Concussion is a very prevalent injury in Rugby Union, however, it is also common in many other sports around the world. There has been a large emphasis recently in NZ on concussion education and better management at a sideline level. Many people see these rules as annoying and unfair, particularly with the new introduction of the blue card here in Mid Canterbury and most players rush back to normal activity. What most people don’t realise is the significance of concussion and how high the risk is for further brain injury and ongoing problems if it is not managed properly. So today we want to help you understand the basics of concussion and why it is so important to follow advice of fully trained health professionals on return to activity and sport!
What is concussion?
Concussion is a traumatic brain injury resulting in a disturbance of brain function, due to either a direct blow to the head or a rapid movement of the head eg whiplash. It is important to note that loss of consciousness (being knocked out) occurs in less than 10% of concussions and loss of consciousness is not a requirement for ,diagnosing concussion.
Who is at risk of concussion?
Anyone can get concussed, but children and teenagers are at higher risk as they take longer to recover, have more significant memory and mental issues and are more susceptible to rare and dangerous neurological complications, including death.
Symptoms typically present in the first 24-48 hours, but they can present at any time.
There are many signs and symptoms of concussion, however, you only have to have one for concussion to be present:
Motionless or slow to get up
Loss of consciousness
Emotional and irritable – more than normal person
Pressure in head
Sensitivity to light or noise
If any of the above symptoms are present, then advice from qualified health professionals should be sort. From here it is important to follow their advice on return to sport, as there is a specific protocol from World Rugby, used for safe return to play which takes a MINIMUM of 7 days to complete once symtoms have resolved. If any symptoms are still present, then progression is not allowed.
This is not because they don’t want you to play your sport, it is because if too much mental activity and movement occurs too soon, then the brain is unable to heal properly and symptoms may persist longer or you may suffer from ongoing problems or worsening symptoms.
Concussion needs to be thought of as an injury that you might have, to your knee or ankle while playing sport. Initially, especially in the first week, it is too sore to move around and therefore pretty obvious that you shouldn’t train or play on it. Your brain is much more complicated and important than your ankle, and therefore takes longer to heal. It doesn’t have pain nerves to tell you it’s sore, so it uses these other symptoms to warn you that you shouldn’t be doing too much, so that it can heal properly. Just as with a knee or ankle injury, if you don’t listen to it then you often find it is still giving you trouble six weeks down the track. In the case of concussion, this could be six weeks of headaches, nausea and confusion, when you could have been back to normal in a couple of weeks. So the moral of the story is listen to your body and to the health professional’s advice, and you’ll be back to sport before you know it.
For the general public and coaches, there is a great online resource to teach you more about concussion and what to look out for, so that you can get the best care for your players and family members. This includes the recognise and remove message with the ‘6Rs’ for sideline recognition of concussion. Check it out here!