With the NFL and NHL seasons well under way, Leddy discusses the progress that doctors, teams and athletes have made in understanding concussions and recognizing the seriousness of the injuries. With colleague Barry Willer, Leddy has developed an exercise-based test that helps doctors understand when it’s safe for an athlete to return to play. Athletes treated at Leddy’s concussion management clinic include Toronto Maple Leafs center Tim Connolly, formerly of the Buffalo Sabres.
On the need to take concussions seriously:
“There’s no such thing as a minor concussion, and the problem is that once you have one or two, you’re more likely to have a third, fourth or a fifth, and then you are at risk for sustaining cumulative and permanent damage over time. The brain is a unique organ. You only have one, and you need it for almost everything else. Clearly, the animal and human research shows that if somebody goes back before they’re fully recovered, they’re going to fare much worse and often will have a second, more significant, injury.”
On the progress that doctors, teams and the public have made in recognizing that concussions are serious:
“When I was playing high school sports, people went into play after concussions. Nobody realized that they were dangerous. They thought you got your “bell rung,” and then you got over it and that was it.”
“It’s really gotten press in the last two or three years at the NFL level and NHL level. And then when you have very prominent athletes like Sidney Crosby and Eric Lindros—they get a lot of publicity and it starts to get public attention. I think with all the publicity about concussions in professional athletes over the past year, scholastic athletes and team physicians are certainly taking concussion more seriously now.”
On the method Leddy and Willer have developed to test whether athletes are ready to return to play:
“We use a standardized treadmill exercise test to establish the exercise tolerance of patients with post-concussion symptoms lasting more than three weeks. In the test, patients exercise on a treadmill with gradually increasing intensity until they can exercise to full capacity without worsening symptoms.”
“The test replicates the physiology of what athletes have to do during sport. It helps us determine when an athlete is physiologically recovered from concussion and is safe to return to play. It is our experience that this program speeds recovery in those with abnormal physiology, especially in athletes.”
"The test also assists in the differential diagnosis of ongoing symptoms—physiologic post-concussion syndrome versus cervical injury versus migraine headaches, for example. Patients with physiologic post-concussion syndrome are given a specific exercise prescription based upon the treadmill results to safely perform at home on a daily basis. When we rule out physiologic post-concussion syndrome with the treadmill test, we are able to direct specific therapy to the underlying problem, such as a cervical issue or a migraine headache."
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