Understanding football concussion

01st Dec 2018

Long-term effects of football concussion

The long-term effects of football concussion on both junior and senior players remains a concerning issue for coaches, clubs and parents.

It has received widespread coverage in the US in recent years due to the high incidence of concussion that players experience in the NFL, and now football concussion is becoming of increasing concern to NRL clubs in Australia.

 

The signs of concussion

A conference in Berlin earlier this year explored head injury and trauma management, and revealed some interesting insights. For example, research has demonstrated that people who have suffered from concussion may experience recurrent headaches.

Headaches experienced following a concussion are a sign that the concussion may still be present, and some players who have had a concussion may get recurrent headaches after exercise that may also be associated with an increase in heart rate. This is another sign that their recovery from the concussion may be slower.

 

Testing for concussion

Concussion is often diagnosed through cogstate testing. It’s a battery of testing that allows the doctor to test memory—what’s called executive function—along with spacial recognition and reflexes.

In the case of football injuries, a cogstate test is usually conducted by a doctor on the field immediately after the impact, and then the player is tested again a couple of hours later. This allows the doctor to assess the effect of the concussion as well as the concussion itself.

 

Concussion in professional football

NRL clubs, for example, have sports doctors on staff who can administer cogstate tests on the field. The NRL is also set to trial independent doctors who are not affiliated with a club. They will attend games and be able to offer an unbiased cogstate assessment of affected players.

I think there’s been a perception among club doctors that they don’t really want independent doctors telling them what to do with their players. But I think they have to respect the fact that these doctors are highly trained specialists and better qualified to diagnose concussion.

 

Concussion in junior football

The problem in junior football is that you’re not always going to have qualified doctors at the grounds during games who can diagnose and manage concussion.

I think the first thing to do is to offer some concussion education programs through schools. The second thing is that there should be some sort of formalised trainer education in concussion management for coaches and parents involved in junior football.

 

Protecting our players

I think that it will become obvious at some point in the future that head protection is probably going to be needed.

However, I don’t think that will necessarily be an NFL-style helmet. In the USA, they use those helmets like a rhino uses its horn, so I’m not sure that’s a robust solution that Australian rugby league should adopt. Instead, I think we’ll see the use of shoulder and neck extension pads and similar protections in the future.

 

About Dr Richard Parkinson

Dr Richard Parkinson is a Fellowship trained neurointerventional neurosurgeon and minimally invasive spinal surgeon based in Sydney. He has been performing minimally invasive and complex spinal surgery for 18+ years and has built his reputation on his conservative approach to surgery. He operates at Sydney’s leading private hospitals and has performed surgery on a very significant volume of patients requiring both straight-forward and complex spine surgery. Read his full biography here.