ICS President John Leddy, MD, FACSM, FACP, speaks on his goals for the future of the Society and what every health care provider should know about concussion
Dr. John Leddy, Medical Director of the University at Buffalo Concussion Management Clinic, recently assumed the role of President of the International Concussion Society, bringing his 30 years of experience as a sports medicine doctor and team physician to the Society.
Until recently, the recommendation for people with concussion was to rest until symptoms resolved. “I started noticing that some of the athletes who were advised on that approach were not getting better; in fact, they seemed to be getting worse,” Dr. Leddy says. He began working with Barry Willer, PhD, to help athletes feel better mentally and recover faster. Together, they developed the Buffalo Concussion Treadmill Test, which assesses athletes’ symptoms and level of recovery “to try to help them get back to their normal lives.”
Now at the helm of the International Concussion Society, Dr. Leddy wants to establish the Society as the leading expert source for concussion-related topics: “We want to ensure that people are getting the best information out there from centers that are leading innovators in concussion investigation and management,” he says. “Our goal is that a doctor in a community that does not have a concussion center can go to Concussion.Org and access resources that would help him or her effectively treat patients.”
Below, Dr. Leddy expands on his personal history with concussion, and why it is imperative that health care providers better educate themselves on its symptoms and lasting effects to better treat those affected by it.
What does the word concussion mean to you?
From a medical standpoint, it means something I am interested in helping people get through to the best of my ability. I want to help individuals recover and give them information on how to avoid any long-term problems or repeat injuries. From a research standpoint, I am interested in studying the physiology of concussion in a systematic way. I want to help clinicians effectively diagnose concussion and help patients recover faster. If we investigate why concussions affect our bodies the way they do, we can develop effective treatments to potentially reduce prolonged symptoms and avoid potential long-term consequences.
How has your perception of concussion changed?
In the 1990s and early 2000s, concussion was thought of as a brain injury that primarily affected your thinking, and that is true, it does. But what the sports medicine approach to concussion has taught me over the years is that it is much more than that. The brain affects every organ system and physiological process in the body. It affects your mood, vision and balance. Additionally, it affects the amount of blood flowing to your brain during exercise and your autonomic nervous system, which impacts the heart, blood pressure, pulse and breathing.
Essentially, I moved from an appreciation of concussion being an isolated brain injury to being a brain injury with widespread physiological effects on the body.
Have you experienced a concussion personally?
Playing basketball in high school, I had my legs taken out from under me and came down on my head. I wasn’t knocked out, but I was clearly disoriented and confused. My mother took me to the doctor, and I remember him shining a light in my eyes and asking me questions. I didn’t have long-lasting effects. Luckily, I got over it, but I’ll never forget it. It was pretty scary, and it affected me for a week or so.
Why is it so important to educate health care providers about concussions?
If health care providers don’t fully understand concussions, they might return someone to a sport or work before the patient is fully recovered. We know that if you do that, and the individual does too much physically or is hit again before full recovery, it makes things worse. There is excellent research in both animals and humans to show that the concussed brain is very vulnerable to repeat injury or to excess physiological stress. That is why it is important for health care providers to recognize and diagnose concussion and to try to establish when somebody is fully recovered.
The purpose of that is not to return someone to their sport as soon as possible. It is to make sure that with practical clinical tools, the doctor can make an informed opinion that the individual is indeed recovered and it is now safe for him or her to return to the former level of activity, whether that is work for an adult or a sport for a scholastic athlete.
I look forward to leading the International Concussion Society and promoting access to the latest evidence-based treatment recommendations for concussions, to inform health care providers and anyone who is impacted by this injury. The field needs an evidence-based resource for people anywhere in the world to easily access online, and that’s what we will provide.
John Leddy, MD, FACSM, FACP, is a member of the Scientific Advisory Board for the International Concussion Society. Concussion.org, sponsored by ICS, is the No. 1 destination for information related to concussion prevention, diagnosis and treatment. Our mission is to serve medical professionals, athletes, administrators, coaches, patients and the public by providing a central repository of accurate and scientifically vetted concussion research. Working alongside our world-class scientific advisory board, Concussion.org aims to be the most trusted global index on one of the most common, yet least understood, forms of traumatic brain injury.