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Cited by 74Traumatic Brain Injury ResearchSports injuries and preventionMartial Arts: Techniques, Psychology, and Education

Concussion management in combat sports: consensus statement from the Association of Ringside Physicians

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Neidecker, John, Sethi, Nitin K, Taylor, Randolph, Monsell, Raymond, Muzzi, Don, Spizler, Bruce, Lovelace, Larry, Ayoub, Edmund +17 more·2019·British Journal of Sports Medicine
DOI 10.1136/bjsports-2017-098799PMC PMC6579496
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Abstract

Various organisations and experts have published numerous statements and recommendations regarding different aspects of sports-related concussion including definition, presentation, treatment, management and return to play guidelines.1–7 To date, there have been no written consensus statements specific for combat sports regarding management of combatants who have suffered a concussion or for return to competition after a concussion. In combat sports, head contact is an objective of the sport itself. Accordingly, management and treatment of concussion in combat sports should, and must, be more stringent than for non-combat sports counterparts. The Association of Ringside Physicians (an international, non-profit organisation dedicated to the health and safety of the combat sports athlete) sets forth this consensus statement to establish management guidelines that ringside physicians, fighters, referees, trainers, promoters, sanctioning bodies and other healthcare professionals can use in the ringside setting. We also provide guidelines for the return of a combat sports athlete to competition after sustaining a concussion. This consensus statement does not address the management of moderate to severe forms of traumatic brain injury, such as intracranial bleeds, nor does it address the return to competition for combat sports athletes who have suffered such an injury. These more severe forms of brain injuries are beyond the scope of this statement. This consensus statement does not address neuroimaging guidelines in combat sports.

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  • The increased risk of hormonal sequelae from sports-related TBI has not yet been reflected in official guidance on sports-related concussions.

    “This increased risk of hormonal sequelae from sports-related TBI has not yet been reflected in official guidance on sportsrelated concussions”

    From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [42]

    The Abstract and Discussion of guidelines describe concussion-management and return-to-sport guidance, but do not address hormonal sequelae. Searches for hormonal, endocrine, pituitary, and hypopituitarism did not find a passage stating that sports-related TBI increases hormonal risk or that official concussion guidance omits it. (LLM, conf=0.74)

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  • There is some evidence that pituitary hormone dysfunction is seen at increased rates after subarachnoid hemorrhage and ischemic stroke, though definitions of deficiencies in this literature vary.

    “There is some evidence that pituitary hormone dysfunction is seen at increased rates after subarachnoid hemorrhage and ischemic stroke, though definitions of deficiencies in this literature vary [39-43].”

    From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [42]

    The paper’s “Current publications regarding concussion in combat sports” section discusses imaging changes and cognitive impairment associated with fight exposure, not pituitary hormone dysfunction. Searches for pituitary deficiency, subarachnoid hemorrhage, ischemic stroke, and varying deficiency definitions found no passage addressing the claim. The indexed passages have no page numbers. (LLM, conf=0.74)

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Authors
Neidecker, J., Sethi, N. K., Taylor, R., Monsell, R., Muzzi, D., Spizler, B., Lovelace, L., Ayoub, E., Weinstein, R., Estwanik, J., Reyes, P., Cantu, R. C., Jordan, B., Goodman, M., Stiller, J. W., Gelber, J., Boltuch, R., Coletta, D., Gagliardi, A., Gelfman, S., Golden, P., Rizzo, N., Wallace, P., Fields, A., & Inalsingh, C.
Affiliations
  • Campbell University (US)
  • NewYork–Presbyterian Hospital (US)
  • Memorial Hermann (US)
  • Royal College of Surgeons in Ireland (IE)
  • University of Minnesota (US)
  • INTEGRIS Southwest Medical Center (US)
  • Desert Regional Medical Center (US)
  • White Plains Hospital (US)
  • Phoenix VA Health Care System (US)
  • Boston University (US)
  • Burke Rehabilitation Hospital (US)
  • University of Maryland, Baltimore (US)
  • Connecticut Children's Medical Center (US)
  • Albert Einstein College of Medicine (US)
  • Saint Agnes Medical Center (US)
  • Loyola University Chicago (US)
  • Cedars-Sinai Medical Center (US)
Corresponding author
Neidecker, John
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2018-07-26
Volume
53
Issue
6
Pages
328-333
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2017-098799
PMC
PMC6579496
OpenAlex
W2884241291
Cited by
74
References
37
Citations by year
2026: 14 · 2025: 10 · 2024: 8 · 2023: 8 · 2022: 5 · 2021: 14 · 2020: 6 · 2019: 9
FWCI
5.66
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • British Journal of Sports Medicine (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
National Operating Committee on Standards for Athletic Equipment
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Social Sciences › Safety Research › Martial Arts: Techniques, Psychology, and Education
Keywords
concussion, combat sports, return to competition, concussion management guidelines, head contact, sports-related concussion
MeSH terms
Return to Sport, Athletic Injuries, Brain Concussion, Humans, Physicians, Societies, Medical, Sports Medicine, Consensus, Athletes

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