Concussion & sport


Many definitions for concussion.

Only pathognomic feature is post traumatic altered short term recall

NB : Not limited to direct head impact

Symptoms usually start at time of impact but may be delayed for 24-48 hours.

Difficult to advise when to return to sport (minimise chances of catastrophic "second impact syndrome")

Symptoms may last up to 6 months

Standardised Assessment of Concussion (SAC) has been proposed as an objective, quantifiable assessment



Second Impact Syndrome

Repeated concussions

Concussive fitting

Graduated return to Play (GRTP) - IRFU

Players can only move on to the next stage once they have been symptom free during the full period of each stage.

Rehab stage Ecercise Objective of stage Adult U6 - U20s
Rest None Rest 14 days 14 Days
1. No activity Complete physical and mental rest without symptoms Recovery 1 day
2. Light areobic exercise

Walking swimming etc. Intensity <70% max HR (Max predicted HR = 220-Age)

↑ heart rate 1 day 2 days
3. Rugby specific exercise Running drills. No impact. Add movement 1 day 2 days
4. Non-contact training drills Progression to more complex drills e.g. passing. May start resistance training. Exercise, coordinationa and mental load 1 day 2 days
5. Following medical clearance, full contact practice May participate in normal training activities Restore confidence and assess functional skills by coaching staff 2 days 2 days
6. After 24hrs, return to play Player rehabilitated Recovered 21 days 23 days

Sports related concussion in children / adolescents

Content by Dr Íomhar O' Sullivan 21/09/2009. Last review Dr. ÍOS 25/02/14.