Concussion

I guess one little perk of our Covid-19 isolation is that there was less sport and road trauma related concussion injuries???

It’s still a very important to understand and discuss concussion so here we go…

Chalk drawing of human brain with inscription concussion

So what is a concussion?

A concussion is a traumatic brain injury that is caused by force either directly to the head (think a football collision) or an impact to another area of the body which transmits a force to the head (think car crash with whiplash of the head and neck).

Multiple concussions, especially in people under 18 years old, is linked to many mental health conditions in the future such as depression, anxiety and anger management issues; and research has shown a link with suicide around middle age. This is why it’s so important to diagnose and manage a concussion well.

How to recognise a concussion?

These lists will be super handy for anyone playing sports, being a team manager, coach or sports trainer; anyone with kids…

Keep in mind that symptom onset can be delayed and that it can be quite common!

Clear signs include:

  • Loss of consciousness
  • No protective action taken by athlete before hitting the ground
  • Seizure
  • Confusion/ disorientation
  • Balance disturbances or impaired coordination
  • Dazed/ blank stare
  • Behaviour change that is unusual for athlete

Possible subtle symptoms include:

  • Headaches
  • Patient “doesn’t feel right”, OR “pressure feeling in head”, OR feeling like they’re “in a fog”
  • Difficulty concentrating or remembering
  • Neck pain
  • Nausea and vomiting
  • Experiencing fatigue, drowsiness
  • Dizziness
  • Confusion
  • Blurred vision
  • Light or noise sensitivity
  • More emotional; anxiety, stress, irritability

What to do if you suspect a concussion?

  • First aid principles still apply
  • Neck injuries should be suspected if; there’s any loss of consciousness, neck pain, or traumatic mechanism that could lead to spinal injury. In this case use a hard collar until injury is ruled out (but only if you are trained to do so!)
  • DO NOT return to the game until cleared by medical professional (this includes on the day of the traumatic event)
  • Referral to medical professional or immediate dispatch to emergency department
  • Players should not be left alone for at least the first 2 hours after the impact

When to go to the hospital?

  • Neck pain
  • Increasing confusion, agitation or irritability
  • Repeated vomiting
  • Seizures or convulsions
  • Weakness, tingling or burning in the arms/ legs
  • Deteriorating conscious state
  • Severe or increasing headache
  • Unusual behaviour change
  • Double vision

Treatment

  • Observation and testing by a health professional. There are some screening questionnaires your health professional may conduct on your to determine the severity and the best course of action for your concussion. This is often then repeated to show your progress over time. As mentioned above, the severity of your symptoms may require you to present to the emergency department for observation.
  • Rest! This includes both physical and mental rest so not only will you need time off your chosen physical activities or sport but you will likely need to take it easy for your work or study too.
  • Pain relief as needed. This can be helpful for the headache that can result from the traumatic impact that caused your symptoms.

If the player is under 18, there is evidence to suggest a slower rate of recovery. A more conservative approach is recommended so that the child does not return to contact/collision activities less than 14 days from resolution of all symptoms.

How can your osteo help?

Obviously concussions are not one of the injuries that are in our wheelhouse. BUT … if you have an osteopath that you see regularly, we will keep a record of your concussion history and help you manage the symptoms and return to your sport of choice. We can also obviously help with any neck or back pain or stiffness that arises from the trauma that caused the concussion (after allowing the concussion symptoms to settle and ensuring no underlying damage to the brain of course).

If you have a history of multiple concussions, especially in an under 18 player, it is important to have a health professional that you report each and every concussion incident to, no matter how mild you think it may be. The more concussions you have the slower the recovery time, just like it is if you strain your hammy multiple times, someone needs to help you monitor and manage that so whether it is us or your GP or another health professional is fine but you need to keep updating one of us. Promise? Good!!

Side note: Have you seen the 2015 Will Smith movie called ‘Concussion’, very eye opening!