11/29/2009 05:12 am ET | Updated May 25, 2011

NCAA Title, Tim Tebow and Proper Concussion Management -- The Nation is Watching

The University of Florida Gator Football team has won 2 of the last 3 NCAA National Championships and is currently 4-0 and ranked number one in the polls.  Many experts and casual observers will agree that Heisman trophy winning quarterback Tim Tebow is the catalyst to the current UF football machine.

I am from Texas and have lived in Florida for over the last decade, so football is in my blood.  It is little exaggeration to suggest that Tim Tebow is the most popular person in the state.  In a head to head poll (held within the state) this college senior would challenge fellow Florida resident Tiger Woods.  I know this statement will be considered heresy by those that live outside of the ‘Sunshine State’ but I promise you that most Floridians will agree.

Now during the beginning of the SEC Conference schedule and a hunt for a third NCAA championship, Tim Tebow a living, Florida football legend has gone down to a serious concussion.  Tebow was already playing with a significant viral respiratory illness that prompted him and several teammates to be flown separately to the weekend match up against the University of Kentucky. 

The viral respiratory illness or flu may not seem like a big deal but as physicians we know that it may cause a potentially serious swelling of the brain that further confounds the concussion picture.

Tim Tebow underwent a CT scan of his brain and was hospitalized overnight for observation.  That’s the easy part.  The difficult question to answer is- When is it safe to allow Mr. Tebow to return to competition?

The proper timing of clearing a contact athlete (any athlete for that matter) for competition and further contact is truly one of the most difficult dilemmas that commonly face sports physicians. 


It’s pretty simple.  Medical science does not understand enough about concussions.  We still do not fully understand what transpires in the brain.  We know what the symptoms are but we do not understand the physiology of the injury.  Also, there are no definitive tests to evaluate the severity of the injury or document adequate recovery. 

The CT scan that was performed on Tebow merely documented that it was not another type of injury, primarily a bleed on the brain that may necessitate surgical decompression.  Currently, a MRI provides little additional information.

The current guidelines require that all symptoms be relieved before considering a return to play.  Hyper-competitive athletes will often minimize or flat out lie about the severity of their symptoms in order to ‘get back out there’.

Neurocognitive testing is the current state of the art tool that we may use to help in determining the proper timing of a return to contact.  It is not definitive and therefore considered another guideline certainly not a rule.

If the team’s medical staff keeps the star player out too long influential boosters complain, championship aspirations and millions of dollars for the athletic department go down the drain as the losses mount.  If the player returns too soon, especially younger athletes with developing brains, catastrophic results may follow.

 And you wonder where our (orthopedic surgeons) premature gray hair comes from.