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Three weeks on the bench for concussed players
The AIS’s new recommendation for all community sport is aimed at offering ‘clear and consistent guidance’ for injured players.
There are around 3100 hospitalisations for concussion caused by sport in Australia each year.
GPs should recommend junior and community athletes wait at least 21 days after sustaining a concussion before returning to competition, according to new guidelines.
Released On Thursday, the Australian Concussion Guidelines for Youth and Community Sport was put together amid growing community concern over the long-term impacts of the injury.
Developed by the Australian Institute of Sport (AIS) and Sports Medicine Australia, along with a range of medical professionals, the document brings Australia in line with New Zealand and the United Kingdom.
It also recommends athletes be symptom-free for 14 days before restarting contact training, as well as prioritising return to work or school above returning to sport.
‘To be clear, that is not 14 days from the time of concussion. It is 14 days from when the athlete becomes symptom-free,’ it reiterated.
The recommended return to sport timeline includes:
- the introduction of light exercise after an initial 24–48 hours of relative rest
- gradual reintroduction of learning and work activities
- at least 14 days symptom free (at rest) before return to contact training
- a minimum period of 21 days until the resumption of competitive contact sport
- consideration of all symptom domains (physical, cognitive, emotional, fatigue, sleep) throughout the recovery process.
The guidelines also say an athlete with a history of multiple concussions is at risk of experiencing prolonged symptoms and should be managed more conservatively by a clinical team with specific concussion training.
AIS Chief Medical Officer Dr David Hughes said the guidelines provide all Australians with a clear, consistent, and strong message on how to manage concussion in sport.
‘It’s important to manage all instances of concussion with an abundance of caution,’ he said.
‘Make it clear that a conservative management approach is needed for people aged under 19 who have growing brains and are at risk of prolonged recovery times, as well as for community sport where advanced healthcare support is often not available.
‘The AIS wants everyone involved in sport to remember, when considering an athlete with possible concussion, “if in doubt, sit them out”.’
The guidelines also recommend clubs and schools introduce a ‘concussion officer’ to oversee the management of concussion as a single point of contact and coordination.
The calls for change come as new data reveals
more than 80% of intracranial injuries in sports are concussions, usually caused by a knock to the head or a blow to the body.
There are around 3100 hospitalisations for concussion caused by sport in Australia each year, about 70% of these are in males and 42% were from some form of football.
Dr Navid Nazarian, Chair of RACGP Specific Interests Musculoskeletal, Sport and Exercise Medicine, welcomed the guidelines, telling
newsGP it is encouraging to see a consistent approach to concussion management.
‘Concussion is a topic that’s getting more and more attention nowadays, so having some national guidelines is great news,’ he said.
‘Anywhere, at any level, at any age, we have concussions, so if people have a better understanding of it and know how to deal with it at their level, that’s fantastic.
‘We live in a country where people are more athletic and we play sports at all levels, so having this step-by-step guide is important.’
Last year, the RACGP called on governments and sporting bodies to do more to limit the long-term impacts of concussion as part of its
submission to a Senate Inquiry examining the issue.
The submission recommends sport governing bodies adapt the rules of contact sports to prioritise prevention of concussion in the first instance, as well as investment to support longer general practice consultations for people with concussion.
Dr Nazarian said while concussion does not make up a significant number of consultations with patients, it is important GPs familiarise themselves with the most up-to-date recommendations.
‘It’s something that all GPs should be aware of at least, and it’s good to have an awareness of these guidelines and when we should use them in our practice – they are really clear and very step-by-step,’ he said.
‘The only thing is it’s a bit hard to implement them in different settings, in remote areas compared to the suburban metropolitan areas, so that’s the part that we need to be aware of.
‘But all in all, I think every general practice, or sports team, or school, or anyone who’s involved in sports at any age level, can refer to these protocols.’
The country’s major sporting codes have acknowledged the guidelines, among them, the Australian Football League (AFL) which said it reviews its concussion results each year and that process is ongoing for 2024.
Cricket, Netball, Rugby, and Football Australia also acknowledge the new guidelines, all saying the health and safety of their players is priority.
GPs are encouraged to use the Sport Concussion Assessment Tool 6 (SCAT6) and the Sport Concussion Office Assessment Tool 6 (SCOAT6) when seeing patients with a possible concussion.
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