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Concussions: The Problem and How we Should Move Forward

by Jake Francis.

Anyone who knows me will know I am very passionate about concussions and their management... or rather, their poor management. You might have seen me post some "controversial" things on social media, like when AJ lost that boxing match, and then has an interview where he describes symptoms he had during the fight which were symptoms of concussion! Oh, and boxing still doesn't see it!

Click on the picture of AJ to take a look at my social post.


So, what is the research saying?

Well, we could say it was first described in 1928, ironically from research of boxers who had significant head trauma from repeated blows to the head. This condition is now known as chronic traumatic encephalopathy (CTE), which was actually only named and evidenced in 2002 from the brain of an ex-professional American football player. This player had died tragically, and its well worth watching the dramatized film, concussion, to get an idea of what happened - it is a very good film by the way.

However, CTE is one small slice of the pie when it comes to concussion. It is actually the result of multiple concussive injuries over a long period of time and can present in a similar way to dementia. But a single concussion is the result of a whiplash type mechanism, where the head can rock back and forth from an unexpected contact/force to any part of the body - it does not have to be to the head directly. This causes the brain to shake violently like jelly inside the skull, as you can see from the GIF. This results in damage to the brain. There are cases where a second impact can happen, which can have very serious outcomes, as serious as death! Yes, you can die from a concussion. This is why the management for concussions in sport is to recognise and remove from play, and this is actually stated in the tool we use, the SCAT5 (backed up by the latest research).


So why is this such a big problem?

Well, for a start we have some professional sporting bodies that are outright ignoring the issue, specifically boxing in recent times. I counted 3 professional boxers that died of brain injuries last year after being taken to hospital after a fight.


THIS SHOULD NOT BE HAPPENING!


Not at any level of sport, let alone professional level! However, the main issue is education at every level of sport.


I was talking to a colleague who was watching their child play rugby, and noticed a number of kids go down with knocks to the head and coaches telling them to get up and get on with it. No check for symptoms or anything... Very dangerous! This is very common though, because the coach's past experience is of no concussion management.. in existence. So as humans, we draw on past experiences to manage situations.

So there needs to be a fundamental shift in the way concussions are thought about in sport. We need to be educating coaches, teachers, parents... Take a grass-roots up approach to ensure the long-term safety of everyone in sport, whatever level they play at!


Rugby Union has shown the best management of concussion at professional level in sport, but a top-down approach to educating people isn't working, so let's try it the other way round.

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