Let’s talk about concussion assessment in sport. Not to put you off, but sport can actually be really bad for you. Well, football specifically. And really only if you’re partial to whacking your head off hard surfaces.
Recently, I’ve been covering as a physiotherapist at football matches. Our team had to take a corner. Our goalkeeper jumped for the ball in a packed 6 yard box, and while he caught the ball successfully, he landed awkwardly and ended up with a heavy knock to his head. The player continued to play and I was not called on to the pitch. At the end of the game the player had asked me to check them over due to the way they had landed in the box.
My first thought was to assess the player to determine if there was any concussion present.
What is concussion?
A concussion is mild traumatic brain injury which occurs due to an impact or “blow” to the head. The impact forces from the injury cause the brain to come into contact and hit off the skull. As a result this can cause irritation to the nerves and blood vessels in the brain. When this damage to the brain occurs many people will then experience an altered level of alertness. A concussion is a serious injury therefore is important we assess for a concussion when dealing with a head injury.
So how do we conduct a concussion assessment?
There are many ways we can assess for a suspected concussion and many different sports will have different protocols and tools in place. One quick effective way is through the AVPU scale. The AVPU scale consists of 4 different parts: Alertness, Verbal, Pain and unconscious. Each area of the scale is outlined below:
Alertness – asking the individual simple questions to see if they are alert and aware of their surroundings for example: where are we just now? what half are we in? what is the score? What position are you playing? What was they score last week?
Verbal – Is the individual able to speak clearly and respond well to what you ask them – it is important to listen for any slurred or slowed speech and also if the person talks about something completely different to what you have asked them
Pain – is the individual currently in pain or can they feel pain if you apply slight pressure on their arm or shoulders
Unconscious – is the individual unconscious or not and is there any problems with their breathing?
What happened to the player?
He passed the AVPU with flying colours, however my gut instinct was that something wasn’t right as they were presenting with other concussion symptoms. When conducting a concussion assessment, we can also look for these other symptoms which include:
Confusion
Reduced alertness
Nausea and vomiting
Headaches
Problems with vision
Sensitive to light
Feeling of pressure in head
Increased irritability
Changes in behaviour such as becoming aggressive
Dizziness and drowsiness
Loss of balance
Speech problems such as slurred speech
Fatigue
Loss of consciousness
*These symptoms may occur instantly however in some cases like in this situation the symptoms may gradually develop after the impact injury which can sometimes make a concussion difficult to detect initially therefore it is important that you monitor someone closely if you suspect they have a concussion.
What concussion assessment symptoms did he display?
On concussion assessment our player displayed the symptoms of nausea, headaches and dizziness therefore on the caution I asked him to attend A&E for a medical check and further investigation. It turns out that shortly after arriving at hospital, he was sick, had changes to his vision and behaviour and also was experiencing more increased confusion. This player had it confirmed by medical diagnosis that they had a concussion and started on the relevant concussion protocol to football. This meant that they had to have a minimum 14 days complete rest from playing football and taking part in physical activity within the first stages of their rehab. After a good number of weeks completing all stages of the concussion protocol and rehabilitation the player made a full recovery and return to football.
Even though sport can be dangerous, we have ways to ensure the safety of all of our players. Our priority at Physioflexx is to make sure that, even if you have had an injury during your sport, you’re well looked after. If you’d like to know more, or to book an appointment, please call us on 01560 483200.
Further Information
If you have any questions about neck, back, shoulder or elbow pain, or would like to book an appointment to see a physiotherapist, please click here to book. Book Online – Physioflexx Ayrshire
