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CONCUSSION IN SPORT Concussion can happen in most sports although it is most frequently associated with contact sports like boxing and rugby. However it can happen during most sports at any level, either during competition or practice. This leaflet gives advice on identifying people who may be suffering from concussion and stresses the importance of getting medical advice at both the time of the event and also during the lead up to returning to participation. This leaflet is not a substitute to seeking individual medical advice.

A concussion is any direct or indirect impact to the head that can cause a change in behaviour, awareness, and/or physical feeling. It may occur due to a direct blow to the head or more indirectly by very sudden stops or changes of direction. It is important to note that you don’t have to be knocked out to have a concussion, more than 90% of concussions do not involve loss of consciousness.

If you experience any of the common features and indicators of concussion shown in the box below, particularly after some sort of impact event, it could be a sign that you have concussion. It is very important that you stop playing and sit down immediately and get medical advice from a doctor.

It is important to understand that you don’t necessarily need to hit your head against something or get hit by an object to suffer concussion. A quickly moving player that hits another player and causes a sudden change in direction may cause a jarring movement of the head and neck that can cause a concussive event. Sometimes you may get knocked out but most of the time the main problems are headaches, dizziness, fatigue and memory problems. These are called post-concussion symptoms.

SECOND IMPACT SYNDROME People who have suffered one concussion impact and still have post concussion symptoms, are prone to second impact syndrome. This results in sudden swelling in the brain which may lead to coma and death and can occur with a relatively minor second impact.

The only way to prevent this happening is better education of people to identify concussion and clear advice that nobody should ever return to play before all the symptoms are completely gone and the individual has been given a clean bill of health by a suitably qualified doctor.

REDUCING THE RISK OF SUFFERING A CONCUSSIVE EVENT a) Training - improving baseline neck strength and the ability to tense the neck muscles. Both help in the absorption and dissipation of forces thereby reducing the risk of injury. b) Good techniques – learning how to block and tackle properly in contact sports and heading the ball properly in soccer.

5 STEPS ON HOW TO RECOGNISE IF SOMEONE ELSE IS CONCUSSED 1 Are they staring vacantly or do they have a confused expression

2 Are they playing appropriately – ie. running in the correct direction, shooting at the correct goal

3 Is their memory altered – ask questions such as’, ‘what ground are you playing at’, ‘which half of the game are you in’, ‘which team are you playing’, ‘when was your last goal’, ‘which team did we play last week and did we win?’ (these have all been identified as good discriminators of memory in concussion)

NUTRITION in sport

4 Keep your eye out for post-traumatic amnesia (the length of time after the impact event during which a person is unable to memorise ongoing events). Ask questions like ‘how did you get injured’, ‘what is the first thing you remember’ and ‘the last thing you remember after you got hit?’

5 Check for any post-concussion symptoms (see box on common features).

IMPORTANT If you detect any of these symptoms in someone, stop them playing immediately and do not let them return to play until they have been properly assessed by a medical doctor. Equally they must not be allowed to return to play after a concussion, however minor, until these symptoms have completely disappeared and this has been confirmed by a doctor.

If you suspect that someone has experienced a concussion it is very important that they are continually observed and not left alone until they have been assessed by a medical doctor who should also monitor their gradual progression to returning to play.

Remember if you return to play too early you are likely you may have to sit out even longer next time and more importantly you are at serious risk of second impact syndrome which may result in coma or death.

FACTS AND FIGURES n 1 million people in Britain attend hospital each year as a result of a head injury. Sport and recreation accounts for 15% of these injuries (source Headway - The Brain Injury Association)

n 7.8% of alpine ski injuries and 9.4% of snowboard injuries (1999-2001) in Scotland occured to the head (source Scottish Ski and Snowboard Injury database)


n Vacant stare, confused expression n Being slow to answer questions or follow instructions n Being confused, easily distracted and/or unable to do normal activities n Walking or running in the wrong direction, maybe even shooting at your own goal n Being unaware of time, place, date n Having slurred or incoherent speech n Being suddenly very uncoordinated and/or dizzy, eg. stumbling or walking in a wobbly line n Having emotions that are out of proportion to circumstances eg. crying for no apparent reason

n Changes in mood eg. anxiety, depression, sleep disturbance, irritability n Any period of loss of consciousness n Feeling ill eg. headaches, ringing in the ears, blurred vision, feeling and/or being sick

The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. To the extent permissible by law, the publisher, editors and contributors accept no liability for any loss, injury or damage howsoever incurred (including negligence) as a consequence, whether directly or indirectly, of the use by any person of the contents of this article.

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