In 2010, Major League Soccer tried to face the concussion issue with medical might, creating the nine-member MLS Concussion Program Committee. It was a medical advisory group brought together to build a concussion protocol. It was the same year that 2005 MVP Taylor Twellman was forced to retire because of a concussion.
Since that committee was formed, the league has published its first concussion protocol, created the MLS Medical Symposium and updated its concussion program twice.
The protocol and the committee were led by Dr. Ruben J. Echemendia, a clinical neuropsychologist who also directed the symposium held 18 months ago.
Echemendia, who pioneered the NHL’s concussion protocol, believed that MLS had to standardize its concussion policy for all 19 teams.
“The management of the injury remains basically the same,” Echemendia said last year. “What’s different are the rules as in soccer. We have rules about substitution that make it difficult to do the kinds of evaluations that we would do in the NHL or even in Henry Melton Jersey the NFL.”
With three substitutions allowed per team in each game, there has been a vocal push among soccer critics for a rule change to allow substitutions for concussion victims. However, the MLS has to yet change in that area.
The MLS, which has required baseline testing for all players since 2007, puts an emphasis on its three-part checklist after a player suffers a concussion:
* He must pass cognitive tests and be symptom-free before returning to physical activity.
* He must remain symptom free after beginning low-level aerobic activity and gradually building up an exertion to the level of competition.
* He can only return to play after he has been cleared by a team physician.
League: Major League Soccer.
Background: MLS started baseline testing in 2007. The league announced a formal concussion protocol in 2011 and has updated the policy each season since. While the league has not released concussion numbers, its officials have said the head-injury statistics have declined as teams are adhering to the protocol.
The basics: The MLS requires evaluation by a medical team after the injury and does not allow a player to return to the practice or game in which he suffered the injury. He cannot play again until he is cleared by a team physician and/or a neuropsychologist.
Before the injury: The league gives all players the ImPACT test for creating a cognitive baseline prior to the season.
After the injury: The MLS does not allow a player to begin physical activity until his cognitive tests show he is back at this preseason baseline level. Then, he undergoes a gradual buildup of physical stress under constant monitoring by trainers and neurological tests along the way.
Back in the game: While some sports leagues require a neurologist’s approval, the MLS only requires the team physician to give a player the final clearance to play. However, neuropsychologists are often consulted.
The details: On Friday, MLS provided NFL Evolution with its “2013 Concussion Program Overview”:
Major League Soccer and its 19 clubs follow an evaluation protocol and return-to-play guidelines for players diagnosed with concussions. The MLS Concussion Program Committee, chaired by Dr. Ruben Echemendia, developed these procedures, which are designed to provide the best possible diagnosis and treatment of brain injuries and they supplement the diagnostic, educational, and preventative measures that MLS has taken in recent years. The MLS Concussion Program Committee (CPC) includes representation from MLS administration, MLS Players Union administration, MLS players, MLS team athletic trainers, MLS team physicians and an independent neurologist.
Before engaging in full contact play, MLS players undergo baseline neuropsychological testing. MLS has conducted baseline testing since 2007. If an injury occurs, baseline data will be compared to results from a comprehensive post-injury evaluation.
As in previous years, MLS has conducted educational meetings during this preseason with every MLS club’s coaches, technical staff, athletic trainers, team physicians, referees and players regarding concussion prevention and symptoms. MLS tracks injuries for purposes of study and future education.
Key elements of the existing protocol and guidelines include:
* Any player suspected of having sustained a concussion will be removed from play immediately and evaluated by team medical staff. If the initial evaluation results in a concussion diagnosis, he will not be returned to play in the same game or practice.
The MLS modified SCAT2 will be used to standardize the acute evaluation of concussion. This measure assists in the assessment of symptoms, orientation, balance, learning and memory, attention and concentration, motor responses and physical exertion.
* Every MLS club has a designated Team Consulting Neuropsychologist, one of whom will conduct the post-concussion neuropsychological evaluation when an injured player is symptom-free at rest, prior to his return to contact play or practice.
* Any player diagnosed with a concussion will be free of somatic and cognitive symptoms for at least 24 hours before starting an individualized, graded return-to-play progression under the supervision of the team physician.
* Once a player is symptom-free at rest and deemed to be neurocognitively at or above his baseline, he can begin the gradual process of light aerobic workout, followed by more intense aerobic workouts, strength training, non-contact sport-specific drills, contact sport-specific drills, heading training and finally, full competition — monitored at each step by the team physician for a re-emergence of symptoms. A player should only progress to the next step if he remains symptom free.
* The www.bearsofficialnfl.com/Authentic-Henry-Melton-Jersey Team physician has the ultimate and absolute authority to decide when a player is fit for return to play, and this decision will be made without regard to competitive considerations.
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