CONCUSSION MANAGEMENT & RETURN TO SPORT

CONCUSSION MANAGEMENT & RETURN TO SPORT

Concussions are widely recognised as a type of brain injury that affects the way your brain functions. A concussion usually occurs following a bump to the head, neck or body, and the impact causes the brain to move rapidly back and forth within the skull.

DID YOU KNOW….

  • A concussion is also known as a mild traumatic brain injury.
  • Two mild traumatic brain injuries within a short space of time can cause similar effects as one severe traumatic brain injury.
  • Most people have resolution of their symptoms within a week, however, the changes in the brain are often still seen 30days post injury.
  • You don’t have to hit your head for a concussion to occur.
  • There is an increased risk for musculoskeletal injury (ie ankle sprain) for up to a year post concussion.
  • Females may be more susceptible to concussion, have a greater range of symptoms and take longer to recover than males. The evidence behind this is conflicting and further research is needed in the area. 
  • Many concussion symptoms are nonspecific and present at baseline in healthy athletes.

 

Concussion signs that may be observed (by someone other than the player):

  • Can’t recall events prior to or after a hit or fall.
  • Appears dazed or stunned.
  • Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
  • Moves clumsily.
  • Answers questions slowly.
  • Loss of consciousness (even briefly).
  • Shows mood, behavior, or personality changes.

 

Concussions symptoms experienced by player/person include:

  • Headache or “pressure” in head.
  • Neck pain.
  • Nausea or vomiting.
  • Balance problems or dizziness, or double or blurry vision.
  • Bothered by light or noise.
  • Feeling sluggish, hazy, foggy, or groggy.
  • Confusion, or concentration or memory problems.
  • Just not “feeling right,” or “feeling down”.
  • Fatigue, low energy, sleeping more or less than usual.

 

Time frames for return to sport varies depending on players age:

  • Children and adolescents (under 19years of age)
    • Mandatory two weeks rest followed by return to play pathway (below),
    • Minimum time for return to contact is 18days, with 19days minimum return to play.
  • Adults (over 19years of age)
    • Mandatory one weeks rest followed by return to play pathway (below),
    • Minimum time for return to contact is 11days, with 12 days minimum return to play.

 

GRADED RETURN TO PLAY

 Below is a table which can be used as a guide for return to play following a concussion. It should only be used as a guide in conjunction with guidance from your doctor.

Stage

Exercise Mode

Example

Progression

1

REST

Complete rest of the brain and body

Medical doctor to decide on amount of time needed

2

Light cardiovascular exercise 

10-15minutes of:

  • light jogging, or;
  • swimming, or;
  • stationary cycle

at low-moderate intensity

 

***No weights training

If no increase in symptoms, start Stage 3 after a minimum of 24hours.

If symptoms occur, rest 24hours then repeat Stage 2.

3

Sport specific exercise 

Individual running drills or skills training without contact

 

***No weights training

If no increase in symptoms, start stage 4 after a minimum of 24hours. 

If symptoms recur or worsen, rest 24hours and repeat stage 2.

4

Sport specific non-contact training

More complex drills ie. passing, kicking without contact.

 

May start light, low level, progressive weights training

If no increased symptoms, review by medical doctor before progressing to stage 5.

If symptoms recur or worsen, rest 24hours and repeat stage 3.

5

Sport specific training (contact)

Full contact practice

***Must have medical clearance***

Player, coach, parent to report any symptoms to medical doctor.

If symptoms reoccur or worsen, a review with a medical doctor is recommended.

6

Game

Full contact game

Monitor for recurrence of signs/symptoms of concussion

 

RESOURCES

Listed below are a few resources with more information on concussion, including a couple of Geelong-based clinics that specialise in concussion management:

  • Email (info@theinjuryclinic.com.au or liz@theinjuryclinic.com.au) or call (03 5229 3911). We will be able to let you know if we can help, or, will be able to point you in the direction of the person most appropriate to see. 
  • Contact Newtown Medical Centre  (03 5221 5044). Dr James Carter in particular, has a special interest in concussion management. 
  • Contact Epworth Concussion Clinic – Email: EG-Rehabassessment@epworth.org.au   General enquiries: 03 5271 7877
  • Australian Institute of Sport ( https://concussioninsport.gov.au/)
  • Complete Concussion – videos etc. ( https://completeconcussions.com/ )
  • SCAT 5 (https://cattonline.com/scat/ )
  • Royal Children’s Hospital Head Injury Parent Information ( https://www.rch.org.au/kidsinfo/fact_sheets/Head_injury/ )
  • AFL:  https://www.afl.com.au/news/603238/statement-guidelines-for-concussion-management-in-community-football
  • NRL: https://www.nrl.com/operations/the-players/management-of-concussion/
  • RUGBY AUS: https://australia.rugby/about/codes-and-policies/safety-and-welfare/concussion-management

TO SUMMARISE…
Concussions are serious injuries and need to be managed as such. If you have a concussion or suspected concussion, please seek appropriate guidance and assistance from health care professionals. If you feel you would like more information or are unsure how to get appropriate assistance with your concussion, please contact The Injury Clinic on (03) 5229 3911 or info@theinjuryclinic.com.au.

 

For more information on what we do at The Injury Clinic, please click HERE

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