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NBA Sees Increase in Reported Concussions Since Implementation of Concussion Policy in 2011

A look at the NBA’s concussion policy and what changes could be made moving forward

Given the ever-increasing insight into concussion and its short and long-term impacts, the National Basketball Association (NBA) – like the National Football League (NFL), National Hockey League (NHL), and Major League Baseball (MLB) – implemented a concussion policy to handle concussion cases in the league (1-4). In comparison to the NFL and NHL (and to a lesser degree the MLB), concussions in the NBA have not been heavily researched. A study published in July 2019 decided to build on the small foundation of research and investigate concussion incidence rates, return-to-play (RTP) rates, and performance statistics from 1999-2018. The goal was to compare these statistics from before and after the NBA’s concussion policy was implemented to see how these stats have changed over time.

Concussions Per Season

After the implementation of the National Basketball League’s (NBA) concussion policy in 2011, reported concussions increased from roughly six concussions/season to almost 17 concussions/season.

After the implementation of the National Basketball League’s (NBA) concussion policy in 2011, reported concussions increased from roughly six concussions/season to almost 17 concussions/season. The increase in concussion after the implementation of a concussion policy is also seen in other sports – such as the NFL, NHL, and MLB. This increase simply highlights more awareness and education on how to suspect and diagnose a concussion rather than an increasingly dangerous sport environment (5-7). 

Time Taken to RTP and Performance after RTP

The duration of time between concussive injury and return to play (RTP) did not change significantly after the implementation of the concussion policy – with a rate of 3-4 missed games (7-8 days missed).

The duration of time between concussive injury and return to play (RTP) did not change significantly after the implementation of the concussion policy – with a rate of 3-4 missed games (7-8 days missed). Finally, the concussed player’s performance in games after they recover from concussion (as measured by game minutes and the athlete’s game score) also did not significantly change when compared to the player’s pre-concussion performance. This latter area should be studied more thoroughly as some studies suggest that concussions do have a short-term impact on a player’s ability to perform (depending on the sport).

Details of the NBA’s Concussion Policy

The NBA’s concussion policy follows a standard format: preseason education, baseline testing, acute evaluation and management, and a RTP program. Each of these components provides a foundation in which one can expect to see increased reporting of concussion as education facilitates the proper recognition and disclosure of symptoms; the assessment tool and baseline testing helps to diagnose concussion as well as assess readiness for RTP; and protocols generally ensure that players promptly receive medical treatment. Also, comprising the NBA’s concussion policy is the rule that any NBA player suspected of concussion must be assessed and, if diagnosed, cannot return to play the same day or the next day. Finally, the director of the NBA’s concussion policy oversees all cases.

Details of the Study

Concussions in the NBA were identified by going through multiple sources and identifying announced concussion injuries, and these were then confirmed by the NBA’s official injury reports. 189 concussions in 153 players were identified, which is an average of about ten concussions/season.

There were 27 players who had repeat concussions, but the average time between concussions was 855 days, with nine incidences of multiple incidences of concussion within a season between 1999-2018. 

There were some issues with this study, including poor quality of online reporting prior to the study period, which means they could not verify concussion history prior to 1999. Furthermore, pre vs. post-concussion performance did not account for extrinsic factors such as which team the concussed player’s team was facing. 

Moving Forward

There are improvements that the NBA could make – implementing a mandatory sit-out period like the MLB, as well as a centralized concussion database, could be wise.

About The Author

Rebecca Babcock is a recent graduate of the University of Otago in New Zealand, completing a Master’s in Bioethics and Health Law. Her thesis examined the ethical and legal issues surrounding concussion management. She currently spends her time working for the Concussion Legacy Foundation – Canada as a programming coordinator and at Sunnybrook Hospital investigating concussion prevention, management, and education services. Her dream is to be a clinical ethicist at a hospital which she is starting to fulfill by volunteering as a bioethics assistant at Humber River Hospital in Toronto.

Works Cited

  • National Basketball Association. NBA concussion policy summary— 2017-18 season. https://official.nba.com/wp-content/uploads/sites/4/2017/12/Concussion-Program-Summary-2017-18.pdf. Accessed February 2019.
  • National Football League. NFL Head, Neck and Spine Committee’s concussion diagnosis and management protocol. https://www.playsmartplaysafe.com/focus-on-safety/protecting-players/nflhead-neck-spine-committees-protocols-regarding-diagnosismanagement-concussion. Accessed February 2019.
  • National Hockey League. NHL concussion management and evaluation protocol. https://nhl.bamcontent.com/images/assets/binary/ 282574512/binary-file/file.pdf. Accessed February 2019.
  • Keller RA, Mehran N, Marshall NE, et al. Major League pitching workload after primary ulnar collateral ligament reconstruction and risk for revision surgery. J Shoulder Elbow Surg. 2017;26(2):288-294.
  • Kuhn AW, Solomon GS. Concussion in the National Hockey League: a systematic review of the literature. Concussion. 2015;1(1):CNC1.
  • Nathanson JT, Connolly JG, Yuk F, et al. Concussion incidence in professional football: position-specific analysis with use of a novel metric. Orthop J Sports Med. 2016;4(1):2325967115622621.
  • Sabesan VJ, Prey B, Smith R, Lombardo DJ, Borroto WJ, Whaley JD. Concussion rates and effects on player performance in Major League Baseball players. Open Access J Sports Med. 2018;9:253-260.

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