Concussion is a Brain Injury
“Don’t leave the decision up to us. Take us out of the game”
Concussion is the most common form of brain injury and must be taken seriously. A concussion can be caused by a direct blow to the head, but can also occur when the player takes a hard knock to another part of the body, resulting in a rapid movement of the head, causing a disturbance of brain function. There are many symptoms of concussion, with the common ones being headache, dizziness, memory disturbance and balance problems. If a player returns to the field with a concussion they put themselves at risk of suffering post-concussion syndrome resulting in a long-term endurance of a collection of concussion symptoms, including headaches, depression, personality change, memory and concentration problems, sleep disturbance and mood swings.
There will always be reluctance for players to come off the pitch and so this decision must be taken out of their hands. It is the responsibility of the coach, parent, referee or team doctor to detect the signs of a head injury following a hard knock, and get these players off the pitch. Less than 10% of concussions are actual knock-outs, leaving 90% of concussions to be detected by the coach or reported by the player. As such, it’s absolutely essential that we increase education for coaches so that they can recognise the signs and symptoms of a concussed player; and get these players off the pitch.
In all cases of suspected concussion it is recommended that the player is referred to a medical or healthcare professional for diagnosis and guidance. Every brain is different, so every brain injury is different, and so the adequate time needed to recover will be different, for each individual. Rest is the cornerstone of concussion treatment and so complete rest for a minimum of 24 hours is recommended following a hit to the head. Unlike a broken arm, or other injuries that you can feel with your hands or see on an X-ray, you can’t see a concussion. It is a disruption of how the brain works. It is not a bruise to the brain, which is why brain CAT scans and MRIs are normal with most concussions. In an effort to effectively manage concussion, an injury that cannot be seen, players must be monitored and gradually return to play at a steady pace, to suit their injury.
The Graduated Return to Play (GRTP) programme is a progressive exercise programme that introduces a player back to the field of play in a safe 6 stage process. The programme guides the player from their rest period through to light aerobic training activities, and finally a return to play situation. The GRTP programme is currently being adopted by many sporting bodies such as the GAA, GPA and IRFU where the player can only proceed onto the next stage of the programme if there are no symptoms of concussion experienced while resting or at the level of exercise achieved in the previous GRTP stage.
Acquired Brain Injury Ireland (ABI Ireland) have developed and launched a concussion application for smart phones, with the support of Medtronic.
The app named Concussion Smart is designed to help coaches, team physicians, parents and other qualified healthcare professionals recognise and respond to a concussed player following a knock to the head. In an effort to provide as accurate an assessment as possible, the assessment questions produced in the app are designed to coincide with the standardised concussion tool SCAT3. Concussion Smart is available to download for free in the App store (IOS) and will be available in the Google Play store (Android) in the coming weeks. This app is a screening tool and not a diagnosis tool. Parents, coaches and even players themselves should not delay or disregard seeking medical advice from a doctor or other medical professional, in addition to using the information provided within this app. Check out Concussion Smart in iTunes here