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Concussion in Sport - Athlete Information Sheet

May 11, 2018

 Concussion in Sport – Athlete Information Sheet

What is concussion?

Concussion is a type of brain injury, caused by a knock to the head or anywhere on the body where the force is transmitted to the head; it can also be caused by a fall. It commonly causes short-lived neurological impairment (impairs the functioning of the brain) and the symptoms may evolve over the hours or days following the injury. While all concussions should be assessed by a doctor, most will resolve without the need for specific treatment. Rest, followed by gradual return to activity is the main treatment. All concussions are serious.

 

How to recognise concussion.

Recognising concussion can be difficult, but proper response and management can help prevent further injury or even death. Most people who sustain concussion do not lose consciousness. There are several possible symptoms and signs but they are not specific to concussion. The signs and symptoms can be subtle. Onlookers should suspect concussion when an injury results in a knock to the head or body that transmits a force to the head. A hard knock is not required, concussion can occur from relatively minor knocks.

 

What are the signs of concussion?

There may be obvious signs of concussion such as loss of consciousness, brief convulsions or difficulty balancing or walking, however the signs can be more subtle. Below is a list of symptoms or signs that may indicate concussion.

 

Possible symptoms/signs

  • Headache

  • ‘Pressure in the head’

  • Neck pain

  • Nausea or vomiting

  • Dizziness

  • Blurred vision

  • Balance problems

  • Sensitivity to light

  • Sensitivity to noise

  • Feeling slowed down

  • Feeling like ‘in a fog’

  • ‘Don’t feel right’

  • Difficulty concentrating

  • Difficulty remembering

  • Fatigue or low energy

  • Confusion

  • Drowsiness

  • More emotional

  • Irritability

  • Sadness

  • Nervous or anxious

  • Trouble falling asleep (if applicable)

Obvious symptoms/signs

  • Loss of consciousness

  • No protective action in fall to ground directly observed or on video

  • Impact seizure or tonic posturing

  • Confusion, disorientation

  • Memory impairment

  • Balance disturbance or motor incoordination (e.g. ataxia)

  • Athlete reports significant, new or progressive concussion symptoms

  • Dazed, blank/vacant stare or not their normal selves

  • Behaviour change atypical of the athlete

Critical symptoms/signs – if an athlete displays these signs they may have a more serious injury. They should be immediately taken to the nearest emergency department

  • Neck pain

  • Increasing confusion, agitation or irritability

  • Repeated vomiting

  • Seizure or convulsion

  • Weakness or tingling/burning in the arms or legs

  • Deteriorating conscious state

  • Severe or increasing headache

  • Unusual behavioural change

  • Double vision

What are the obvious signs an athlete is concussed?

In addition to the above listed symptoms of concussion, if an athlete has one or more of the following signs after a knock, tackle or fall, the athlete has signs of concussion and should be immediately removed from sport and reviewed by a medical practitioner.

  • Loss of consciousness

  • Seizure or jerky movements after a knock

  • Dazed or looking blank/vacant

  • Confused                                                                             

  • Slow to get up, drowsy

  • Unsteady on feet or balance problems

  • Changed behaviour – may be more irritable, agitated, anxious or emotional than normal

A medical practitioner should review any athlete with suspected concussion. If a doctor is not immediately available, the athlete must not be returned to sport on the same day. If there is any doubt about whether an athlete is concussed that athlete should not be allowed to return to sport that day.

An athlete with suspected concussion should be reassessed to look for developing symptoms and cleared by a medical practitioner before returning to sport. Due to the evolving nature of concussion, delayed symptom onset is common. Therefore, any athlete cleared to return to sport after medical assessment for suspected concussion should be monitored closely for developing symptoms or signs. If symptoms develop, the athlete should be removed from sport.

 

How to manage concussion

Any athlete with suspected or confirmed concussion should remain in the company of a responsible adult and not be allowed to drive. They should be advised to avoid alcohol and check medications with their doctor. Specifically, they should avoid aspirin, anti-inflammatories (such as ibuprofen, diclofenac or naproxen), sleeping tablets and sedating pain medications.

The athlete’s medical practitioner should provide head injury advice to the athlete with concussion and their carers.

Once the diagnosis of concussion has been made, immediate management is physical and cognitive rest. This allows the brain to ‘rest’ and helps recovery. To allow both physical and mental rest, time off school or work may be needed. Mental rest may include refraining from playing computer games, reading and watching television.

 

Return to sport

Having rested for 24-48 hours after sustaining a concussion, the athlete can commence a return to moderate intensity physical activity if such activity does not cause a significant and sustained deterioration in symptoms. Concussive symptoms usually resolve in 10-14 days. Once symptoms have resolved the patient can begin a staged return to sport. The activity phase should proceed as outlined below with at least 24 hours spent at each level. The activity should only be upgraded if there has been no recurrence of symptoms during that time. If there is a recurrence of symptoms, there should be a ‘step down’ to the previous level for a minimum of 24 hours after symptoms have resolved.  The steps in the activity phase are:

  • Begin with light aerobic activity (at an intensity that can easily be maintained whilst having a conversation) until symptom-free

  • Basic sport-specific drills which are non-contact and with no head impact

  • More complex sport-specific drills without contact, may add resistance training

  • Full contact practice following medical review

  • Normal competitive sporting activity.

 

Long-term consequences of concussion

There has been recent concern about potential long-term consequences of concussion. While the link between concussion and long-term illness is uncertain, taking a conservative approach to concussion management is important.

 

Children and adolescents recovering from concussion

Children and adolescents may be more susceptible to concussion and take longer to recover. Concussive symptoms usually resolve in less than 4 weeks. A more conservative approach to concussion management should be taken with those aged 18 years or younger. Return to learn should take priority over return to sport. School programs may need to be modified to include more regular breaks, rests and increased time to complete tasks. The graduated return to sport protocol should be extended such that the child does not return to contact/collision activities less than 14 days after the resolution of all symptoms.

 

Skipton FNC Trainer Management

The Skipton Trainer team will implement at least one (1) week off football/netball following a concussion for all athletes who have sustained a concussion. Athletes are also required to obtain a medical clearance/certificate stating that they are cleared of concussion and cleared to return to contact sport prior to being permitted to take the field/court for Skipton FNC

Trainers contact details –

Jason York – 0457 331 025  

Sarah O’Brien- 0459 193 791  

Bonnie Fitzpatrick – 0417 187 094

Aaron McGregor – 0491 080 237

Charnie Moss – 0408 200 391

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