The battle against concussion

It seems the more we learn about concussion, the more questions are raised. Should we be wearing helmets? Should we be playing contact sports? I often wonder what runs through the head of those that are on the frontline in regards to researching head injuries. Surely amongst them there has to be someone that loves to watch a cheeky game of football from time to time. Do they too fear that we will one-day lose contact sport to concussion?

In recent times there has been an increase in the amount of information available regarding the long-term effects of multiple concussions. Post-concussion syndrome has been identified as a possible long-term effect of a severe or concurrent head injury and comes with various undesirable symptoms. But could the way we handle a concussion also affect the likelihood of longer-term problems?

In our profession, we are passionate about handling injuries with the upmost care. For me, the way you manage a concussion is the most important. Remember, concussion is a brain injury, an injury to our most vital organ.

We saw on the weekend a sickening head-clash between two Sydney Swans. We saw one of them, Buddy Franklin, lose consciousness from a knock to his cheek. He’s out cold well before he hits the ground. You wouldn’t be silly to be surprised that the result was a concussion rather than a fractured cheekbone. But it’s what we don’t see, which explains why Buddy was left laying there the way he was.

Buddy’s brain, had rattled within his head, hitting his skull, most likely once at the front and once at the back, much like how a pin ball bounces quickly from a nearby barricade and then ricochets back to where it came. The brain suffers trauma and Buddy loses consciousness.

The way we manage someone like this is important. Obviously professional sports people have professional support, but in the general community we don’t necessarily have this on hand. So what should we do?

Anyone that loses consciousness, no matter how short a time that may be, should be removed from the ground and should not be allowed to return to play. This topic is well debated amongst those in professional sport and still to this day many players return later in the match. The AFL introduced the concussion rule a few years back to allow the highly trained staff extra time to assess a player thoroughly and ensure they were not at risk of returning to play. This is still being debated as best practice within media circles. But I think it’s safe to say that if people are still discussing it at the highest level with the highest professional support, we can say it’s best to keep people off the ground at community level.

Allow the player to rest. Just like when you tear a hamstring, that initial stage requires a level of relative rest to allow tissue healing. This means avoid vigorous exercise and anything that stimulates the mind. So put away the Suduko’s and cross words for a while and let the mind recover.

Avoid alcohol; it is a vasodilator of your blood vessels, which means it will increase your blood vessels diameter. When you suffer a concussion the body is already pumping blood to the brain to help with healing. This is normal and healthy. If you add alcohol to the equation, more blood will be pumped to the brain then is required for healing and it will ultimately impede recovery.

Importantly keep the patient safe and monitor their symptoms. Make sure they don’t drive, they have someone that can stay with them at home and look for signs that they maybe deteriorating. Any headache, dizziness, nausea or vomiting and vision impairments that are becoming gradually worse should all be taken as a sign to be checked out immediately. Remember if they fall asleep you can’t monitor this so don’t allow them to go to bed until around their usual bedtime. Don’t be cruel and keep them awake all night, remember the brain needs rest. And as always, the safest bet is to have them checked by a healthcare professional.

In regards to returning to play, most local competitions these days have imposed a policy of having a concussed player assessed by a GP and obtaining a medical clearance before returning to sport and I think this is a fantastic initiative.

Please treat brain injuries the right way. Hopefully the better we become at managing concussion, the more often a patient will completely recover, the fewer the incidence of long-term symptoms will occur and the less likely we will lose contact sport to concussion.