How Many Concussions is Too Many?

It’s difficult to say how many concussions are too many. There is no general rule. The American Academy of Neurology recommends termination of the season after the third concussion within that same season. Important for coaches and parents of young athletes to understand is that an athlete disqualified for a “season” may need to continue to be held out through successive sports. Each young athlete must be considered on an individual basis. Factors to consider will be the number of concussions sustained and the severity of each concussion. The risk level for concussion in a particular sport must also be considered as must the athlete’s age and level of participation. Some other research suggests that an athlete who has sustained three previous concussions in a career should no longer be allowed to participate in contact sport.What is known is that once an athlete sustains one concussion, he or she is at increased risk for sustaining subsequent concussions. Furthermore, with the evidence surrounding the need for additional recovery time, coaches and parents should be extremely conservative when managing younger athletes with concussion. Regardless of the number of concussive injuries, return to play should only be considered after all symptoms have resolved and when the athlete has returned to normal on post-concussion neurological or postural stability examinations such as the SACBESS or software-based test.