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What is a Concussion?

Sports-related brain injuries / Concussion can unfortunately happen in countless ways. A football player can sustain a traumatic brain injury in a head-to-head collision. A basketballer can fall on their head during a ball toss. A skier can smash into a tree. A skateboarder can lose control and fall against a curb.

In the last several years, sports and concussion have received a lot more attention and scrutiny, justifiably — so much so, that rules in certain games are changing, and laws are being implemented to keep athletes of all ages and skills safe. But coaches, parents, and athletes need to learn about brain injury to prevent injury and make the best decisions if an injury does occur.

According to Brain Injury Australia, recent statistics show there are around 3,000 hospitalisations annually for concussion from sport. In reality, hospitalisations radically underestimate the incidence of concussion in the community: as few as one in every four people who experience concussion will seek medical attention and then only if their symptoms persist. The number of unreported concussions in sport may be as many as 10 times the number disclosed to team doctors annually.

While the majority (80-90%) of concussions resolve in a short (7-10 day) period, physical, psychological-behavioural and cognitive symptoms – including headache, dizziness, irritability, anxiety, depression, aggression, mood swings, anger, impaired attention, concentration and memory – may persist longer for the minority.

Here is some basic must-know information:

  • A Concussion can occur without loss of consciousness – An athlete can sustain a concussion or brain injury without necessarily losing consciousness.
  • A Concussion is a BRAIN INJURY – A concussion can have serious and long-term health effects, and even a seemingly mild ‘ding’ or bump on the head can be serious.
  • A concussion changes how the brain normally functions – in the short or long-term, depending on the severity of the injury and the time taken to recover.
  • Concussions can occur in any sport, males and females equally.

What to Do if You Suspect a Concussion

If an athlete has sustained a concussion — recently or ever — it’s crucial for the athlete, teammates, coaches, and parents to take the appropriate steps.

  • Know the signs and symptoms of concussion.
  • Seek medical attention, even if you think the brain injury is “mild.” A healthcare professional in conjunction with a medical practitioner will be able to decide when it is safe to return to sports.
  • Do not return to play with a known or suspected concussion until evaluated and given permission by a medical practitioner. (Second concussions that occur before you have recovered [second impact syndrome] can be very serious.)
  • Tell your coach or child’s coach about any recent concussions.

What are the signs and symptoms of a concussion?

Often, you can’t see a concussion. Signs and symptoms of concussion can show up right after an injury or may not appear or be noticed until hours or days after the injury. It is important to watch for changes in how your child or teen is acting or feeling, if symptoms are getting worse, or if s/he just “doesn’t feel right.” Most concussions occur without loss of consciousness.

If your child or teen reports one or more of the symptoms of concussion listed below, or if you notice the symptoms yourself, seek medical attention right away. Children and teens are among those at greatest risk for concussion.

Common Signs observed by parents or guardians:

  • Appears dazed or stunned
  • Is confused about events
  • Answers questions slowly
  • Repeats questions
  • Can’t recall events prior to the hit, bump, or fall
  • Can’t recall events after the hit, bump, or fall
  • Loses consciousness (even briefly)
  • Shows behavior or personality changes
  • Forgetful

Common Symptoms reported by your child or teen:

Thinking/Remembering:

  • Difficulty thinking clearly
  • Difficulty concentrating or remembering
  • Feeling more slowed down
  • Feeling sluggish, hazy, foggy, or groggy

Emotional:

  • Irritable
  • Sad
  • More emotional than usual
  • Nervous

Physical:

  • Headache or “pressure” in head
  • Nausea or vomiting
  • Balance problems or dizziness
  • Fatigue or feeling tired
  • Blurry or double vision
  • Sensitivity to light or noise
  • Numbness or tingling
  • Does not “feel right”

Sleep:

  • Drowsy
  • Sleeps less or more than usual-difficulty sleeping

When is it Safe to Return to Sport “Concussion Return to Play Criteria”

“When in Doubt, Sit It Out”

An athlete should only return to sport under the supervision of an appropriate health care professional once a concussion has been identified. Return to play can be varied amongst individuals depending on the level of concussion suffered.

At Spinal and Sports Care, our Sports Chiropractors & Physiotherapists work closely with Sports Doctors and your GP in the management of an athlete’s safe return to play. As is common practice amongst our sporting codes in Australia, the medical profession utilises an evidence based assessment criteria for concussion. The SCAT 3 is a standardized tool for evaluating injured athletes for concussion and can be used in athletes aged from 13 years and older. For younger persons, ages 12 and under, there is a Child SCAT 3.

We employ a rule of “When In Doubt, Sit it Out”.

After a player has experienced a concussion, our concern is that we not return them to play until they have fully recovered and they are cleared by a General Practitioner or Sports Doctor.

And the best way to do that is, first of all, rest. But then introduce light exercise and continual monitoring their symptoms and behavior. We’re also concerned about whether they’re thinking well or not.

When we are assessing whether an athlete is safe to return to play, it is important that we gradually and methodically stress their system and to watch for the onset or return of concussive symptoms.

So we’re constantly checking to see that all symptoms clear up even when you put them under gradual increased stressful conditions. It includes the brain being under a stressful condition of increased intracranial pressure, which is what happens when you actually exercise.

Only then, when the athlete is at a pre-injury status, and in consultation with other medical specialists and practitioners, would clearance for return to play be granted.

Sports bring risks, but they also come with myriad benefits like fitness, good health, confidence, friendship, and team sportsmanship. They just need to be played safely.