The primary focus of the initial on-pitch assessment of a player who has sustained a head trauma during training or match play is to screen the player for concussion or a more severe head or cervical spine injury. Once this has been done, and the assessment suggests that the player has sustained a concussion, he/she should be managed according to the (Concussion in Sports Group) consensus guidelines. From this point, the diagnosis should be confirmed ideally within the next 24 to 72 hours in a clinical setting by a concussion specialist. Making an accurate diagnosis (which includes the understanding of signs and symptoms) is the key to making an individualised therapeutic approach, preventing further harm and facilitating a safe return to school, work or football.
Most players who have sustained a concussion need a short period of cognitive and physical rest (about 24 to 48 hours). The player is then progressed through a graduated return-to-play programme, developed by the Concussion in Sports Group. In many situations, players may require additional treatments. These may include physiotherapy focusing on vestibular and ocular motor or cervical spine treatments, analgesics or other treatment modalities. Physical activity can also be an important part of the treatment protocol.
The player should not be allowed to return to routine training or match play before his/her symptoms have resolved and not before medical clearance. 1
In this module, you will learn about how to assess and manage a player in a clinical setting, guide a return-to-play programme and learn about some of the potential sequelae and challenges that can be associated with a concussion.
Dr Mark Fulcher
Sport and Exercise Physician