Concussion hits sufferers hard
Iwatched the All Blacks take on the Lions at the weekend, and found myself cringing as Sonny Bill Williams’ shoulder charge was replayed over and over again.
As in other households I am sure, the ‘‘red carding’’ of an All Black led to plenty of heated discussion. Others in the room felt he was harshly treated, and the collision was highly unfortunate but unintended.
However I think the referee sent out a really important message when he played that card: heads, brains and necks of players need to be protected at all costs – being mindful of that as you play, even in the most highly charged emotional battle on the field, is your duty as a responsible sportsman or woman.
Concussion is a huge issue in this country. An estimated 24,000 New Zealanders get concussed every year, many of them sustained playing sports.
For some, that will mean time off work, sports, and family life. For the really unfortunate ones, full recovery may never happen – life forever tainted by the symptoms of a one-off event. Avoiding concussion in the first place is obviously key, but so is ensuring early detection, and then minimising any impact it might have by treating it properly.
So here are some basic facts that you should know if you’re playing sport:
Concussion is a mild brain injury. Contrary to popular belief, you don’t actually have to get a blow directly to the head itself – impact anywhere on your body that causes your head to shake violently can lead to concussion.
You don’t have to be knocked out to get concussion. In fact, only 20 per cent of concussions will be preceded by a loss of consciousness.
Any symptoms that might indicate concussion should lead to a player being immediately removed from the field. Symptoms can occur immediately after the injury, or up to several weeks later. Common symptoms include:
Headache.
Feeling confused, disorientated or ‘‘dazed’’.
Poor balance or lack of coordination. Nausea or vomiting. Blurred or double vision. Loss of memory – this is known as amnesia; in concussion it is really common to lose memory for the events leading up to and immediately after the injury itself.
Tiredness – this can be pronounced, with some people reporting a need to sleep far longer than they normally would.
Irritability or ‘‘fragility’’ – this can include feeling like you might burst into tears or lose your temper more easily than normal.
Heightened sensitivity to noise and light.
Tinnitus, or ‘‘ringing’’ in your ears. Luckily all these symptoms are temporary, but if you don’t let your brain fully recover after an injury, concussion can lead to permanent damage or even death.
When removed from the field after a head injury, no-one should play sport again until they have been properly assessed by a medical doctor.
At professional level, a concussion assessment (known as the SCAT test – the Sport Concussion Assessment Tool) can be performed on the sideline – if the player passes the test and has no evidence of concussion they may be allowed to resume play.
If they don’t pass the test (in comparison with their previous test scores when fully fit), they are not allowed back on. At other levels of sport, your GP or local emergency medical centre will be able to do a SCAT for you, and let you know if and when you should be playing again.
If your SCAT test result isn’t improving during the weeks following an injury, then you should be referred to a concussion clinic for further assessment and advice – these clinics are usually based within a hospital and are funded by ACC.
Although rugby is the obvious culprit when we think of head injuries, other sports are risky too – think of head clashes on the netball court, hitting the ground diving for a ball in hockey, or heading the ball on the soccer pitch.
All of these sports, and numerous others, have the potential to lead to concussion so ensuring you are equipped to play safely (wearing good mouthguard protection at all times) is crucial to reduce your risk.
If you do get a head injury, the first 24 hours after the event are crucial. This is the time when serious complications are more likely to occur, so it is really important you are not alone and have someone who can monitor how you are doing – if symptoms start to worsen in any way, you need to be reassessed by a doctor urgently.
To avoid serious or ongoing concussion after a head injury, follow these rules, and don’t increase your activity level until you are medically cleared to do so – it’s truly not worth the risk:
Rest and sleep – as much as your body needs.
Avoid anything that ‘‘stimulates’’ your brain too much – screens, loud music, noisy environments. Avoid alcohol and drugs. Stay off work until you are allowed back.
Avoid any sport for at least three weeks – a second concussion within a short time of the first one can be disastrous. Dr Cathy Stephenson is a GP and forensic medical examiner.