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Concussion - If in doubt, sit them out

Sport plays a key role in keeping us fit and healthy, with team sports providing a host of additional benefits including social interaction and, instilling discipline and teamwork in young people. As with in life in general, however, accidents and collisions can occur in contact sports – with head injuries commonplace in sports such as football, rugby, hockey and many others. And while rules are in place in such sports to protect players from head injuries, collisions are inevitable in contact sports. It is vital that all who participate in or watch sport are aware of the risks of concussion – particularly those involved at a grassroots or junior level, where ambulances and medics are not on standby should something go wrong. What is Concussion? Concussion is an injury to the brain which results in a disturbance in the brains function. It can be caused by a direct blow to the head but can also occur when a blow is taken to a part of the body and results in a rapid movement of the head e.g whiplash. There are many symptoms of concussion, the most common are:
  • Headache
  • Dizziness
  • Memory Loss
  • Lack of balance
Symptoms of concussion usually appear rapidly after impact, but their onset can be delayed and appear any time after the injury. Loss of consciousness only occurs in around 10% of concussions. Concussions can happen at any age, however children and adolescents:
  • Are more susceptible to brain injury
  • Take longer to recover
  • Have more significant memory & mental processing issues
  • Are more susceptible to rare and dangerous neurological complications.
If any of the signs or symptoms below are present after a player has been injured, they should me removed from play immediately and not return to play or training until seen by a medical professional. If there are signs of further injury such as severe neck pain, weakness in arms or legs, severe headache or repeated vomiting, the player must be taken to the nearest hospital; emergency department. Rest the body: Rest the brain Following concussion, rest is the most important part of concussion treatment. Not only resting the body put also allowing the brain to rest cognitively. Anyone who has suffered a concussion should not be left, consume alcohol or drive for 24 hours. All sports activities should not have taken place until agreed by a doctor and then it is advised to follow the standard protocol set by all sports governing bodies. The general protocol for returning to place starts is made up of six stages. An individual can only advance onto the next stage if there have been no repeat symptoms of concussion. After each stage a medical professional to confirm recovery. The stages are out table below. The guidelines in the this table are set by The FA but are the exact same for all sport. Concussion whether diagnosed or suspected should always be taken seriously. A head injury no matter how low the impact, can lead to concussion or more serious injury. Given the difficulty in identifying concussion and the risk of continuing to play once one has been sustained, the message is clear: If in  doubt - sit them out! "Concussion in sport is hugely under the spotlight at the moment, with high profile incidents taking place across the sporting world in the last few years. We are reminded of the seriousness of head injuries in sport when these horror stories are published about fatalities in sport, following head trauma. Some cases are currently unpreventable but other stories of head injury fatalities in sport may have been a result of mismanagement. Knowing that my management (or lack of) of a potential concussion injury could be fatal if the correct steps are not taken is quite scary and ensures that I keep my first aid training and skills up-to-date. At Lincoln City FC, we often practise our spinal manoeuvres, meet with the club's match day paramedics and attend external first aid course to ensure we can provide a safe environment for our players, should they sustain a major head injury. The problem with concussion is that, you cannot see it (normally). For example, a dislocated shoulder you can see, a broken leg you can see, acute muscle tears you can see the inflammation but often a concussion has no visible marker. The judgement on a player's condition after sustaining a head injury is made by the medical staff on duty. Sometimes it can be clear that the player is concussed, if they have been knocked out or are struggling to answer any of the subjective testing questions relating the their team and environment. Other times is may be very subtle, they may be slightly delayed in their responses to questions or be acting slightly differently to normal. Once a player is deemed concussed, they must be removed from play and assessed further (in accordance with the medical authorities of the given sport). One of the toughest dealings with head injury for myself was last season when one of our players got knocked unconscious in an away game (one of our players insisted he was unconscious, even though I could not be sure by time I arrived to the player). Our goalkeeper clattered him in the first 15 mins and the player in question had no idea that he had been knocked out (we trusted that our other player had made the right call in that it was actually a KO!). He insisted he felt fine and was going to carry on. Remaining strong in those scenarios is important and, on this occasion, the player eventually (begrudgingly) began walking round the pitch, back to the dugout with me. Once we got back to the dugout, he began asking questions relating to the score and who scored etc. at that point I was heavily re-assured that the right decision had been made. He then was assessed further by the opposition team's doctor. This scenario is a fine example of there being no real 'clear-cut' 100% confirmation of concussion or not but the morale of the story is 'if in doubt, sit them out'. Remember, head injuries can be fatal." - Mike Hine - Head of Sports Science & Medicine, Lincoln City Football Club   You can find emergency aid equipment on our website here