Symmetry Blog

Injury of the week - Concussion

Symmetry Physio - Thursday, August 22, 2019

Steve Smith has been diagnosed with concussion and will miss the third Ashes test.




Cricket followers will most likely be aware of the recent injury to Australian cricket batsman Steve Smith who has been diagnosed with concussion after receiving a fast ball to the head at Lords last week. In general adults will recover between 10-14 days and children within 4 weeks. However in some cases it can take months to recover.

Diagnosis of a concussion is based on symptoms rather than medical scans as the injury to the brain results in a functional disturbance rather than a structural injury that would be seen on a scan. 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'.

Steve returned to play however the following day did not past the screening protocol and therefore has been ruled out with delayed concussion symptoms and may possibly miss the third test starting this Thursday. The Australian Cricket medical staff are not taking any risks and will only allow Steve to return when he is no longer displaying any concussion symptoms for a full 24 hrs and is able to get through training without any delayed side effects.

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 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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