Concussion: We Need To Educate

The conference perfectly demonstrated how concussion education is essential to ensuring the continued welfare of those engaging in sports, particularly at grassroots level.  

All governing bodies of contact sports have a critical role in ensuring those playing, officiating or supporting have a true understanding of the seriousness of concussion and the consequences for those participants who are concussed and whose recovery is not properly managed.

A key step, for all sports, has to be the education of those involved with the sport to recognise the signs and symptoms of concussion and the importance of removing those affected from the field of play.

Underlining the commitment for continued player welfare the IRFU recently redeveloped and launched a new concussion strategy which has five goals, including:

1. Leadership, to change attitudes and the culture within sport in relation to head injuries.
    
2. Education, of players, parents, coaches, referees, officials and medical personnel.
    
3. Partnerships, with all those involved with rugby, including health professionals such as GPs and Emergency department staff, schools and clubs and the International Rugby Board.
    
4. Communication, both internally to officials and externally to players, parents and the media on the importance of concussion education.
    
5. Research, to improve the management of suspected and confirmed concussion in this evolving area of medicine.

A key element of the strategy is that from January, any rugby player under the age of 20 who suffers a concussion will be automatically removed from play for a minimum or 23 days, which must include three weekends, while an adult amateur player over 20 will be removed for a minimum of 21 days, which must include two weekends. 

These minimum rest periods go beyond the latest recommendations of the International Rugby Board.

Our SAFE rugby programme, which is the first national rugby specific first aid programme, includes a bespoke module that focuses on suspected concussion and its management. 

To-date over 1,500 medical and non-medical personnel from clubs and schools from across the length and breadth of the country have attended these courses and they will continue.

To widen education among coaches it is now mandatory to complete a comprehensive IRB first aid/concussion module before a coach can be accredited at even mini-rugby level, while we have also introduced ‘hands on’ concussion modules as mandatory for those seeking coaching accreditation for children from 13 years of age upwards, to ensure they receive practical training, in addition to the required IRB education modules.

To assist with the education of players and parents in particular, we have produced our Guide to Concussion in Rugby Union to help people spot the signs and symptoms of concussion, educate them on what action to take if they suspect a player has a concussion and to ensure they understand the importance of return to play protocols.

Over 30,000 copies of this guide will be sent to clubs and schools, to provide a very clear concussion message – STOP- INFORM- REST – RETURN.

1. Stop – A player with a suspected concussion must be removed immediately and must not return to the field.
    
2. Inform – A player with suspected concussion should report it to a team medic, coach, teammate, friend or family member and be properly assessed and managed. They must not be left alone or drive a vehicle.
    
3. Rest – A player with a concussion must undertake a mandatory rest period as per IRFU guidelines outlined in the guide.
    
4. Return – A player with a concussion must follow the IRFU Graduated Return to Play protocols and should be medically cleared prior to returning to full contact.

Our guide calls on players to report symptoms and outlines the need for comprehensive medical assessment of such injuries and warns that returning to play before the concussion is completely resolved may have extremely serious long-term health consequences.

The guide contains a pocket Concussion Recognition Tool that lists concussion signs and symptoms for players, coaches, officials, parents, team managers and medical staff.

This allows them to Recognise and Remove any player displaying concussion symptoms until the player has completed the appropriate IRFU Graduated Return To Play protocols.

Rugby, like all contact sports, can result in injury. Potentially serious injury such as concussion must be taken seriously from the outset. 

The IRFU hopes to dispel the myth of a ‘knock to the head’ or a ‘minor concussion’.

Our guide is targeted at everyone playing, officiating or connected with a person who is playing rugby, and follows our recent concussion poster campaign aimed at players of all ages, to reinforce the core message of STOP, INFORM, REST and RETURN. 

The guide is downloadable from www.irishrugby.ie/medical.

Dr Rod McLoughlin