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American Medical Society for Sports Medicine Position Statement on Concussion in Sport

Harmon, Kimberly G., MD*,†; Clugston, James R., MD‡,§; Dec, Katherine, MD; Hainline, Brian, MD; Herring, Stanley A., MD**; Kane, Shawn, MD††; Kontos, Anthony P., PhD‡‡; Leddy, John J., MD§§; McCrea, Michael A., PhD¶¶,║║; Poddar, Sourav K., MD***; Putukian, Margot, MD†††; Wilson, Julie C., MD‡‡‡; Roberts, William O., MD§§§

doi: 10.1097/JSM.0000000000000720
Position Statement: PDF Only

Abstract: Sport-related concussion (SRC) is a common injury in recreational and organized sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment, and management of SRC. In addition to a growing need for knowledgeable health care professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC. The American Medical Society for Sports Medicine formed a writing group to review the existing literature on SRC, update its previous position statement,1 and address current evidence and knowledge gaps regarding SRC. The absence of definitive outcomes-based data is challenging and requires relying on the best available evidence integrated with clinical experience and patient values. This statement reviews the definition, pathophysiology, and epidemiology of SRC, the diagnosis and management of both acute and persistent concussion symptoms, the short- and long-term risks of SRC and repetitive head impact exposure, SRC prevention strategies, and potential future directions for SRC research. The American Medical Society for Sports Medicine is committed to best clinical practices, evidence-based research, and educational initiatives that positively impact the health and safety of athletes.

Departments of *Family Medicine; and

Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington;

Departments of Community Health; and

§Family Medicine and Neurology, University of Florida, Gainesville, Florida;

Department of Physical Medicine and Rehabilitation, and Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia;

National Collegiate Athletic Association, Indianapolis, Indiana;

**Department of Rehabilitation Medicine, University of Washington, Seattle, Washington;

††Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina;

‡‡Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania;

§§UBMD Department of Orthopaedics and Sports Medicine, State University of New York at Buffalo, Buffalo, New York;

Departments of ¶¶Neurosurgery; and

║║Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin;

***Department of Family Medicine and Orthopedics, University of Colorado, Denver, Colorado;

†††Princeton University, University Health Services, Internal Medicine/Sports Medicine, Rutgers—Robert Wood Johnson Medical School, New Brunswick, New Jersey, Princeton, New Jersey;

‡‡‡Department of Orthopedics, University of Colorado, Aurora, Colorado; and

§§§Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota.

Corresponding Author: Kimberly G. Harmon, MD, Departments of Family Medicine; and Orthopaedics and Sports Medicine, University of Washington, 3800 Montlake Blvd, Seattle, WA 98195 (kharmon@uw.edu).

The authors report no conflicts of interest.

This article has been co-published in the British Journal of Sports Medicine.

Received November 13, 2018

Accepted November 30, 2018

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