A synopsis of the article by John Leach in the Independent Practitioner magazine is as follows:
Management of head injury in sport is undergoing a revolution. Previously, a knock to the head may have been shrugged off or even glorified, but these days there is increasing recognition that concussion is a form of Traumatic Brain Injury (TBI) that can have significant implications for a player or athlete. Specialist medical assessment for prolonged concussion symptoms or multiple concussion episodes has historically been somewhat disorganised. The Concussion Clinic at The Manchester Institute of Health & Performance brings together a multi-disciplinary team of experts, who provide structured assessment of amateur and professional players with concussion injuries from a wide variety of sports. The service consists of two consultant neurosurgeons and a Sports and Exercise Consultant, Dr John Rogers, who collectively believe the best way to manage and rehabilitate a concussion is through an individualised treatment plan, based on the patient's specific needs and goals.
Concussion in Sport
The incidence of concussion is highest in horse racing and contact sports such as rugby and boxing. Precise figures vary but the incidence of concussion is increasing; the 2014-15 Professional Rugby Injury Surveillance Report for the English Rugby Union Premiership reports that concussion was the most common match injury for the fourth year running, affecting 17% of players.
International guidelines on recognition and management of concussion are now available and both Rugby Football Union and Rugby League have invested in education to raise awareness of concussion. Being 'concussion aware', removal from field of play, side-line head injury assessment (HIA), physical and cognitive rest and 'graded return to play' have all now entered the fabric of rugby life.
Common signs such as headache, dizziness, foggy thinking and visual disturbance usually resolve within 2-3 days. Research on cognitive impairment suggests that deficits usually resolve slightly more slowly than symptoms, over a 3-7 day period. Approximately 85% of athletes can return to full training around one week following injury - but what about the remaining 15%?
Some athletes experience prolonged symptoms following a concussion or suffer multiple concussion episodes, and it is these injuries that The Concussion Clinic seeks to address. There are some facts we know: players who suffer multiple concussions within one season are more likely to suffer further concussions in the next season; prolonged symptoms require a prolonged period of physical and cognitive rest; repeat concussion episodes are likely to result in more severe symptoms and particularly if they occur in quick succession; a small minority of athletes exposed to repeated head injury may experience early cognitive decline in later life. This condition, known as Chronic Traumatic Encephalopathy (CTE), is a specific tau-protein mediated neuro-cognitive disorder that was first recognised in boxers in the 1920's. The discovery of CTE in NFL players was highlighted in Will Smith's film 'Concussion'. Although rare, the severe implications for quality and length of life have made it a hot topic in sports-related concussion.
The Concussion Clinic
The specialists at The Concussion Clinic enter into a partnership with affected athletes, that includes information on current medical research, use of neuropsychological and eye movement data to enable longitudinal assessment, and information to answer some of the most pressing questions, such as 'When is it safe to return to play?' and 'Which athletes suffering concussion are most at risk of late cognitive decline?'.
The overriding mission of the clinicians at The Concussion Clinic is to protect the brains of their patients.
More information on The Concussion Clinic is available on the Manchester Institute of Health & Performance website.