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Mind your head

Dr Mike Loosemore tackles concussion

What is concussion? That’s the most difficult question of all really. The definition has changed a lot, but what was decided at the 5th International Conference on Concussion in Sport was that concussion is something that affected the brain, and only the brain. However, the symptoms that you can get from concussion may be caused by other injuries to the head and neck, which can make it confusing.

Importantly, a concussion doesn’t necessarily lead to a loss of consciousness; it’s a brain injury that’s been caused by a significant blunt trauma to the head or body (causing a ‘whiplash’ type injury). If you do experience this type of injury and develop any signs or symptoms of concussion, you should treat it as if it were a concussion, until you can show/prove it’s something else.

What can I do?

Obviously the best thing to do is get checked out by a doctor or medical professional who will know what to look out for. If you get a bang on the head that knocks you out or makes you feel wrong, you’ve got to err on the side of caution and treat it as a concussion; speak to your coach or doctor and let them know.

What are the signs?

The ‘guide’ that medical professionals use to diagnose concussions in athletes is the Sport Concussion Assessment Tool – 3rd Edition AKA (SCAT3). It’s a check list that helps evaluate potential symptoms and assesses cognitive, coordination and balance reactions. There are around 22 symptoms associated with concussion, ranging from ‘not feeling right’ or being sensitive to light/sound, to nausea, dizziness and headaches.

Next steps

If you have had a concussion or taken a knock on the head, it’s important to abstain from alcohol, despite the normal post-match rituals in sports like rugby and football. It’s also important during the acute phase – for the 24-48 hours after the injury – that you make sure you’ve got someone around to keep an eye on you just in case you deteriorate.

Contact sports

If you’re participating in a contact sport such as boxing or rugby, where a blow to the head is likely to happen, it is helpful to understand the provisions put in place to protect against any kind of brain injury. 

In amateur boxing they have a  very strict policy on concussion. If you are stopped when you are fighting because of blows to the head, then you get an automatic 30-day suspension. If you get knocked out, as in rendered unconscious, this increases to 90 days. 

When I do ringside bouts and have to assess whether a boxer has had a particularly hard fight with multiple blows to the head, then I can give them a mandatory 30-day suspension. It’s difficult for the boxer to hear that advice sometimes but it should be an easy decision for us to make.

Sports such as rugby have now brought in video replays to help catch such knocks where in the melee of action it may be unclear what actually happened.

A wider understanding

The awareness across all sports now is greater after the big pay-outs in America to the NFL. People are much more aware of concussion as an issue and there are better programmes in place, to educate more junior or amateur athletes on how to spot it. ‘Weekend Warriors’, playing for enjoyment, still need to learn to spot the signs and hopefully now know what to do if they take a bang on the head.

Dr Loosemore ()

 

Illustration Dale Edwin Murray

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