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Returning to sport after concussion

WebMD Feature
Medically Reviewed by Dr Rob Hicks

Bashes and knocks are often part and parcel of contact sports like rugby, football and hockey, but blows to the head are different. They can cause concussion which can be dangerous if not treated correctly.

Sport keeps children fit and healthy, and fear of concussion shouldn't put parents or their kids off playing, as long as they know how to deal with the immediate and longer term impact of a blow to the head.

What is concussion?

Concussion is sometimes referred to as a minor traumatic brain injury.

"It's a temporary disturbance in brain function as a result of a blow to the head," says Luke Griggs from Headway, the brain injury association.
Concussion can be caused by a jolt to the head as well as a bang or blow.

What are the symptoms?

Only around 20% of reported concussions result in a lack of consciousness.

Typical symptoms include confusion, memory loss, tiredness or mood swings. People who are concussed may not be able to understand instructions, have slurred speech or experience nausea or vomiting. They may be sensitive to light or have balance problems.

"It's often difficult to immediately identify concussion as a lay person or even as a doctor as it can be an evolving condition with symptoms that may not be immediately apparent," says Luke. "That's why it's important to seek medical attention and ensure the patient is supervised for up to 48 hours after the injury."

Get them off

If a player gets a blow to the head during a match or game and concussion is suspected, they should come off the field immediately.

"It's about the elite level setting a good example to grassroots and juniors who haven't got immediate access to ambulances and experts," says Luke. "All those involved, coaches, trainers, referees and parents should adopt the message: 'If in doubt, sit it out'."

Multi-sport guidelines on how to manage concussion during grassroots sport have been drawn up by sportscotland, the Scottish Football Association and Scottish Rugby Union together with senior medics.

It has also produced a downloadable pocket card for easy reference for coaches to keep with them on the field of play to use in case of a suspected concussion.

Individual sports also have their own guidance, most notably in rugby. The message in the RFU's concussion guide is: "Don't be a headcase - check for concussion". Anyone on coaching, refereeing or first aid courses is made aware of the dangers of concussion and how to treat it. The message is:

RECOGNISE: Know the symptoms and signs of concussion

REMOVE: Any player you suspect has concussion immediately and arrange a further assessment by a health care professional

RECOVER: Give player time to recover as with any other injury

RETURN: All players must follow a graduated return to action and can't go back to rugby/sport until they have been cleared by a doctor.

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