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Concussion in Sport - How Do We Manage It?

October 6, 2017

After Roy Keane's controversial comments about concussion, it's been in the news a lot recently. But how much of an issue is it?



What is Concussion?


Also known as a minor head trauma or minor brain injury, concussion is a head injury with a temporary loss of brain function, usually caused by trauma to the head, causing the brain to "rattle" around inside and collide with the inside of the skull. The most common causes of the injury are sports collisions, car accidents and falls. According to Headway.org, 75-80% of all head injuries fall into the category of "concussion".


Monitoring is key with any brain injury to ensure the athlete/patient does not deteriorate. Stress must be reduced on the brain so cognitive and physical rest is essential; use of digital devices, work and exercise should be avoided until symptoms are no longer reported.


Return To Play


The Sport Concussion Assessment Tool (SCAT) is an essential tool in assessing both diagnosing concussion as well as assessing a player's fitness to return to play. The tool, published in the British Journal of Sports Medicine, covers both the on field and off field assessments as well as physical and cognitive tests to outline a player's physical state; such as memory and balance tests. The tool provides quantitative data to clearly decide whether or not the player is fit to play.


The latest version of the SCAT (SCAT5) includes a graduated return to sport (below) and school plan to allow the player to safely resume normal activity without aggravating the injury further. 




Long Term Effects of Concussion


The effects of concussion vary depending on the severity of the injury, the frequency of injuries and also by the return to play time following injury. A return to sport before an adequate recovery can obviously lead to further injury and potential long lasting effects.


The 2015 film "Concussion" starring Will Smith, follows the work of Dr Bennet Omalu who fought against the NFL in court after finding links between repeated blows to the head over a player's career and a brain degenerative disease called Chronic Traumatic Encephalopathy (CTE). The film observed the links between players that reported early retirement and in severe cases domestic violence and suicide, with diagnosis of the disease. The film displays his fight against the NFL to push the protection of players and eventually lead to the franchise being sued for its lack of action in 2011. The National Football League has since changed its procedures to protect players, however there are still arguments against them, stating more can be done.



Going back to football, the 1966 winning World Cup side completed a 50th anniversary parade back in 2016. At the time, Ray Wilson, Martin Peters and Nobby Stiles, three members of that famous team, had been diagnosed with Alzheimer’s in their 60's. According to the Alzheimer’s Society, the number of men suffering from dementia in a normal population between the ages of 65 and 69 is one in 75. Yet here were three teammates all with the same condition. In addition, Alf Ramsey suffered with the disease before his death, while Jack Charlton admitted to suffering from periods of memory loss.


Although a lot has changed in sport since the 60's, concussion is still present and will continue to be so in the future. It is impossible to remove the risk of injury but with tools like the SCAT5, the management is definitely becoming safer and easier.




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