Why Baseline Testing Isn’t a Silver Bullet for Concussion Prevention or Management
Baseline testing for concussions have been pushed as a great way to protect your athletes in sport and to help them prevent a concussion. The new evidence is showing that It’s not as useful or accurate as we once thought and isnt even recommend for most athletes.
How Baseline Testing Falls Short
Baseline tests can be unreliable because so many factors can affect the results—mood, fatigue, stress, or goofing around during testing. Scores can vary so much that it’s hard to establish a true baseline to compare against when a concussion does happen.
It’s also common for athletes to intentionally underperform during testing (known as sandbagging) to make future test results seem normal. That alone makes baseline testing tricky. And even when athletes are giving their best effort, baseline tests are mostly designed to catch obvious cognitive issues—not the subtle but significant symptoms like dizziness, headaches, or vision problems, especially if those symptoms were pre-existing.
On top of all that, baseline testing is expensive and time-consuming, making it challenging for many schools and teams to stay on top of.
Guidelines Are Changing
Experts like the International Concussion in Sport Group (CISG) and the American Academy of Neurology (AAN) now recommend focusing on symptoms and gradual return-to-play plans over baseline testing.
What Should You Do Instead?
Instead of relying on baseline testing, focus on these practical steps:
- Educate and Empower: Teach athletes and everyone involved what concussions look like, how they feel, and why speaking up about symptoms is so important.
- Encourage Open Communication: Encourage athletes to speak up when something feels off, without fear of letting the team down.
- Act Early: Assess and treat concussions as soon as symptoms show up for the best recovery.
- Use Symptom-Based Recovery Protocols: Tailor return-to-play and return-to-learn plans based on the athlete’s progress, not pre-season testing.