Concussion is a brain injury and must be taken extremely seriously to safeguard the short and long term health and welfare of all players. The majority (80-90%) of concussions resolve in a short (7-10 days) period. The recovery time is longer in children and adolescents, and because their brains are still developing, a more conservative approach needs to be taken with them. While symptoms may resolve, the brain takes a bit longer to recover fully so this needs to be factored into the recovery protocols.
During this recovery period, the brain is more vulnerable to further injury, and if a player returns too early, before they have fully recovered, this may result in:
• Prolonged concussion symptoms
• Increased risk of developing Post-Concussion Syndrome (PCS) with symptoms lasting over 3 months
• Possible increased risk of long term health consequences e.g. mild cognitive impairment or degenerative brain disorders in later life.
• Further concussive events before recovery in adolescents while very rare and poorly understood, can be FATAL, due to severe brain swelling. This is known as second impact syndrome.
The standard in sideline assessment is the Concussion Recognition Tool (CRT). Every sports trainer should have easy access to this in the event of a concussive event so they can make the right decision for the player’s welfare.
As a guide the following should be a minimum procedure when dealing with a player who has sustained a possible concussive event;
- Recognize the injury by using the Pocket CRT
- Any player with suspected concussion should be IMMEDIATELY REMOVED FROM PLAY, and should not be returned to activity (training or playing) until they are assessed medically.
- Club Trainer to report incident to their club officials and league governing body if required
- Monitor the player with a suspected concussion which includes:
- NOT consume alcohol and keep well hydrated.
- NOT drive a motor vehicle.
- NOT be left alone, and be woken every 2-3 hours during the night to ensure they are well.
- Rest from all activity until symptoms recover.
- A player should consult with a medical professional on a graduated return to training and playing.
- Medical clearance required to return to play.
- Player to submit medical clearance to Club.
Different sports leagues may have different protocols set in place. Many leagues will require reporting of concussive events to the governing body and will also require medical clearance prior to return to play. It is best to contact your league and ask them specifically what their protocols are for managing player concussion. The AIS has an excellent website with loads of information on concussion and is a terrific guide. It is definitely worth checking this out.
Follow the below links to information created by the AFL regarding protocols to follwo regarding a concussive event.
For community clubs
- Community Concussion Guidelines
- Head Injury Assessment Form
- AFL Position Statement on Helmets & Mouthguards
For medical practitioners
- Community Concussion Guidelines
- Sports Concussion Assessment Tool 5 (SCAT5)
- Child Sports Concussion Assessment Tool 5 (SCAT5)
Rugby Australia Guidelines
Rugby Australia has some excellent information on their website on how to manage concussive events. Check it out here. Please download the following helpful guides that can help you manage a player with concussion;
- Rugby Australia Concussion Management procedure (table)
- Rugby Australia Concussion Management Medical Doctor Information
- Concussion Management Flow Chart
Rugby Australia has also developed the following checklists to assists players, managers and coaching staff manage their player’s concussion and return to play;