Concussion Explained and how you can manage it !

Concussion:

What is a concussion?

Concussion is caused by trauma to the brain, which can be either a result of a direct (head impact) or indirect (e.g. whiplash) head injury.

Concussion has a high prevalence in community sport. With more information coming out about the potential long-term effects there is more emphasis on managing this type of injury appropriately.

Guidelines have been developed to assist how to assess and manage any player who has suffered concussion or is suspected of having a concussion. These are guidelines that our Physiotherapists at Instinct Health are trained in and follow appropriately. These guidelines are as follows:

1. Recognise and Remove
2. Refer to Hospital Immediately
3. Review by Medical Doctor or Physiotherapist
4. Return to Sport

1. Recognise and Remove

The assumption of a concussion is that an individual must lose consciousness or “black out” to be considered as having a concussion. However, this is not the case. Concussion is characterised by a range of observable signs or reported symptoms from an individual.

Observable Signs

• lying motionless on the ground
• blank or vacant look
• balance difficulties
• motor (movement) coordination issues

Reported symptoms:

• Headache
• Confusion
• Blurred vision
• Dizziness
• Nausea
• Memory loss
• Reduced ability to think clearly and process information
• Balance problems
• Fatigue
• Feeling “not quite right”

It is also important to note that concussion can often have a delayed effect. Understanding this and taking precaution in this initial management is vital to ensure the health and safety of an individual. It is therefore essential, a medical assessment by a medical doctor or physiotherapist be performed immediately. If either is not accessible, removing the individual from play/training is strongly recommended until an appropriate assessment can be completed.

Game-day Assessment Tools

1. Check for observable signs or reported symptoms (Refer above)
2. Stand on 1 leg and assess balance both eyes open and eyes closed for 30 seconds each
3. Walk in a straight line in a tightrope fashion for a 5m distance
4. Perform sport specific tests (running, jumping, throwing/catching etc.)

2. Refer to Hospital Immediately

If there are any “red flags” an ambulance should be called, and the player referred to hospital immediately. Otherwise, the player should be referred to a medical doctor for assessment

Red Flags:

• Loss of consciousness
• Neck pain
• Weakness or tingling/burning in the arms or legs
• Worsening headache
• Vomiting

3. Review by a Medical Doctor or Physiotherapist

Our physiotherapists are equipped to help diagnose a concussion and provide a plan for management in the days after injury (including time off work, school, sport or driving a car). We can also begin initial treatment which may include options like neck massage techniques to help settle symptoms. Where appropriate, we may also refer back to a GP or Sports Physician to ensure appropriate assessments and medical clearance is achieved before returning to competitive sport.

4. Return to Sport

The 4 phases include

1. Rest:A complete rest in physical (exercise) and cognitive (driving, work) tasks for 24-48 hours
2. Recovery:Symptom-limited activity including a return to simple tasks (watching TV, going to school or work, or driving) that do not bring on or worsen any symptoms
3. Graded loading program:Incremental increases in physical +/- cognitive load id concussion-related symptoms do not return
4. Return to sport:Medical clearance to be obtained before returning

Remember, if you suspect a concussion remove yourself from the activity immediately. Your physio can help diagnose, educate, and refer you to a sport physician to help you return to sport safely.