Concussion and Head Injuries in Sport

A concussion is a brain injury and occurs when an individual receives a blow that causes rapid movement of the brain inside the skull. The common misconception is that the blow needs to be directly to the head, but it can be a blow to any part of the body that results in forces being transmitted to the head.

In the past, a concussion was believed to have occurred only when there was a loss of consciousness due to a to direct blow to the head during a game. Incidents were rarely highlighted, and levels of awareness remained very low. The modern redefinition of what constitutes concussion has raised public awareness of brain injuries and resulted in many more cases being reported.

The importance of sport

People are encouraged to participate in sports to boost physical and mental wellbeing and to promote a healthy lifestyle. Sport can provide opportunities for social interaction and team sports offer the additional benefit of encouraging positive behaviours such as teamwork, discipline, and respect, which can be particularly important in young people.

However, growing awareness of concussion has by default highlighted the potential risks of participation in sporting activities. Rising public health concerns have been extended by media coverage of instances of concussion and brain injury in sports and the neurodegenerative illnesses of former prominent sportspeople.

A new approach

There remains a lot of confusion and debate on what the symptoms of concussion are, making identifying instances difficult as athletes, coaches, and parents are not certain exactly what to look for.

In recognition of the need to develop cohesive protocols surrounding concussion and sport, the Government has commissioned studies into the subject and has plans to collaborate with medical experts and sports governing bodies to build a national framework to improve understanding, awareness, prevention, and treatment of concussion at all levels and in all settings.

Stopping short of introducing statutory regulation, the Action Plan on Concussion will commission a single set of shared protocols and mandate national and sports governing bodies to report incidents of suspected brain injuries so there can be a central hub of quantitative data from which further research can be directed.

Concussion and professional sport

Professional sportspeople are contracted to commercial organisations to play sport and like any employee, their employers have statutory responsibilities to safeguard their wellbeing. Although sporting organisations provide access to better medical and scientific resources, in practice, national bodies play the dominant role in managing brain injuries and are the ones behind driving improved standards.

What is lacking is consistent protocols applied to suspected concussions, with each sport still left to define their own approach and fund resources independently. Some governing bodies have oversight across the whole of the UK, but others only within each home nation, creating a fragmented landscape lacking in a coherent strategy.

Concussion in education

All children take part in some sports whilst in full time education, with many also playing for grassroots clubs in their local community. It is inevitable that this level of participation will bring greater risks and incidents of knocks that result in potential bran injuries. Symptoms of concussion can impact a child’s ability to concentrate, so as with any injury, concussions take time to heal and require physical and mental rest.

The issue facing many educational establishments is a lack of specialist coaches, but there is a clear recognition of the need to safeguard the long-term health and welfare of children and young people. Some popular sports have seen fundamental rule changes introduced to mitigate the risks of concussions and address the potential for children to experience serious symptoms in later life.

Bush & Co case management

Bush & Co have an experienced team of case managers that specialise in working with concussion cases. Clients can experience a wide number of sporting injuries, but brain injuries have had an increased focus in recent years and identifying them and understanding the symptoms is key to ensuring appropriate care is given.

Symptoms are not always obvious, and they can present themselves immediately or be delayed for several hours or days. In some scenarios, the case manager may have been instructed to work with a client where a different injury is prevalent and in fact there is also an underlying brain injury or cognitive complication.

Brain injuries can also cause physical symptoms such as fatigue, but other symptoms can be cognitive and result in memory loss or confusion. Bush & Co case managers are experienced in recognising these symptoms, like fatigue, and ensure the client receives further medical examination or support to identify any impact on the brain.

Bush & Co vocational case managers

Bush & Co has a long-standing relationship with the RFU Injured Players Foundation; supporting them and their clients to rehabilitate injured players. Vocational case managers (VCM) have a key role in assisting these individuals with getting back into work or meaningful activity when their lives have been thrown off course. The importance of vocational input cannot be understated as this very often forms most of our weekly routines and gives an individual a sense of purpose and boost self-esteem.

From a vocational perspective, the VCM needs to look at and asses the clients’ symptoms, which could affect memory, concentration, decision making, and stamina or affect a person’s behaviour, all of which can increase the difficulty of returning to the workplace.

Consideration must also be given to the employer. There is every chance an employer will have no experience of working with someone with a brain injury so a key part of the VCM’s role is explaining how the clients’ symptoms will affect them and agreeing on reasonable adjustments that will allow them to perform their duties effectively.

Reasonable adjustments can range from amended working hours to modifying specific aspects of the client’s role and can be achieved by using assistive technology or support workers where required.