When Should an Athlete Return After a Concussion?

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Legally Reviewed by
Allan Siegel

Updated 4 months ago

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Three of the firm’s partners — including the co-founders of the Brain Injury Association of Metropolitan Washington, DC — discuss TBI litigation, the firm’s preferred attorney status with the Brain Injury Association of America, and the DC Athletic Concussion Protection Act, which attorney Joseph Cammarata drafted into law.

Ira Sherman (00:01): Your brain is like the yolk in an egg, so when you shake the egg, you don’t have to crack it. You just go like that, and the yolk is affected. I was on the board of Directors of the Brain Injury Association of America. I was treasurer of the Brain Injury Association of America. Mr. Camara and I started the DC chapter, the Affiliate of the Brain Injury Association of America, which didn’t exist. We are the preferred lawyers of the Brain Injury Association in the Washington DC Metropolitan area. And what I mean by that is, is that the Brain Injury Association of America designates individual attorneys that they recognize as being experienced in handling cases involving traumatic brain injury to determine if they have a case and make sure that it’s handled properly.

Allan Siegel (00:54): You get hurt in sports and you get sent right back into the game, or you knocked your head and you get back up and you go about your day. Nobody really thought much about those injuries a long time ago, but we did. We understood the seriousness of those types of injuries and how sometimes you could have serious ongoing effects from what is even a mild traumatic brain injury or what is often referred to as a concussion.

Joseph Cammarata (01:21): I co-founded the Brain Injury Association of Washington, DC. I drafted legislation which became law in the District of Columbia to protect youth athletes from concussion. Concussion is a brain injury, a traumatic brain injury that can cause significant harm, cognitive deficits, emotional disturbances, vision problems, hearing problems. And so it’s important to be able to do the investigation, but do the legwork that’s necessary to put together the case to establish that there has been harm, but it’s invisible, right? You can’t see it, but the impact is real. And so it’s our job to bring to life the impact and show that this is real as a result of some trauma.

Nolan Axenfeld is a senior at DeMatha High School in Hyattsville, Maryland. He was expected to be one of the soccer team’s stars this season. He has already been recruited to play for Virginia Tech, and his coaches are eager for him to return to the field. So why has Nolan not returned to play? Over the summer season Nolan played for the Bethesda-Olney academy team, and he suffered a severe concussion in June. His head collided with another player’s head with such force that Nolan’s head was split open and had to be closed with staples. Nolan spent two weeks recovering from that injury and returned to the field in July for the team’s last two games.

Soccer Concussion

Nolan went on to spend the rest of his summer the way that many boys his age do. He vacationed by the water and spent his time diving, waterskiing, and tubing. Nolan quickly began to experience concussion symptoms again. He did not realize that his first concussion put him at risk for second impact syndrome. The repeat injury to his brain had a cumulative effect, which can result in long-term and even permanent impairments. Nolan sought help from a neurologist, an ophthalmologist, a chiropractor, and an acupuncturist, but he has received little relief. Nolan still experiences black spots that almost continually rotate through his field of vision and he has headaches that often last the entire day. Still some of his coaches are confused as to why he has not returned to the team.

One tool that professionals use to determine if a player is ready to return to play is a baseline test. If a player performs as well or better on their baseline test, which was conducted prior to the concussion, then some professionals believe that the player is fit to return to play. Other professionals like, Gerard Gioia, the Director and the Division Chief of Neuropsychology for the Safe Concussion Outcome at Children’s National Health System, believe that the baseline test is only one of many factors to examine.

Gioia says many players come to him asking “did I past the test”, as if it is the only factor involved in the decision to return to play. He responds to these players by saying, “our brain is too complicated for there to be [one] test. It really involves multiple kinds of factors, and we want to make sure we’re covering all of those factors, like the symptoms, the cognition, the balance, your school, your social function and so on. One of the ways the brain manifests an injury is through problems with your cognitive performance, but not every injury impairs your cognitive performance.” Nolan will not base his decision to return to play on the baseline test alone. He knows that as long as he is still experiencing concussion symptoms he is a very high risk to suffer repeat damage to his brain, which could result in catastrophic impairments.

Nolan’s coach Dafydd Evans, says, “what’s really strange is he keeps passing all of his concussion tests, so nothing shows that he is still concussed, which is very, very strange. He’s tried all types of things, and there seems to be a couple of things still bothering him.” Nolan’s teammates also wonder why he has not just shrugged off the symptoms and returned to the field. It was not an easy decision in the midst of pressure from many angles, but Nolan made the difficult yet admirable decision to put his health first.

At Chaikin, Sherman, Cammarata, and Siegel we continually stay informed of the developments in brain injury litigation. If you were injured playing sports, in an accident, or due to the negligence of another, we may be able to help you recover damages for injuries due to a traumatic brain injury. Please call our firm for a free legal consultation.

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