There has been growing concern in Australia and internationally about the incidence of sport-related concussion and potential health ramifications for athletes. Concussion affects athletes at all levels of sport, from the part-time recreational athlete to the full-time professional. If managed appropriately most symptoms and signs of concussion resolve spontaneously. Complications can occur, however, including prolonged duration of symptoms and increased susceptibility to further injury. There is also growing concern about potential long-term consequences of multiple concussions. 1.
Sports-related concussions (SRCs) are traumatic events that affect up to 3.8 million athletes in the US per year and account for 5%–9% of all sports-related injuries. Alarmingly, nearly 30% of these concussions occur in individuals between 5 and 19 years of age, and most result in a visit to the emergency room. SRCs are usually transient episodes of neurological dysfunction following a traumatic impact, with most symptoms resolving in 7–10 days; however, a small percentage of patients will suffer protracted symptoms for years after the event and may develop chronic neurodegenerative disease. Rarely, SRCs are associated with complications, such as skull fractures, epidural or subdural hematomas, and edema requiring neurosurgical evaluation. Current standards of care are based on a paradigm of rest and gradual return to play, with decisions driven by subjective and objective information gleaned from a detailed history and physical examination. Specific biomarkers are being developed and validated. It is hoped that these advances will allow a more accurate assessment of when an athlete is truly safe to return to play, decreasing the risk of secondary impact injuries, and provide avenues for therapeutic strategies targeting the complex biochemical cascade that results from a traumatic injury to the brain.2.
In Victoria, the most common activities leading to hospitalisation between the years 2002 and 2011 were: team ball sports (particularly the football codes), modes of active transportation, and snow-based adventure sports. Together, the football codes accounted for 36.0% (1709/4745) of all hospitalisations. The activities with the highest mean participation-adjusted rates of hospitalisation for concussion over the 9-year period were motor sports (181.8 per 100 000 participants), equestrian activities (130.3/100 000) and Australian football (80.3/100 000).3.
US high schools taking the fight to concussion
1. 'Concussion in Sport' position statement AIS, AMA, ACSEP & SMA. Dr Lisa Elkington, Dr Silvia Manzanero and Dr David HughesAustralian Institute of Sport. Oct 2018.
2. Jonathan G Hobbs, et al Sports-related concussions: diagnosis, complications, and current management strategies Neurosurg Focus 40 (4):E5, 2016
3.Caroline F. Finch, et al. Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia. The Medical Journal of Australia, May 2013 Vol 198 Iss. 8