CONCUSSION – An Injury Requiring Rehabilitation

With the recent onslaught of rugby in the media and doctors trying to ban tackling in school rugby, now seems a good time to discuss the reason for all of this. Concussion.

Head injury can occur in many sports and the targeting of rugby seems a little unfair. A concussion is an INJURY to the brain that can result from a blow to the head, face or neck or even impact of the body that can cause a jarring of the head. This can lead to immediate confusion, short-term memory loss, blank or dazed expression. The injured individual may mention having a headache, feeling dizzy, blurred vision, ringing ears, sleepiness, nausea, vomiting, slurred speech, poor concentration and altered emotions.

I have once heard the head and brain described as a bucket filled with jelly. Many things have previously been implemented in a number of sports to reduce the impact on the brain. However, as with a bucket of jelly, impact to the outside will still shake the material in the centre. Therefore, sudden acceleration or deceleration can cause impact of the brain against the inside of the skull and lead to a concussion.

As ridiculous as it is to try and remove tackling from rugby, I hope this recent increase in media coverage will encourage more research and education for those responsible for looking after players of all ages. We’ve all heard of players continuing in a match following a loss of consciousness; it is these rare occurrences giving sports a bad name.

If you are still unsure of the long-term risks of concussion please watch this video.

How Is Concussion Treated

Rugby is one of the few sports that have begun to implement education programmes for coaches, players and medical supports staff. All of which helps to reduce the risk of long-term effects of concussion. Many sports have nothing in place as rugby, ice hockey and a few other sports do; yet these are the sports receiving most criticism.

The RFU have a system of protecting all players with their 4 Rs:

RECOGNISE – Signs and symptoms
REMOVE – The player from play
RECOVER – Fully prior to returning to sport
RETURN – After full completion of a graduated return to play

The graduated return to play protocol differs depending on the athlete and symptoms but follows 6 phases in returning to sport.

REST – complete cognitive and physical rest without symptoms

LIGHT AEROBIC EXERCISE – <70% max intensity with no return of symptoms

SPORT-SPECIFIC – Non-impact drills without return of symptoms

NON-CONTACT – More complex drills plus resistance training without return of symptoms

FULL CONTACT PRACTICE – Normal training activity without return of symptoms

RETURN TO PLAY – Rehabilitation complete and can return to unrestricted sport

In all players the REST phase must last for 2 weeks symptoms free and a player may only progress if the player has not had a return of symptoms within a 2-week period. Following the rest period and clearance by a therapist, a player must complete a minimum of 24 hours (Adults) or 48 hours (Under 19s) at each stage of the graduated return to play. If at any stage there is a return of any concussion symptoms then the player must regress to the phase of the graduated return to play where they had no symptoms and again complete the allotted time at that phase.

This means that adults should not return to play until at least 19 days following the injury and for under 19s a minimum of 23 days is required.

There is one exception! For players in professional clubs or academies the return to play can be sooner as long as a doctor clears each phase. In adults the rest period is reduced to 24 hours and 17-19 year olds require a minimum of 7 days rest; both age groups would then have 24-hour minimum graduated return to play phases.

If your club or team doesn’t currently have any concussion protocols in place then please encourage them to do so or get in touch to and enquire about Reboots concussion rehabilitation.

Concussion is an injury and should be treated as such; please ensure your rehabilitation is completed correctly.

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