Consensus statement on concussion in sport
This time we´re looking at: Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016
You can find the link to the article HERE:
Every year there is an international conference on SRC (Sports Related Concussions) where some of the best within this field tries to improve their and other peoples’ knowledge on SRC. The problems are many and sometimes there are more questions created than there are answers. But is this a bad thing?
Of course not! The simple fact that people are starting to ask more and more questions is proof of improvement. People are scared and confused. Parents don´t want to make the wrong choices for their kids, trainers don´t want to spoil anything for their athletes and the athletes themselves want to keep chasing their dreams. Knowledge is power, but what do we know? Do we know exactly how to define and diagnose a concussion? Do we have enough routines to make sure we don´t take more risks than is necessary?
In the consensus statement on Sports Related Concussions, they wrote:
"SRC is considered to be among the most complex injuries in sports medicine to diagnose, assess and manage. The majority of SRCs occur without loss of consciousness or frank neurological signs. At present, there is no perfect diagnostic test or marker that clinicians can rely on for an immediate diagnosis of SRC in the sporting environment."
Did you guys see that? It says that the majority of Sports Related Concussion occur without loss of consciousness or frank neurological signs. With this in consideration, please keep reading.
At any sports event, there is (or at least should be) a doctor or some other healthcare provider or physician that should be able to properly examine and treat a SRC.
But here we run into trouble. Because far from all sports events have doctors or physicians with knowledge of SRC. This is a big problem because some of the decisions that are made to keep players in the game are mostly made by doctors. They are the ones who are supposed to be able to decide if players or athletes are fit to keep playing. How is it that the injury which is the most difficult to diagnose, is also the one that is most overlooked?
This is sometimes the biggest problem of them all. Not the injury itself, but the trainers and physicians who don´t know their limits. They think it´s tough for athletes to "take a punch, like a man" and keep going. And of course, the athletes listen to their coach, they don´t know any better.
Me myself have had discussions with doctors on competitions while they were examining my athletes saying to me that "No, it can´t be a concussion. She is still conscious..."
WOW!! So, I was told by the doctor at the ----------- championship, that my athlete didn´t have a concussion, because she was NOT knocked out?? Is that the standard? Is that really where they draw the line? The person may be a good doctor but in that scenario, the knowledge of SRC was limiting the safety of my athlete.
But even if you have doctors and physicians with enough knowledge, is that still enough? Just think of your own sport, the chaos, the speed of the game, the audience, the coaches, the parents and friends who are screaming and shouting. It´s not an easy environment to make a calm decision and diagnose an athlete in. Some of the athletes only have minutes and seconds between rounds. How are you supposed to make the diagnosis of SRCs flawlessly? It´s a difficult task, but consider this statement from the SRC-meeting:
"We acknowledge that many contact sports are played at a fast pace in a disorganised environment, where the view of on-field incidents is often obscured and the symptoms of SRC are diverse, all of which adds to the challenge of the medical assessment of suspected SRC."
Depending on which sport or sport event we´re looking at the problems are quite different. In future articles I´m going to write about standardised tests for SRC such as SCAT5 and King Dewicks, but for now we´re only looking at the surroundings. Imagine your sport or any other sport event and take this next statement in consideration:
"When a concussion is suspected, the athlete should be removed from the sporting environment and a multimodal assessment should be conducted in a standardised fashion (eg, the SCAT5). Sporting bodies should allow adequate time to conduct this evaluation. For example, completing the SCAT alone typically takes 10 min. Adequate facilities should be provided for the appropriate medical assessment both on and off the field for all injured athletes. In some sports, this may require rule changes to allow an appropriate off-field medical assessment to occur without affecting the flow of the game or unduly penalising the injured player’s team"
Can you imagine what this would mean for sports where they are depending on a tight time schedule, where things are supposed to happen smoothly and effectively? This would mean some major rule changes in all of sports. Are we ready for that? Is that a sacrifice we are willing to make just to make sure that our children and athletes won´t go the rest of their life with life changing symptoms from their sport related brain injury? Is it worth the time, money and education to make sure that our athletes world-wide won´t die younger than necessary from Alzheimer’s, Parkinson’s and CTE due to that their coaches didn´t know enough or that the sport they were playing didn´t give them that support because it was too much of a sacrifice of money and time to keep their players healthy?
I sincerely hope not. I hope that we in a few years will look at SRC in the same way we look at knee injuries. We all can in some way recognise a knee injury, and maybe in the future, we will be able, as a crowd, trainer, athlete and doctor to recognise Sports Related Concussions and take them seriously.