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“If in doubt, sit them out” – new guidelines for concussion in sport

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Children and teenagers with suspected sport-related concussion should be kept from training or playing for at least two weeks after their symptoms clear, new guidelines developed jointly by the AMA and the Australian Institute of Sport recommend.

The nation’s leading medical and sporting bodies teamed up to develop new guidelines and resources for dealing with concussion on the sporting field.

“Concussion is something that occurs on the sporting fields. It’s not just something that occurs for professional athletes,” outgoing AMA President, Professor Brian Owler, said at the launch of the new website, concussioninsport.gov.au.

“This resource is designed for those coaches, trainers, teachers, parents – those people who are dealing with injuries that happen on sporting fields on Saturday mornings, or on school days.

“I hope that parents and coaches can use this resource. It gives them some reassurance, and we can get some better management of concussion and make sure that we avoid some of the problems that can come along if people don’t pay enough attention to it.”

AIS figures show a 60 per cent rise in the number of people admitted to hospital for sport-related concussion over the past decade, it is estimated there are as many as 100,000 sports-related concussions each year.

But general knowledge about concussion management at a community sporting level in Australia is poor.

“I’ve been in sports medicine for 25 years, and I have to say that I still find each case of concussion challenging,” AIS Chief Medical Officer, Dr David Hughes, said. “I certainly know from my discussions with athletes, parents, and coaches that concussion is an issue that causes a certain amount of anxiety and concern, and rightly so.”

The concussioninsport.gov.au website provides simple but specific advisory tools for athletes, parents, teachers, coaches and medical practitioners.

“There are videos that are recorded by experts from the sporting world, and also GPs, emergency doctors and myself as a neurosurgeon,” Professor Owler said.

“It shows the important things that people need to look out for, and also gives some pretty clear instructions on how to manage concussion in terms of return to training and returning to play.”

The website, and the joint AMA-AIS Position Statement on Concussion in Sport, recommends that children avoid full-contact training or sporting activity until at least 14 days after all symptoms of concussion have cleared.

“We’ve erred on the side of caution,” Professor Owler said.

“No-one is going to have ill-effects from sitting out two weeks of sport. But we know that if people go back too early, then they risk having more concussion, and it’s the compounding effects of concussion that can actually end their playing careers.”

Dr Hughes said there was growing evidence that children were more susceptible to, and took longer to recover from, concussion.

“It’s not the most conservative policy in the world,” Dr Hughes said. A group in Scotland has recommended a four week break, but he said the evidence did not support such a long period.

He said the policy was closely aligned with World Rugby’s current policy on children in sport, and “we certainly feel strongly that children should not be treated the same way as adults when it comes to concussion in sport.”

The joint AMA-AIS Position Statement on Concussion in Sport and a new website, concussioninsport.gov.au, were released at the 2016 AMA National Conference in Canberra.

The Position Statement can be viewed at: position-statement/concussion-sport-2016

 

Maria Hawthorne

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