What is a concussion?
Concussion is a form of traumatic brain injury, occurring following a head knock, where there are neurological impairments and symptoms that may be instantaneous, or develop over the following days to weeks. Most uncomplicated, first time concussions resolve without medical intervention over a period of up to 2 weeks.
Recognising concussion can sometimes be difficult as the symptoms and signs are variable, non-specific and may be subtle. The obvious loss of consciousness, brief convulsions or difficulty balancing or walking are easy to spot. However, some of the more subtle signs of a concussion are a headache, ‘don’t feel right’, ‘pressure in the head’, difficulty concentrating, neck pain, impaired memory, nausea or vomiting, fatigue or low energy, dizziness or confusion, blurred vision, drowsiness, balance problems, sensitivity to light or noise, changes in emotion, feeling of fogginess, nervous or anxious and difficulty sleeping.
Various tools have been developed to identify a concussion early such at the Sport Concussion Assessment Tool (SCAT6), developed by Concussion in Sport Australia and should be used following all head knocks, however minor.
What happens next?
Any athlete with suspected or confirmed concussion should remain in the company of a responsible adult and avoid aspirin, anti-inflammatory drugs, sleeping tablets and sedating pain medications.
Management involves physical and cognitive rest. This may include time off school or work and rest from general cognitive activities. After resting for 48-72 hours, the patient can follow these steps in returning to activity are (spending at least 24-48 hours at each step with no increase in symptoms):
- Low intensity aerobic activity at an intensity that can easily be maintained while 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 including resistance training
- Full contact practice after a medical review
- Normal competitive sporting activity
Post-concussion syndrome
Post-concussion syndrome occurs when concussion symptoms persist for longer than the usual 10-14 days. It is uncertain what causes post-concussion syndrome to develop, with no proof of a correlation between injury severity
Long term implications
There is concern about the potential link to CTE (Chronic Traumatic Encephalopathy) and other conditions.
The AFL has put in new regulations around concussion in junior sport for this season - whereby a player who has a concussion has a mandatory 21 day period of no heavy training and playing. It is important that coaches, teams, parents and players are aware of this so that the best management is followed to give the best outcome.
If you suspect you may have sustained a concussion, have lingering symptoms following a concussion or would like advice on returning to sport after concussion, please let us know and we can help guide you. You can book online here.