DAZED & CONFUSED - THE ISSUE OF CONCUSSION
The winter sports season is almost upon us, and brings with it the risks associated with contact sports. The issue of concussion has again been highlighted in the media particularly regarding the possible long term consequences of traumatic brain injury and concussion. Concussion is a serious injury and occurs frequently.
ACC data (which can be found on the ACC website) reports that there are estimated 35,000 head injuries in New Zealand per year. 21% of these are sustained in sporting activity, most commonly rugby, cycling and equestrian activities. Of these, 11% have had multiple concussions within a 2 year period. Evidence shows that with repeat concussion people may experience a decline in general health and quality of life up to 10 years following injury. Confusion often exists as to what a concussion actually is and how it should be managed. Can someone be concussed if they haven’t lost consciousness? Should they be allowed to play on? And how long before the injured player can safely resume sport? As parents and spectators we have a responsibility to recognise and have some basic understanding of management of concussion, as at many games there will be no medically trained personnel present.
Concussion may occur without loss of consciousness. It is relatively easy to recognise signs such as an inability to get up after a knock, or if somebody is confused or disorientated. More subtle signs may be harder to recognise and some symptoms may not be present immediately. Symptoms such as headache, nausea, difficulty concentrating, irritability, difficulty sleeping, blurring of vision or memory problems may take some time to become apparent. If you are uncertain whether somebody may have sustained a concussion remove them from activity-”If in doubt, sit them out”. The safety of the athlete must always be the most important priority and is more important than any match. If a player has suspected concussion, see a medical doctor immediately.
Recovering from concussion involves rest from cognitive (activities involving concentration), and physical activity until the acute symptoms improve, and then a graduated return to activity under the guidance of your doctor. Return to sport or physical activity should only occur after a full medical clearance. ACC has developed National Guidelines for Concussion in Sport. The guidelines are an excellent resource for coaches, managers, players and parents, and I encourage you to have a look at them. They are easily found on ACC’s website. We all have a role to play in better recognising and properly managing concussion. Michelle Sintmaartensdyk is a physiotherapist at the Oamaru Physiotherapy Clinic. She has post graduate qualifications in sports medicine, acupuncture and manual therapy.