Symmetry Blog

Injury of the week - Concussion

Symmetry Physio - Wednesday, July 03, 2019

A serious injury, that we are learning more about. 


Injury of the week - Concussion

Big ruckman Oscar McInerney from Brisbane Lions went down in a sickening clash with his opponent on the weekend. It was immediately obvious that he had been concussed and left the ground dazed and groggy. A concussion does not always need to be so traumatic with less obvious incidents occurring that can sometimes be more difficult to identify in the untrained eye. Most players will miss a minimum of one game however some can miss weeks or even months following a concussion injury. In general adults will recover between 10-14 days and children within 4 weeks.

Sports related concussion (SRC) is classified as a traumatic brain injury induced by forces transmitted to the head. This can be caused by a direct or indirect blow to the head along with an associated whiplash injury to the neck.

Diagnosis of a concussion is based on symptoms rather than medical scans as the injury to the brain during a concussion results in a functional disturbance rather than a structural injury that would be seen on an MRI. Scans are however advisable to rule out any other injury to the brain or spine. It is therefore very important that any concussion or suspected concussion be assessed by a medical practitioner.

A SCAT5 is standardised evaluation tool used off-field by physiotherapist and/or the medical team after a suspected concussion incident. If a concussion is suspected then the player will not return to the field. Any player returning to play following a concussion is at high risk of physical injury and if there is any ‘doubt they should sit it out'.

Symptoms of concussion can result in a wide range of clinical signs and symptoms and a loss of consciousness does not need to occur.Symptoms that may present can include:

Neck pain and headache, fogginess, amnesia, behavioural changes such as irritability, cognitive impairment (slow reaction time), balance issues, fatigue and sleep/wake disturbances.

Treatment following a concussion is generally a period of physical and cognitive ‘brain’ rest for 24-48 hours. Thereafter an active recovery approach is adopted with a graded return to daily activities, School then onto sports related activities such training drills and finally full contact training as long as symptoms are not exacerbated with a minimum of 24 hrs between each stage in order to assess and monitor their progress and ability to cope with returning to play.

A physiotherapist role may include using the SCAT5 for pre-screening players to attain baseline measures then re-assessing following a suspected incident. Following concussion physiotherapy management will generally be associated with the concurrent whiplash injury that occurs to the neck. A physiotherapist can help improve neck pain, restore neck movement, reduce muscle spasm and assess and treat any balance disturbances or make referrals for further testing and management where required.

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Kim Garland 

Symmetry Physiotherapy





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