occurs.
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When you no longer have symptoms you are cleared to train again, right? Symptoms may last for only 5 days but the metabolic energy crisis in the brain may last for up to 30 days. ✳️Even when you think you are fine your brain is still vulnerable❗️
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How do I know when it is safe to return? Here is a recommended guideline on when to return. (Zurich consensus statement 2013)
1️⃣Symptoms resolution
2️⃣Neurological assessment return to baseline
•Cranial Nerve normal •Balance normal •Vestibular Ocular Reflex normal
3️⃣Neurocognitive assessment return to baseline
4️⃣Graduated physical exertion
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Get cleared by a medical professional trained in concussion management before returning to training / competition❗️
As a martial artist I understand wanting to return to training ASAP but without adequate recovery it is possible for symptoms to become chronic and linger.
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I would recommend professional MMA fighters to get a baseline neurological / neurocognitive assessment prior to competition to accurately determine a safe time to return.
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Reference:
1️⃣McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvořák, J., Echemendia, R. J., … & Sills, A. (2013). Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med, 47(5), 250-258.