Return to play guidelines cannot solve the football-related concussion problem.

Area of Science:

• Neuroscience
• Sports Medicine
• Pediatric Traumatology

Background:

• High school football players represent a large cohort of athletes in tackle football and experience the majority of sport-related concussions.
• Return to play guidelines (RTPs) are currently the primary approach for managing concussions in young athletes.

Purpose of the Study:

• To review the risks and effects of football-related concussion and subconcussive brain trauma.
• To evaluate the effectiveness of RTPs in preventing concussions and mitigating brain trauma in youth athletes.

Main Methods:

• A comprehensive literature review was conducted using PubMed and Google Scholar.
• Search terms included "football," "sports," "concussion," "Chronic Traumatic Encephalopathy," "athlete," "youth," and "pediatric."
• Emphasis was placed on medical journals and primary neuroscientific research concerning youth athletes.

Main Results:

• Sport-related concussion poses a significant risk to student athletes, who are more vulnerable and susceptible to long-term neurocognitive deficits.
• RTPs demonstrate limited effectiveness in addressing sport-related concussions or the chronic damage from subconcussive brain trauma.
• Student athletes face risks of neurocognitive deficits impacting academic and athletic performance for over a year.

Conclusions:

• Relying solely on RTPs may hinder essential reforms for concussion prevention in youth football.
• More effective strategies are necessary to prevent concussions and reduce brain trauma.
• Recommendations include eliminating tackling for athletes under 16 and implementing broader safety modifications in football.