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Abstract
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Mild traumatic brain injuries or concussions are a substantial health concern, particularly in collision and contact sports such as rugby and football. Consequently, there is growing concern regarding the acute and chronic effects of repeated brain trauma, with player welfare protocols central to these discussions.
Athletes, parents and patient advocacy groups have voiced concerns over the management and safeguarding of athletes during their respective playing careers from youth sport to professional levels. However, the science related to the purported long-term effects of repeated brain trauma in athletes is still in its infancy, and has struggled to keep pace with the growing concern and calls to action.
Recently, a spate of rule changes and protocols were introduced across many sporting codes including rugby, soccer, Gaelic Football and Australian Football, in an attempt to improve player safety. Although these changes are well intentioned and supported by biomechanical studies, only time will tell if they will be effective on the field.
In the meantime, fear and concern among athletes and parents may result in decreased sport participation to avoid potential long-term effects. Researchers have reported a mismatch between the restoration of physical symptoms and physiological homeostasis in acute and chronic concussion [1], as well as injury to white matter tract fibres [2] which represents a period of vulnerability to athletes. The work of the current authors has highlighted the adverse effects, including a doubling of recovery time and evidence for a dose response associated with continued sport participation immediately following a concussion [3, 4]. Specifically, athletes who played for just 15 min beyond the point of having symptoms took on average 25–28 days longer to recover than players who were removed from play immediately [4]. Together, these findings highlight the risks of returning to play prematurely as well as the importance of early recognition of concussion and immediate removal from play. Specifically, players with a suspected concussion should not continue to play, even for a few minutes, as they risk more serious injury and prolonged recovery. Recently, the Rugby Football League and the Australian Football League introduced a revised 11-day and 12-day return-to-play (RTP) protocol, respectively, in response to concerns about returning to play too soon. Despite these efforts, players continue to place themselves at risk by under-reporting, concealing or ignoring symptoms. However, the news on concussion is not all bad …
Language: en |