Concussion in Sport - What now?
Unlike elite sport, there isn’t a Doctor on site to perform a Head Injury Assessment, so players and their carers need to make decisions about what actions to take. If a concussion is suspected, immediate removal from play is essential to avoid serious injury and prolonged symptoms.
If in doubt, sit them out
When do I go to the Hospital?
As always, your personal level of comfort, or ‘trusting your gut’ is an invaluable tool. If the following are present, you should take your child to an Emergency department.
In an Emergency, always call 000.
H worsening Headache, seizure, unconscious
E worsening Eye problems (blurred/ double vision)
A Abnormal behavior change
D Dizziness, persistent vomiting
B Balance dysfunction with weakness or numbness in legs/arms
U Unsteady on feet, slurred speech
M Memory impaired, confused, disoriented
P Poor concentration, drowsy, sleepy
S Something’s not right (concerned about child)
Source: www.schn.health.nsw.gov.au/fact-sheets/concussion-and-mild-head-injury
After a suspected concussion, players should be supervised by a responsible adult for at least 4 hours, avoid alcohol, aspirin, anti-inflammatories (such as ibuprofen) and and sedating sleep or pain medications. Check medications with a doctor.
What is a Concussion?
A concussion is an injury that occurs through a blow to the head, or an impact to the body that causes the head to move in a way that transmits forces to the brain.
Less than 1 in 10 concussions cause a loss of consciousness
A concussion affects the function of the brain temporarily. If a scan is performed, structural or physical changes cannot be seen in a concussion. Your medical assessment will look for symptoms and signs that suggest that further imaging of the brain or neck is advisable, but this is uncommon.
Symptoms may include:
Pain/Physical
Headache
Dizziness, poor balance
Visual blurring, double vision
Fatigue
Sensitivity to light and noise
Emotional
Mood changes, sadness
Nervousness, increased anxiety
Irritability
Cognitive
May appear dazed
Confusion, drowsiness
Difficulty remembering
Trouble concentrating
Feeling ‘in a fog’ or ‘not right’
Sleep
Trouble falling asleep
These symptoms may be worsened by mental or physical activity.
How is a Concussion Diagnosed?
If hospital attendance is not required, an athlete should see a doctor experienced in the management of concussion, such as a Sports and Exercise Doctor, or their GP within 48 hours.
A diagnosis is based on video footage or recall of the injury, the symptoms experienced by the player and bystander observations. This is then combined with testing of cognitive function, balance testing and neurological examination. Examining the neck is also important to inspect for serious injury and also whether neck dysfunction is contributing to the symptoms.
How do I Recover from a Concussion?
Concussion is a treatable condition. Knowledge has moved forward from the previous advice to simply rest and wait. In fact, although a couple of days of both physical and mental rest is crucial as prolonged rest can slow down recovery. This is why early assessment and advice from a doctor experienced in the management of concussion is important.
The majority of athletes with a sport-related concussion will recover within 2 weeks for adults and 4 weeks for children.
Once assessed by a doctor, gradually increase mental activity, focusing on returning to school, work or study. Start with small blocks of light reading, use rest breaks and talk to your school or employer early to make accommodations.
Return to Learn before Return to Play
While increasing mental activity, light exercise can begin and may be as simple as a couple of brisk walks over the day. Gradually increase to cycling or swimming, then jogging. Keep to a ‘conversational’ pace, where you can easily talk in sentences. Moving on to more intense or complex training will be guided by your doctor.
Concussion disrupts many areas of life and has a range of symptoms from physical, social, emotional and cognitive. A team of health professionals may be recommended, such as Physiotherapists, Vestibular/Balance Therapists, Psychologists and Occupational Therapists.
Recognizing that most people recover well and being optimistic towards recovery is important.
Where Do I Find Out More?
Concussion in Sport Australia brings together the most contemporary evidence-based information on concussion for athletes, parents, teachers, coaches and medical practitioners.
Sport Australia - Concussion in Sport
The Concussion Recognition Tool – A field side guide to identify a possible concussion
Sydney Children’s Hospital Network has extensive information, including return to school advice
