Concussion

ConcussionConcussion is a very serious condition often seen in sport and more and more incidents are being reported in contact sports. It can range from mild to very severe depending on the circumstances and is usually caused by a sudden impact to the head from a traumatic (contact) event.

Severe concussions can result in permanent brain injury or even death so all concussions MUST be taken seriously. Concussion is an injury to the brain caused by impact against the skull. It can, but does not always, involve a loss of consciousness. Symptoms include headaches, dizziness and sickness but the vary depending on severity of injury.

Symptoms of Concussion

Mild concussions include symptoms such as slight mental confusion with possibly some memory loss. Mild tinitus (or “ringing in the ear”) may be heard along with mild dizziness and/or a headache. There is likely to be pain in the area of contact or impact. The athlete will often have a normal ability to balance and will usually no have lost consciousness during the incident. The degree of memory loss and the ability to recall information will be variable from athlete to athlete.

Moderate concussions include symptoms such as mental confusion with often some memory loss. Moderate tinitus (or “ringing in the ears”) may be heard with moderate dizziness and usually a headache. Overall balance may be altered and the player may experience some nausea (feeling sick) or even vomiting (being sick). Loss of consciousness may happen but will this will usually last no longer than 5 minutes. The degree of memory loss and the ability to recall information will be variable from athlete to athlete.

Severe concussions will more than likely result in mental confusion lasting for 5 minutes or more. Severe ringing in the ears or tinitus may be experienced. Prolonged loss of memory of events before the accident may occur. Loss of consciousness for more than 5 minutes is possible along with an increase in blood pressure and a decrease in heart rate.

Assessment

If a concussion is suspected the athlete should ALWAYS be removed immediately from the training pitch or match and should not be left alone. You should always seek professional medical advice to determine the extent of the head injury and in no circumstances should the athlete return to playing sport until they have been fully assessed by a doctor.

SCAT 3 Test is used by a doctor to assess for concussion is called a SCAT 3 test. SCAT stands for Sport Competition Anxiety Test and has been developed over a number of years to be sensitive enough to detect subtle symptoms of concussion and monitor the progress of an athlete. The test consists of a number of questions and short tests to assess the athlete’s symptoms, their ability to balance and their ability to memorise and recall information.

The doctor will perform a SCAT 3 test as soon after the incident as possible and then repeat the test over a period of a number of days or weeks until the results are back to normal. It should be noted that this may take a number of weeks to normalise.

SCAT 3 for information purposes only can be downloaded here – this must always be carried out by a medical doctor.

Read more about on field concussion management.

Treatment

The main treatment for concussion is resting from all activities until the symptoms start to subside. As the symptoms decrease the doctor will allow the athlete to slowly and progressively start exercising with constant monitoring.

Return to Playing Sport

This should be a gradual step-by-step process and should always be supervision by a qualified medical person, usually a doctor. When the athlete does not have any symptoms at rest then they may be able to start light exercise which may include stationary cycling or walking. If the symptoms do not return during or after this, then the next step is to perform sports specific activity without contact, for example running. If at any stage the symptoms return, then the athlete will be instructed to take a step back in the process.

The next stage is on-field practice without contact and the final stage is full contact sport. All of these stages are closely monitored by the medical professional and symptoms are constantly assessed. Although this may seem to be a slow process t the athlete, the step by step progression is absolutely vital to the athlete’s health and must be taken seriously.

Post Concussion Syndrome

Post concussion syndrome is a complication with symptoms which occur after the main symptoms of the original injury have gone. If the athlete experiences strange symptoms such as loss of taste or smell, anxiety or depression among a number of potential symptoms then they must seek medical advice immediately.

Read more on Post Concussion Syndrome.

“Second Impact” Syndrome (SIS)

This is a condition where a second impact takes place before the symptoms for the first hit have cleared up. This can cause a sudden swelling of the brain and can result in death. It can happen days or weeks after the first impact. There have been a number of high profile cases in the media in where athletes have reportedly suffered SIS. For this reason and knowing that even the mildest of concussions can lead to SIS is why all concussions must be taken seriously.