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Pastrana’s Choice: Forfeit Championship or Ignore Concussion Recovery Guidelines

With the retirement of famous football player Steve Young a few years ago due to recurring concussions on the field, head injury in sports, and concussion, in particular, has become a relatively hot topic.

If anything, concussion is just as big a topic, or should be just as big a topic, in the motocross arena. Concussions are not uncommon in motocross accidents, and the question of rehabilitation time always arises.

From what we can tell, sport team physicians (professional team physicians) most frequently apply the Colorado Medical Society Guidelines for the management of concussion in dealing with loss of consciousness from head impact. Those guidelines recommend a minimum of six weeks before “return to play” by an athlete who has suffered a Grade 3 (severe) concussion (which is defined as “loss of consciousness” whether brief or extended). If a second concussion is suffered during the same “season” (apparently the same year), these guidelines recommend terminating the season, and “return to play” next season if the patient is without symptoms. One medical study indicates the risk of sustaining a new concussion can be four to five times higher in patients who have had at least one concussion in the past.

Suzuki factory motocross rider Travis Pastrana suffered his first Grade 3 concussion this year (as defined by the Colorado Guidelines — and based on a Cycle News report describing the loss of consciousness) on January 14, during Round 2 of the AMA Supercross series in San Diego, California (riding a 250, before the East Coast 125 series started). Pastrana attempted to “return to play” by racing the very next weekend in the 250 class, but, pulled out of the 250 main event after feeling dizzy and lightheaded (again, according to a Cycle News report, and an additional report the following week by Cycle News containing comments by Robert Pastrana, Travis’ father). Ultimately, Pastrana decided to wait until the East Coast series started several weeks later, and was apparently without symptoms from concussion until his most recent accident at Unadilla, New York last weekend.

At Unadilla, racing in the 125 class during the second moto, Pastrana again lost consciousness following a crash. This occurred on the last lap, and the accident forced him to surrender the moto lead and victory to KTM’s Grant Langston.

Pastrana still leads the AMA 125 Outdoor National Championship series by 22 points. There are 5 races left in the series, and the next two races occur on consecutive weekends (beginning this coming weekend). Pastrana must decide whether he will race this weekend and attempt to gain his second, consecutive 125 Outdoor title, or whether he will take time off to recover from his head injury.

Of course, we hope Pastrana is feeling well following his second serious concussion this year, and we hope he makes the right decision regarding his rehabilitation from that injury. The conflict between the pressures of maintaining his championship points lead and following accepted medical guidelines for rehabilitation are obvious. We wish him the best.

Related Links: emedicine.com; Neurosurgery://On-Call.