Getting Back on the Horse: Sport-specific return to play in rodeo athletes after concussion injury

Abstract

Context: Despite a high incidence of injury in their sport, rodeo athletes have been underrepresented in the concussion literature. No standard postconcussion protocols are available across rodeo organizations for evaluating fitness to return to competition. Objective: To review the literature on concussion in rodeo, examine published guidelines, and offer an active return-to-play (RTP) protocol specific to rodeo athletes. Background: Unique barriers complicate the management and treatment of rodeo athletes with concussion, such as the solo nature of the sport, lack of consistent access to health care professionals, and athletic conditioning that often occurs outside of a traditional gym-based exercise regimen. In addition, the rodeo culture encourages a swift return to competition after injury. Description: Best practices for managing concussion are removal from activity, proper diagnostic evaluation, and gradual return to sport, with medical clearance when an athlete is symptom free and able to tolerate cognitive and physical exertion. An RTP protocol for rodeo events needs to capture the distinctive features and challenges of the sport and its athletes. Clinical Advantages: Rodeo athletes would benefit from an RTP protocol that can be initiated by an athletic trainer or medical professional in the acute stage of injury, integrates exercise into activities of daily living, and is appropriate for athletes who travel frequently. At the organizational sport level, a formal RTP protocol could enhance consistency in medical-clearance techniques among providers responsible for the return to sport of rodeo athletes. Conclusions: Rodeo athletes represent a sport population that has received little formal guidance on the diagnosis, management, and RTP after concussion. A sport-specific RTP protocol sensitive to the particular culture of these athletes is an important first step in protecting the health and safety of rodeo athletes after a concussive injury.