Across all sports, special attention must be given to head and neck injuries. This is because in rare cases, these injuries are potentially serious and can lead to a prolonged course of treatment or have catastrophic consequences. Football is generally not considered to be a high-risk sport. In international championships (1998 to 2012), approximately 13% of all injuries were classified as head and neck injuries. 1 Of these, between 1 and 5% of all injuries were diagnosed as concussion.
This key documents to refer to when considering how to assess and treat a sport-related concussion are the 5th Consensus statement on concussion in sport and the SCAT5 .
Across all sports, special attention must be given to head and neck injuries. This is because in rare cases, these injuries are potentially serious and can lead to a prolonged course of treatment or have catastrophic consequences. Football is generally not considered to be a high-risk sport. In international championships (1998 to 2012), approximately 13% of all injuries were classified as head and neck injuries. 1 Of these, between 1 and 5% of all injuries were diagnosed as concussion.
One of the main challenges for a team doctor faced with a player who has sustained a head injury is the difficulty of estimating the severity of the injury on the pitch or on the touchline. 2 One of the reasons for this difficulty is because a brain injury can be dynamic (its course can change unexpectedly and acutely). Likewise, a single objective diagnostic test or clinical marker for a direct early diagnosis of a concussion (or other brain injuries) does not yet exist. As a result of the inherent vagueness in the early assessment of head injuries, a standardised diagnostic and therapeutic approach, aimed at identifying occasional serious injuries, is essential. 3 This standardised approach is also advocated for injuries to the cervical spine.
The short- and long-term consequences of playing football, including the impact of heading and head injuries on the brain structure and function, have been debated widely. FIFA has conducted different projects on the acute effects of heading and head injuries and has supported a number of other studies which investigate the incidence, prevention, on-pitch and touchline assessment and appropriate management of concussion. These studies have also investigated the role of baseline testing and concussion modifiers like coexisting cervical spine dysfunction or peripheral vestibular impairment. Moreover, the long-term health status of former elite football players is currently being investigated as part of a large multicentre study.
In this module, we will review the current consensus on the acute management of head and neck injuries, including concussion, in football. The subsequent clinic-based assessment, treatment and return to play is considered in a separate “Concussion” module.
