Recently I attended a seminar held by Sports Medicine Australia regarding the most updated understanding of concussion management. Although a lot of the scientific understanding is improving with concussion, the more the medical community learns about concussion, the more we realize how little we have previously known regarding how to manage this common complaint.
Over 3,000 patients attend hospitals in Australia each year complaining of concussion syndromes BUT up to 10 times this may be affected and do not recognise they have a concussion. This is due to poor community education about what concussion is, and the symptoms of it.
We now know that less than 10% of concussions have a loss of consciousness, therefore you can see that many affected people would go about their daily life not knowing they had obtained a concussion.This will not adversely affect everyone, and some patients will luckily recover well, however patients who have suffered even mild concussion do have 3-4 times more risk for another injury returning to sport, and another hit on a symptomatic brain has a worse prognosis for that patient and not to mention players can have a worse performance ongoing.
The testing is still being updated with SCAT (sport concussion assessment tool – our clinical test protocol for concussion patients) likely to receive an update soon. Excitingly, there is talk about a saliva test and blood tests potentially showing symptoms that can alert a practitioner to need to look after a person more closely. A large thing to remember with concussion tests is that it is not all about the objective score, it is more about how a well or easily person is doing them, for example you can say the alphabet backwards correctly but if it’s taking you 10 minutes instead of 5 minutes it alerts us to an issue.
Progressing to no symptoms is also highly debated in society and media, with the previous “10 day” rule, changing to “12 days” before you can return to training or games. What the media does not talk about is that this rule begins from the first day of no symptoms, not the day of the injury. This means that the majority of people will definitely miss one game, but some can miss 2-4 games due to waiting for their symptoms to subside. If symptoms last longer than 2 weeks, it is considered severe concussion and you may need more advanced medical help to return to daily habits. During this time, the normal procedure is to see a GP for clearance to play sport again, the newest recommendation is to see a Sports Medicine Doctor to clear you to play as they have more training in concussion and can accurately examine and give you clearance.
Around 20% of concussions need medical assistance and there are more sports medicine, allied health practitioners including neurophysiotherapsits that can help you move through this frustrating time.
If you have any more questions on how I may be able to help manage your concussion please do not hesitate to call the clinic.