As sure as the sun rises and sets every day, resistance from sports parents and young athletes with …

[Sam Colon]

As sure as the sun rises and sets every day, resistance from sports parents and young athletes with return to play recommendations, especially when it comes to concussions, is something I’ve come to expect in my work as an urgent care pediatrician. This is one of the biggest uphill battles we face as pediatricians but one we can’t afford to lose without resulting in dire consequences for an athlete and a family.

For concussions, Boston Bruin’s Patrice Bergeron’s story and his continued cautious, step-wise slow return to play are the exact play book we need to follow when handling concussions in athletes of ages, and is consistent with current recommendations from the American Academy of Pediatrics as explained in the January 2009 Pediatrics (Volume 123, Number 1 pagers114-123).

Bergeron sustained his second concussion on December 20, 2008, the having occurred on October 27, 2007 after playing only ten games during that season. On January 4, 2009, two weeks post-injury, Boston Bruins General Manager Peter Chiarelli reported that Bergeron was starting light exercises because his symptoms were progressing well. Bergeron continued his slow, step-wise return to play until his return to the ice January 11, 2009 but was not cleared to play a game until January 27, 2009. His health was the driving factor; not playing in a game.

The currently accepted, step-wise return to play protocol involves starting with rest and progressing slowly as follows:

Step 1: No activity with rest.

Step 2: Light aerobic activity

Step 3: Sport-specific exercise

Step 4: Noncontact drills; progressive resistance training

Step 5: Full contact training after medical clearance

Step 6: Game play

Like with Bergeron, we have to be very cautious with concussions in young athletes...

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