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CAT Scan
17 Jul 2018
17 Jul 2018
by Dr. Steven Gilchrist

Concussion Management

The footy season is well underway for 2018!

There are many benefits to exercise, in all its forms, and I would encourage everyone to aim for 30minutes of moderate exercise, 3x/week as a minimum.  However, with all sports, there is a risk of injury.  Depending on the activity, the risk of this will vary.

Over the past few weeks, there have been increased numbers of athletes presenting to Sportsmed Biologic with the concussion after head injuries at the weekend - or presenting a few days & weeks later with ongoing symptoms.

In contact sports, there is always the risk of contact trauma, including head injuries & concussion.  While it is difficult to prevent injuries in all cases, the first step to recovery for concussion is recognition of a potential concussive episode.

 
CONCUSSION

Concussion is a traumatic injury to the brain, which is generally associated with contact sports.  While it is true that concussion can occur from sports, there can also be a non-sports related concussion.

Concussion falls into the category of mild traumatic brain injury, however, this does not mean that the symptoms & effects that it can have on an individual are only mild.

An important part of treating a concussion is recognizing it early & stopping any further activity.  Trainers, coaches, officials, family & supporters should all be aware of concussion & alert team officials if there are any concerns regarding a player that may have an injury.

 


RECOGNISE & REMOVE

Recognise concussive features with the potential mechanism for a concussion.

Recognition of potential concussion should NOT be confused with diagnosis.

Any concerns regarding potential concussion should be treated as such, until medical review.  Athletes attempt to hide their concussive symptoms so high suspicion is necessary.

Loss of consciousness & post-traumatic amnesia (memory issues) is not required.  If unconscious, manage the airway, protect patient, call for assistance & an ambulance.

If there has been a period of unresponsiveness or slow to get up, think about concussion.

These could be related to other injuries also or due to gameplay circumstances, however, if in doubt, sit them out.

 


IF IN DOUBT, SIT THEM OUT

If you see obvious facial wounds or head wounds, these do not always signify concussion but think of it & if there are any concerns, sit them out.  Clutching/ grabbing/ shaking head is a concerning sign also.

If concerns regarding concussion signs or symptoms, remove from play.  Get them to rest before a medical review.  They should not return to training or gameplay on the same day.  If concerns from patient, family, others at the time, or symptoms worsening have assessment the same day - either an Urgent Care Centre or an Emergency Department.

Doesn’t have to have direct contact to head.

Unaware of what happened

 


REST & RECOVER

The player is not allowed to play or train the same day as concussion suspected.  Rest is strongly recommended for the first 24-48hours.  This means avoiding study, work & driving, as well as reducing screen time.  Reduce visually stimulating activities, such as using phones & tablets.  Reduce trips outside of home & others coming to visit - it’s better to have increased sleep & rest than to socialize.

A medical review should occur within the first 24-48 hours - rest until medical review occurs.

 


REVIEW

Referral to a doctor with knowledge of concussion is recommended for assessment and to develop an appropriate management plan for a return to sport & learning.

If an assessment is required in an Urgent Care Centre or Emergency Department, another assessment should be carried out before starting their return to sport or learning.

 

Prolonged Concussive Symptoms

If symptoms are ongoing, or any concerns that there is an injury other than concussion going on, we are able to refer for appropriate investigations and appropriate specialist review if necessary.

 

Why bring them off if they “give permission” to stay on the field?

  •     They are unable to make this decision due to brain injury
  •     To reduce the risk of potential secondary injury
  •         Contact or non-contact musculoskeletal injury
  •         “Second Impact Syndrome” (a fatal, rare complication of concussion)
  •     Enable a thorough assessment of the athlete
  •     Maximise potential recovery (if continues, likely to make symptoms worse & prolonged)


 

Take Away Points:

  • ANY concerns regarding concussion, remove from play.
  • Do not allow the player to return to sport or activity on the same day as the suspected concussion.
  • Rest until the medical review
  •     May require immediate/ same day medical review, depending on concerns
  •     Otherwise, clinic review after 24-48hours.
  • Reduce screen time & visually stimulating activities.
 
Clubs we work with
Carlton Football Club Sydney Swans AFL Eastern Ranges Football Club Box Hill Rugby Union Club Eastern Football League (EFL) Melbourne City Football Club Collingwood Football Club Northern Blues Football Club
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