Could you spot Concussion?

Concussion assessment

Have I or someone else got a Concussion? How to tell the pitch side if you or someone else needs to stop playing?


A concussion is a traumatic brain injury and should not be ignored. It happens in many sports and can be from a contact or non-contact injury and is typically from rotational or linear forces transmitted to the brain.

There is a significant range of tolerance between individuals to head impact forces and therefore every person should be treated individually. Secondary impact injury to the brain where people have died through continuing to play with a concussion in the same game or returning some weeks later not fully recovered is well documented and must be avoided.

Analogies and advice should be:



The 6Rs – Recognise, Remove, Refer, Rest, Recover, Return

Identifying signs and symptoms of concussion can be difficult at times and in elite sports, there are set protocols and now video analysis to aid decision-making for healthcare professionals. Although many tools are available in elite sports problems still occur, with players continuing to play who have suffered a concussion during a game, like the George North incident for Wales Rugby Union.

This shows the requirement for continuous improvement and ever-evolving player welfare and safety measures. If anyone is unsure at any level of the sport take the safe option and remove them from the field of play to avoid further injury or delayed issues. It may be a teammate, coach, parent, friend or spectator at different levels of sport helping to identify and remove a player.

If a player has any of the signs or symptoms listed below they may have a concussion and should be removed from playing immediately and taken to a healthcare professional or hospital immediately. They should not be left alone and should not drive, ride a bike or drink alcohol

Visible clues of concussion – what you see:

Anyone or more of the following visual clues can indicate a concussion:

  • Dazed, blank or vacant look
  • Lying motionless on the ground/slow to get up
  • Unsteady on feet/balance problems or falling over/incoordination
  • Loss of consciousness or responsiveness
  • Confused/not aware of plays or events
  • Grabbing/clutching of head
  • Seizure (fits)
  • More emotional/irritable than normal for that person

Symptoms of concussion

The presence of any one or more of the following signs and symptoms may suggest a concussion:

  • Headache
  • Dizziness
  • Mental clouding, confusion, or feeling slowed down
  • Visual problems
  • Nausea or vomiting
  • Fatigue
  • Drowsiness/feeling like “in a fog“/difficulty concentrating
  • Pressure in head
  • Sensitivity to light or noise

Other signs that are related to the game itself or sport that the person is playing can be and not isolated too

  • Does not know time, date, place, period of the game, opposing team, or the score in the game
  • General confusion
  • Cannot remember things that happened before and/or after the injury
  • Seems slow to answer questions or follow directions
  • Seems easily distracted
  • Not playing as well as expected
  • A blank stare/glassy-eyed

Serious injuries that may seem initially like concussion happen and medical help should be called immediately especially if the person:

  • Is having a seizure or fit
  • Remains unconscious after an initial injury
  • Repeated vomiting or prolonged nausea
  • Vision problems or disturbances
  • Loss of power, weakness or numbness in the body
  • Balance problems
  • Bleeding from one or both ears
  • Clear fluid leaking from the nose or ears
  • Difficulty staying awake
  • Neck pain that is central or the neck being blocked (associated fracture)

Below is a pocket tool for the recognition of concussions that is used in many sports and is easily printable or kept to aid Concussion recognition.

Concussion guidelines apply to all ages. Care needs to be taken with children and adolescents because their brain is still developing. Children and adolescents with suspected concussions MUST be referred to a healthcare practitioner immediately for an initial assessment. They may also need further assessment by a doctor. IF IN DOUBT SIT THEM OUT!!!

Handy Resources:

  • Headcase Concussion Advice Card and/or the Pocket ConcussionRecognition Tool which can be downloaded from the resources section of
  • Concussion Guidelines diagnosis and Initial management Chart (
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