Concussions are serious injuries and can be a scary when they happen to you or someone you love. The importance of early recognition of concussion and subsequent management has recently gained significant traction within the sporting world and in the media. With the football season well and truly underway, we thought we would share how our Physiotherapists at Restore Function Physiotherapy are helping to manage concussions within the local sporting teams we service.
What exactly is a Concussion?
Concussion can occur when the brain experiences a sudden impact or jolt. Due to the high impact nature of sports such as Australian Rules Football, concussions are unfortunately a common injury. Concussions are a traumatic brain injury. A person does not need to have a direct blow to the head and/or does not need to lose consciousness to experience a concussion. A concussion can alter chemical balance of the brain and cause damage to brain tissue. The chemical imbalance and damage to brain tissue can cause a variety of symptoms, including headache, dizziness, and confusion. In many cases, the onset of neurological symptoms is fast. Often these symptoms are short lived and resolve spontaneously, however in serious cases they may continue to develop or intensify, in which case calling 000 or immediate presentation to the nearest emergency department is necessary.
In some cases, symptom onset may be delayed or develop over several hours. It is important to be vigilant with monitoring of a person you suspect may be developing concussion related symptoms.
What are the symptoms? What should I do if I notice symptoms develop later?
As per the Sport Concussion Assessment Tool (SCAT5), symptoms may include any of the following:
– Headache – “Don’t Feel Right”
– “Pressure in Head” – Difficulty Concentrating
– Neck Pain – Difficulty Remembering
– Nausea or Vomitting – Fatigue or Lower Energy
– Dizziness – Confusion
– Blurred Vision – Drowsiness
– Balance Problems – More Emotional
– Sensitivity to Light – Irritability
– Sensitivity to Noise – Sadness
– Feeling Slowed Down – Nervous or Anxious
– Feeling like “In a Fog” – Trouble Falling Asleep
The following are RED FLAGS and require immediate and urgent transport to hospital by another individual:
– Neck pain or tenderness – Double Vision
– 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
– Vomitting
What should I do if myself or someone I know has sustained a suspected concussion?
If symptoms do not require presentation to a hospital, you should always consult your doctor if a concussion is suspected. At Restore Function Physiotherapy, we work closely with local GPs who are experienced in managing concussion and administering appropriate concussion testing such as the SCAT5.
The initial 24-48hours following concussion should always involve a period of relative rest to allow symptoms to settle. It is vital to consult a licenced healthcare professional following this period to get advice on returning to activity and play.
The HeadCheck app is an excellent tool to assist members of the community with recognising a suspected concussion. The app will ask you a series of questions that help to direct management of concussion. Damien Hardwick, ex-coach of the Richmond Football Club says “If in doubt, sit them out!”
How long do I have to rest if I sustain a concussion?
The AFL guidelines on concussion state:
“The earliest that a player may return to play (once they have successfully completed a graded loading program and they have obtained medical clearance) is on the 12th day after the day on which the concussion was suffered.”
“A more conservative approach is required if there is a lack of baseline testing and active medical practitioner oversight of each stage of the graded return to football. A more conservative approach is important in certain situations including for children and adolescents, players with a history of concussion and where there is a recurrence of symptoms at any stage during the return to play program.”
Our physiotherapists help to facilitate early diagnosis of concussion by referring to our network of experienced GPs and guiding athletes presenting with concussion through the recommended recovery protocol.
The protocol consists of three distinct stages – rest, recovery, and graded return to training and play. The updated guidelines insist on a minimum period of 24 hours (or longer) for each step of the progression and, if any symptoms recur during the graded return to training and play stage, the player athlete must go back to the previous symptom-free step.
We continue to monitor athletes on return to training and contact for symptoms once they have gained medical clearance and liaise with parents and coaches to regularly update on progress and return to sport timelines.
If you are interested in reading more, a link to the AFL guidelines can be found here: https://www.afl.com.au/news/882098/afl-releasesupdated-concussion-guidelines-and-strategic-plan
While pushing the limits and healthy competition is thrilling in sport, we must maintain player welfare by mitigating risks and minimizing the lasting effects of concussions. So, let’s remember that when it comes to concussions, education, proper care and following recovery protocol are paramount.
