A retrospective view of concussion in American football, 1900-1959: What was suggested then we now know.

Abstract

While published work and media attention about football-related concussion in the USA have increased exponentially in the past few years, these injuries have in fact been written about for over a century. In this work, we undertook a selective review of the PubMed database of the published reports on concussion in football prior to 1960, with attention to the definitions used, physician attitudes, epidemiology, return to play criteria and recommendations and concerns related to long-term outcomes. Search inclusion criteria were English language, publication between the years 1900 and 1959 and studies written by healthcare professionals treating football-related injuries. Twenty-six studies met the inclusion criteria for this review, and the findings are grouped by topic area and detailed chronologically. Early sports medicine physicians struggled with many of the same issues faced today by clinicians such as honest reporting of symptoms by athletes, lack of uniform diagnosis and treatment and ambiguity over maximum 'safe' number of lifetime concussions.