concussion

Last reviewed 05/2023

Concussion is a traumatic brain injury resulting in a disturbance of brain function.

• research in English rugby has shown that head injuries are common in rugby and account for about 25% of injuries during play (this includes concussions, laceration, bruises etc)
  • how common concussion is varies depending on the level of play; studies in professional rugby have shown that it occurs at a rate of about 3.9 per 1000 player hours (i.e. 1 concussion in every 6 games amongst all the players involved) whereas studies at amateur adult level suggest that concussion occurs at a rate of about 1.2 per 1000 player hours (i.e. 1 in every 21 games)

There are many symptoms of concussion, common ones being headache, dizziness, memory disturbance or balance problems.

Loss of consciousness, being knocked out, occurs in less than 10% of concussions.

Loss of consciousness is not a requirement for diagnosing concussion.

Typically standard brain scans are normal.

Concussion can be caused by a direct blow to the head, but can also occur when blows to other parts of the body result in rapid movement of the head, e.g. whiplash type injuries.

According to the NHS Choices website (www.nhs.uk ) the three main causes of concussion are:

• being involved in a road accident
• accidental trip or fall
• taking part in sporting or other recreational activitie

Concussions can happen at any age. However, children and adolescent athletes:

• are more susceptible to concussion
• take longer to recover
• have more significant memory and mental processing issues
• are more susceptible to rare and dangerous neurological complications, including death caused by a single or second impact

Athletes with a history of two or more concussions within the past year are at greater risk of further brain injury and slower recovery and should seek medical attention from practitioners experienced in concussion management before return to play

• the Glasgow Coma Scale (GCS) is commonly used to both assess the severity of brain injury and to serially monitor patients following traumatic brain injury (TBI).
  • the GCS is used to classify TBI as follows:
    • Mild; GCS = 13 - 15
    • Moderate; GCS = 9 - 12
    • Severe; GCS = <8
    • typically in rugby, players who sustain a concussion have a GCS score of 13 - 15 at the time of medical assessment and therefore fall into the mild end of the injury severity spectrum. The clinical features usually appear rapidly after injury and resolve spontaneously over a variable timescale (2)

Reference:

• 1) International Rugby Board (accessed 8/3/2015).Concussion Guidance for the General Public
• 2) England RFU website (accessed 8/3/15). Concussion in Rugby