An international doctors group offers new guidelines for sports at all levels, incorporating the latest research on the effectiveness of protective gear.

An international brain injury panel says that athletes young and old should continue to wear mouth guards and helmets, but warn they may only make sports more dangerous.

The report, “The Consensus Statement on Concussion in Sport,” was drafted by a panel of 32 experts from around the globe and incorporates the latest research into guidelines for how we evaluate, treat, manage, and prevent concussions in sports at all levels.

The authors argue that while protective gear helps shield your body, it may encourage players to take greater risks by the sheer nature of increased competitiveness.

“There is no good clinical evidence that currently available protective equipment will prevent concussion,” the paper states. “An important consideration in the use of protective equipment is the concept of risk compensation…where the use of equipment results in behavioral change, such as the adoption of more dangerous playing techniques, which can result in a paradoxical increase in injury rates.”

While no qualified expert anywhere wants anyone to bash their heads together without proper equipment, they don’t want the illusion of safety in contact sports to overshadow the lasting effects of all-too-common head injuries.

The paper piggybacks on-going research that is taking a closer look at the lasting effects of sports-related head trauma. Just this year, researchers have found that former NFL players have a higher rate of depression and dementia later in life, the effects of childhood head injuries can last for decades, and repeated head trauma can cause tangles in a person’s brain tissue.

The latest research says that a single concussion can cause lasting damage, and that even mild injuries can cause bleeding in the brain.

Even mild head injuries can disrupt blood flow to the brain, potentially starving its tissues of oxygen.

Scientists at the Human Brain Lab at the Medical College of Georgia at Georgia Regents University were able to view a mild traumatic brain injury in a living mouse’s brain, helping them better understand the full effects of the injury.

The researchers watched as astrocytes—cells that supply neurons with nutrients while helping to maintain normal blood flow and electrical impulses—swelled to the point that they smothered the cells they supported.

“We saw every branch, every small wire and how it gets cut,” neuroscientist Dr. Sergei Kirov, co-author of the the study in the journal Brain, said in a press release. “We saw how it destroys networks. It’s the first time we know of that someone has watched this type of minor injury play out over the course of 24 hours.”

The brain cells can still remain alive for several hours, which would give emergency room doctors time to help save precious brain tissue. Kirov said the next step is investigating how to protect the brain from further damage after an injury.

While researchers clamor for the best ways to treat brain injuries, the new sports injury guidelines hope to solidify best practices for people at the highest risk—those who engage in contact sports.

“Concussion is one of the most complex injuries to diagnose and treat, and our understanding of concussion is constantly evolving,” Dr. Willem Meeuwisse, leader of the University of Calgary Brain Injury Initiative at the Hotchkiss Brain Institute, said. “This document attempts to give health care professionals a roadmap to what we believe will provide the best patient outcomes.”

The guidelines say that:

  • No athlete should be allowed to return to play after a suspected concussion.
  • Athletes must receive medical clearance from a physician before returning to competition.
  • Extended rest and other standard treatments may not be ideal for the first week following an injury because they are largely untested.
  • The injured player should make a “sensible,” gradual return to school, social, and physical activities.
  • Sports rules should be improved to help prevent concussions.

“In high profile sports, team doctors are under pressure to get players back into competition as quickly as possible,” researchers said in a press release for the British Journal of Sports Medicine. “But safe return to play after concussion is a key issue across all sports, irrespective of whether they are played at elite level.”

Read the full “Consensus Statement on Concussion in Sport.”