The Australian Institute of Sport (AIS) published this week new guidelines for youth and community sports, which aims to change the way concussion is treated across the country.
While the guidelines contain a number of recommendations on how to manage concussions on the field and identify symptoms, the biggest changes concern how to manage concussions after they occur.
Specifically, all players who have suffered a concussion should be symptom-free for at least 14 days before resuming contact training. This was already advice for children, but now it also applies to community sports. It is worth noting that all players should wait at least 21 days after a concussion to return to competition.
This contrasts with previous recommendations from many Australian sporting bodies, which typically enforce a minimum period of ten to 14 days before an athlete with concussion can be back to competition.
The new guidelines incorporate a number of recommendations from last year’s guidelines Senate inquiry to concussions and repeated head injuries in contact sports. So what is the justification for forcing people to sit longer?
Dangers of concussion
Sports-related concussion has been defined How:
traumatic brain injury caused by a direct blow to the head, neck, or body that transmits the impulse force that occurs during sports or exercise-related activities to the brain.
Concussion in sports has become an increasingly popular topic in recent years – and for good reason. The effects of a concussion may include changes in blood flow and inflammation affecting the brain.
In the short term, a concussion can cause fatigue, sensitivity to light and nausea, and is more severe symptoms including changes in behavior, loss of balance and coordination, and severe headaches.
There is also evidence to suggest that repeated concussions can have long-term effects. These include permanent ones decline in cognitive functions (how people think, make decisions and process information) and in some cases: increased risk of dementia in older adulthood.
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Concussion in children
Children who have previously had a concussion are almost four times more likely to have had a concussion more probable more likely to suffer a concussion in the future than people who have never previously suffered a concussion.
Similarly, our research showed that young athletes who recover from a concussion are approximately 50% more likely to suffer any future injury compared to other athletes. My colleagues and I also found that most athletes returned to competition after about 12 days, which may suggest that inadequate recovery increases the risk of injury after a concussion.
We don’t know the exact reason why children and teenagers take longer to recover from a concussion, but it seems that they do.
The latest evidence showed that the average recovery and sports participation in children may not occur until approximately 20 days after concussion, while adults may be recovered after approximately 14 days. However, this does not apply to everyone, some people take a lot longer to regenerate.
A step in the right direction
Taking these factors into account, I believe that extending the concussion recovery period to 21 days is not only justified, but a positive step. While additional recovery time seems particularly important for children, this change will also increase the likelihood that adults participating in community sports will be ready to return, especially if they do not have access to medical guidance.
Most people who play sports readily accept that recovery from a muscle tear can take four to eight weeks, so why wouldn’t they accept that the brain (which is arguably a much more important part of the body) takes less time?
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Australia is not the first country to tighten its guidelines.
In April 2023, the first concussion guidelines the same minimum rest days should be set for UK-wide non-elite sport.
Similar guidelines have also been implemented throughout New Zealand for a number of sports disciplines.
There have been no studies examining whether these updated guidelines have already had a positive effect, but given that returning too early may pose risks, they offer very few downsides.
Implementation of guidelines
While these guidelines have a positive impact on the health and well-being of athletes across the country, there are also potential issues with their implementation – particularly at the local level where there may be few medical staff on site.
The good news is that you don’t have to be an expert to mitigate the effects of a concussion.
The first step for those involved in community sports is to simply familiarize themselves with the concussion management protocols proposed by the AIS. This means making sure club staff know what the symptoms of concussion look like and when to encourage their players to see a doctor.
The second step, as recommended in the updated guidelines, is to introduce “shock officer” to oversee concussion treatment. This person does not need to be a concussion expert and is not expected to diagnose a concussion. As with the fire department, the concussion officer ensures that anyone diagnosed with a concussion follows the agreed upon protocol.
Finally, when it comes to young athletes, when in doubt, wait them out. A more conservative approach is always best.
