A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious. Most concussions do NOT have a loss of consciousness.
Concussions can occur in any sport or recreation activity. So, all coaches, parents, and athletes need to learn concussion signs and symptoms and what to do if a concussion occurs.
Recognizing the Symptoms of a Concussion
Unlike some other common injuries on the rugby pitch, it is not always easy to “see” a concussion. This is why it is so important for everyone to be aware of the signs and symptoms. If you suspect the athlete has taken a blow to the head, these symptoms might include one or more of the following: headache or pressure in the head, nausea or vomiting, blurred or double vision, dizziness, confusion, difficulty concentrating or memory issues, feeling sluggish or “in a fog”, sensitivity to light and/or noise. A coach or parent might notice the player moving slow or clumsily, forgetting assignments, appears dazed or stunned. These are just a few of the many symptoms a player with a concussion might experience. We recommend that players who have symptoms of a concussion be referred to a physician for further evaluation.
What to do if you suspect a concussion has occurred
The absolute first step is to remove the athlete from play immediately. The next step is to get the athlete evaluated by a healthcare professional immediately to access the severity of the concussion. If emergent care is required – call 911 immediately. There are some helpful tools available that the healthcare professional can use to access the head injury. One excellent tool is called the SCAT – Sport Concussion Assessment Tool (pocket exam) – Please click on the links to download the Pocket Concussion Tool and/or the Concussion Tool. Coaches and parents should be familiar with this tool as well as healthcare professionals are not always readily available and this assessment can be utilized by coaches or parents, although the player does need to seek out assessment and care by a healthcare professional.
Management of the Concussion
Following the match or training session in which the concussion occurred, the athlete’s parents or guardians should be notified verbally and in writing of the incident. They should be given a concussion fact sheet. If the athlete is not a minor these instructions should be given to their roommate(s), friend, significant other or a close responsible party. Here is an example of a Concussion Take Home Form. After the player is declared symptom free, he or she can begin the gradual return to play guidelines. Here is an example of a return to activity guideline. It should be noted that there should be a minimum of 24 hours between each progression. If the athlete develops concussion-like symptoms, they should stop the activity, wait until they are symptom free and return to step 1 in the progression. If the symptoms persist they should consult their physician.
Return to Play
Because of the potential seriousness of a concussion, rugby has a very stringent policy in regards to return to full play. Per the IRB Rules and Regulations, the following must be enforced and adhered to at a minimum.
Regulation 10.1 Concussion*
10.1.1 A Player who has suffered a concussion shall not participate in any Match or training session for a minimum period of 3 weeks from the time of injury and may then only do so when symptom free and declared fit after proper medical examination. Such declaration must be recorded in a written report prepared by the person who carried out the medical examination of the Player.
10.1.2 Subject to sub-clause 10.3 below, the three week period may be reduced only if the Player is symptom free and declared fit to play after appropriate assessment by a properly qualified and recognised neurological specialist. Such declaration must be recorded in a written report prepared by the properly qualified and recognised neurological specialist who carried out the assessment of the player.
10.1.3 In age grade rugby the three week minimum period shall be mandatory
*Concussion occurs when the brain is injured following a blow to the head or face. Concussion may occur without an apparent period of unconsciousness. The signs and symptoms of a concussion may include any of the following:
Loss of Consciousness
Loss of memory
Confusion and disorientation
Double or blurred vision
Giddiness or unsteadiness
Vomiting
Headache
What exactly does this all mean??
The bottom line in ALL situations and ALL age levels following a concussion is that in order to return to Match and Contact Training Sessions is you must be:
A. Symptom Free
B. Declared fit to play in WRITING following a proper medical examination.
The time period for this to occur is a minimum of 3 weeks for all players and age levels. For non-Age Grade players, who are symptom free prior to the 3 week time period from the time of injury, you may be able to return to play earlier ONLY if you are SYMPTOM-FREE & ARE DECLARED FIT TO PLAY IN WRITING BY A NEUROLOGICAL SPECIALIST
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