Under new British guidance for grassroots rugby, football and other sports clubs, anyone with suspected concussion must be immediately removed from the game and made to rest for at least 24 hours – with players being restricted from competitive sports for at least three weeks.
The countrywide guidelines are aimed at parents, coaches, referees and players, with its authors saying a “culture change” is needed in how head injuries are dealt with, reports BBC News.
“We know that exercise is good for both mental and physical health, so we don’t want to put people off sport,” said Professor James Calder, the surgeon who led the work for the government, “but we need to recognise that if you’ve got a head injury, it must be managed and you need to be protected so it doesn’t worsen.”
Concussion can alter how someone thinks, feels and remembers things. Only about 10% result in being knocked out and losing consciousness.
Usually, the effects are temporary and most people recover fully with rest.
The new guidance, drawn up by a government-appointed panel of sports-medicine experts, is based on work in Scotland, which has had its own official recommendations in place since 2015.
It says anyone with a head injury must be removed from playing and not participate in any further exercise or work activity until they have been checked by a onsite health professional.
If the player displays “red-flag” symptoms, like loss of consciousness, amnesia or difficulty speaking, they must be urgently assessed at the side of the pitch by a medic or taken to an emergency unit.
For 24 hours after being removed from the game, the new guidance says, the injured player must not:
• be left alone;
• drink alcohol; or
• drive a car
The advice is also to minimise smartphone and computer use for at least 48 hours, as staring at a screen can lengthen recovery time.
The panel had “big debates” about how long players should remain on the sidelines, amid concerns some may cover up or disguise the extent of their injuries, Calder said.
“There has now been a realisation that washing someone with a magic sponge is not the right approach. If you feel there has been a concussion, that player should be removed,” he said.
“The new mantra is: ‘If in doubt, sit them out’.”
The NHS and most sports authorities do not routinely collect data on the number of concussions in grassroots sport.
But the charity Headway estimates 1.4m people attend Accident & Emergency units in England and Wales with some type of head injury each year, with 95% of those classed as mild.
Data from the Rugby Football Union (RFU) suggest a team of 15- to 18-year-olds will have a player concussed once in every 10 games on average, rising to one in every two or three in professional rugby.
The new national guidance is designed as a base set of recommendations for all sports, which can be added to by individual governing bodies if required.
The RFU already runs its Headcase programme to raise awareness of concussion, while rules lowering the legal tackle height in community rugby are due to come into force from July.
The Football Association introduced its own concussion guidelines in 2015. More recently it said under-12s should not be taught to head balls in training, while in England the advice in the adult game is fewer than 10 “maximum-force” headers in practice each week.
Concussion guidelines
BBC News article – Players told to 'sit it out' under new concussion guidance (Open access)
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Even one, moderate concussion can lead to cognitive deterioration – large study
Physical activity 72 hours post-concussion is safe for children – PedCARE trial