|Born:||January 9th, 1987 (age 26),|
|Height:||1.98 m (6ft 6in)|
|Weight:||119kg (18st 10lb)|
|Plays for:||Wales, Cardiff Blues|
November 24, 2012 : “He’s [Bradley Davies] got severe concussion. He won’t be available this weekend,” said assistant coach Rob Howley on Monday.
What is Concussion?
Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November (McCroy et al, 2008) defines concussion as…..
Concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilised in defining the nature of a concussive head injury include:
1. Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head.
2. Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously.
3. Concussion may result in neuropathological changes but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury.
4. Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course; however it is important to note that in a small percentage of cases however, post-concussive symptoms may be prolonged.
5. No abnormality on standard structural neuroimaging studies is seen in concussion.
What are the symptoms of concussion?
- Slurred speech
- Difficulty concentrating
- Difficulty swallowing
- Reduced balance
- Feeling ‘spaced out’
- Cognitive impairment (slow reaction times)
- Change in behavior (irritability/emotional)
- Inability to answer Maddock’s questions.
How do you assess concussion?
The Canadian Centre for ethics in sport has produced a brilliant assessment tool. Anyone considering a career as a pitchside/sports physiotherapist should read this. It is also great useful knowledge for anyone working around people who may become concussed.
- Check if patient is experiencing any symptoms of concussion?
- Glasglow Coma Scale
- Maddock’s questions
- Balance testing
- SCAT 3 testing
- Cognitive testing
- Are they deteriorating? (ie more symptoms/increased severity of symptoms?)
- Patients should not be left alone (problems can arise within 24-48hrs) and attend A and E if symptoms are worsening, ie patients not recognising people, places, numbness/weakness in limbs, repeated vomiting.
Rules for pitchside assessment.
- Player must be removed from play if concussion is suspected. If symptoms are mild, consider whether you are qualified to make this judgement (ie a qualified medical practitioner with relevant training), then family and friends of player should be debriefed and given concussion advice sheet recommending patient to attend A and E should they deteriorate. Check that the patient has someone who will be around overnight who can take them to hospital should this occur.
- If someone is not medically qualified to assess concussion patients should attend MIU or A and E to be checked.
- Anyone who experiences a loss of consciousness should attend hospital and may be monitored over night.
So when will he be back?
- Return to play (Click here to see graduated return to play – Table 3)
- For those being managed by a medical practitioner the minimum time to return to sport would be 6 days.
- If not managed by a medical practitioner then players must not return before the 21st day and below guidelines should apply supervised by someone who knows the player.
- 2 weeks complete rest
- Light aerobic exercises if nil symptoms after 24hours rest.
- Sport specific exercise- light change in direction if nil symptoms from stage 2.
- Non contact training drills if nil symptoms from stage 3.
- Full contact practice. If nil symptoms within 24hours.
- Fit to play.
If the player has not been managed by a medical practitioner they must not play until the 21st day however should still follow the above graduated return to play per IRB guidelines.
Useful Resources – Click below:
McCrea M. Standardized mental status testing of acute concussion. Clinical Journal of Sports Medicine. 2001; 11: 176-181
McCrea M, randolph C, Kelly J. Standardized Assessment of Concussion: Manual for administration, scoring and interpretation. Waukesha,
Maddocks, Dl; Dicker, GD; Saling, MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32–3