With winter sport starting up again, it seems a perfect time to talk about concussion. Concussion seems to be the hot topic over the past few years. Sports commentators are talking about it far more than ever before. Even Hollywood has shown the impact of concussion on people’s lives.
In this article we will cover:
What is Concussion?
Signs and symptoms
What do the latest guidelines say about assessment and treatment
When can a player return to sport
Post concussion syndrome and how physio plays an integral role in rehabilitation
What is concussion?
Concussion is a head injury caused by traumatic forces to the brain. This can happen either by a direct hit to the head or a ricochet effect from a big impact.
What does concussion look like?
There are obvious and subtle signs that someone has sustained a concussion.
– Loss of consciousness
– Slow to get up.
– Blank look
– Balance, walking and coordination problems
– Memory Loss – you can ask them some simple questions like “What venue are we at today? What half is it?
– Light and noise sensitivity
– More emotional than normal
– Feeling foggy
What do the latest 2021 guidelines say about concussion?
A player who has a suspected concussion must be removed from the game immediately and must not return under any circumstances.
There are a few important initial things to do with a player suffering a suspected concussion:
1) Monitor symptoms, particularly for any serious symptoms. You should call in ambulance immediately if player has any of the following signs or symptoms:
Neck pain or tenderness
Weakness or tingling/burning in arms or legs
Severe or increasing headache
Seizure or convulsion
Loss of consciousness
Deteriorating conscious state
Increasingly restless, agitated or combative
2) Player must not be left alone for 1-2 hours
3) Player must avoid alcohol
4) Player must not drive home, a responsible adult must drive them home.
5) You can conduct a memory test.
Within 72 hours of the initial injury, the player must be referred to an emergency department or see a medical professional who is experienced in concussion management.
Once the player has returned home, they need 24 hours of total rest from mental and physical activity. This includes minimal screen time, no school/work and no physical activity. The total minimum time for complete and relative rest (until symptoms had stopped with no medication) is 7 days for 19years and over and 14 days for 18years and under.
When can the player return to sport?
This time will vary from player to player however the minimum times are as follows:
– Under 18 years cannot return for at least 19 days after all symptoms have disappeared
– Over 18 years cannot return for at least 12 days after all symptoms have disappeared
Does headgear reduce the risk of concussion?
There is a strongly held idea that wearing headgear will reduce the risk of concussion. Significant research has been conducted in the area and unfortunately has not found that wearing headgear will reduce concussion risk. Does this mean you shouldn’t wear headgear…no! Headgear is particularly useful at reducing the risk of cut to the head, as well as the dreaded cauliflower ears.
How can physio help in concussion?
While most people will recover without problem from concussion, some players will develop post concussion syndrome (PCS). PCS can limit players from return to sport for extended periods of time.
Physiotherapy plays a key role in PCS and can help players to return to sport up 4 times quicker. Neck pain, stiffness, weakness and reduced joint position sense (JPE) all contribute to PCS and can be addressed with specific exercises and manual therapy.
If there is 1 key thing to remember with regards to concussion, it is this… “If in doubt, sit it out!”
If you have any questions regarding concussion or post concussion syndrome, please do not hesitate to get in touch with us.
Andrew Clark is a father of 3 and the owner and principal physiotherapist at Clinical Physiotherapy, St Ives. He graduated with a Masters degree from the University of Sydney in 2010 and has since had 10 years experience working in musculoskeletal private practice. He has undergone extensive professional development and has experience treating a wide variety of patients and musculoskeletal conditions.