Back in the game

Once a concussion has been suspected there appears the immediate problem of returning to sport safely. This can be done systematically, allowing players and parents high levels of confidence that it is being done with minimal risk. Set protocols of blanket bans of one to four weeks out of the game can be both, restrictive for many that recover quickly, and dangerous for those who have not fully recovered. Processes need to be put in place where sports people are slowly exposed to demands of the sport as they recover.  Simultaneous monitoring of signs and symptoms and cognitive function alert those coordinating the return to sport of possible complications and prevent unnecessary risks being taken.

In order to maximise the confidence of returning a player to sport, a sound knowledge of their pre-injury function is known. Obviously after injury this cannot be done. There are several measures that can be recorded prior to possible injury that assist in the transition of a player back to the game. There are computerised testing programs that can measure several aspects of cognitive function that are highly sensitive to detecting impairment after injury. The great benefit of these tests are that they detect people who are slow to recover and highlight this to allow necessary medical intervention to be implemented. They can highlight players who in other circumstances may return to play too early.  In addition to this testing, a combination of balance measures can also assist in monitoring recovery, as well as be used in developing exercises for the recovery process. For parents and family members, an understanding of the process can assist in safe guarding against any poor management decision that does not comply with what is best practice. Management of concussion is something that will continue to evolve. There are still many questions that remain unanswered. We need not be frightened though, nor is complacency an attitude that is safe. An informed, systematic and objective approach is, like all approaches to recovery, undoubtedly the best approach.