Ask Dr. Vieder – Sports Related Concussions

    football player wearing helmet on the field seen from behind as he looks at a few other players and the setting sun.
    Credit: Ben Hershey

    I saw that there are new guidelines for diagnosing sports related concussions in young athletes. What has changed?

    After reviewing 25 years of scientific research from 1990 to 2015, there are now new guidelines for the diagnosis and management of a mild traumatic brain injury (mTBI), commonly known as a concussion. One of the more important aspects is the recommendation to not perform a complete diagnostic brain imaging by CT scan unless there is a specific set of signs and symptoms present indicating high risk factor that would justify the use of neuroimaging. There are a number of excellent updated validated concussion assessment tools now available to physicians to help guide in the diagnosis and treatment of TBI. The Centers for Disease Control has excellent resources for patients and families who wish to learn more about head injuries and more, at

    Dr. Vieder of Lakes Urgent Care. Medical Director. Sleep Hygiene. Healthy Travel. Tinnitus, hives and allergies. college health, sunscreen and sun protection
    Dr. Vieder

    If my son has a concussion, is total bed rest still the best treatment option?

    New research indicates that a small amount of bed rest is appropriate over the first 48 to 72 hours after a mild traumatic brain injury or concussion. The newest recommendations are to limit bedrest to no more than three days and encourage a gradual return to normal activities, as long as there are no obvious continued symptoms such as headaches, dizziness, nausea, poor balance or visual disturbances. Close monitoring for symptoms during the recovery period is critical.

    How soon after a concussion can my son resume playing sports?

    Current recommendations for return to athletic activity follows a 6- step program, beginning 3 days after the initial injury with a return to normal school routines and light to moderate activity such as fast walking or riding a stationary bike.  If there are no symptoms associated with this initial step, then there is a progression to moderate aerobic activity to increase heart rate and head movement, such as jogging, or sports skill related drills. If your student remains symptom-free, there is a stepwise progression to heavy aerobic activity, full unrestricted practice and finally a return to competition. In general, this process takes approximately 2-3 weeks, but should be guided by the managing physician in concert with either the athletic trainer or team coach. It is important to note that if symptoms do reoccur, the process would be restarted and require reevaluation by a physician who is familiar with concussion recovery programs. Most importantly, it is critical to understand that injuries to the brain can take a long time to heal and the treatment and recovery plan should be guided by a health professional knowledgeable of these types of injuries.

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    Dr. Sanford Vieder, DO, FACEP, FACOEP, Medical Director at Lakes Urgent Care, West Bloomfield/Livonia.

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