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Coaches and Teachers

Coaches and Teachers

Coaches can play a vital role in diagnosing concussion

Coaches probably have the most important role in the prevention and management of concussion.

Research has shown that young players in particular rely on their coach to provide information on concussion and are influenced most in their behaviour towards concussion by their coach.

All coaches should be able to recognise suspected concussion and are in the best position to remove the player from play.

What is a concussion?

A concussion is an injury to the brain that cannot be seen on routine x-rays or scans. It affects the way a person may think and remember things for a short time, and can cause a variety of symptoms.

What causes a concussion?

Any blow to the head, face or neck, or a blow to the body which causes a sudden jarring of the head may cause a concussion.

Recognise the symptoms and signs of concussion

A player does not need to be knocked out (lose consciousness) to have had a concussion.

Thinking problems the player may experience:

  • Does not know time, date, place, period of game, opposing team, or the score in the game. 
  • General confusion
  • Cannot remember things that happened before and/or after the injury
  • Seems slow to answer questions or follow directions
  • Seems easily distracted
  • Not playing as well as expected
  • A blank stare/glassy eyed, 'the lights are on but nobody's home'

A concussion may have taken place if the player is unable to answer these questions:

  • “What venue are we at today?”
  • “Which half is it now?”
  • “Who scored last in this game?”
  • “What team did you play last week / game?”
  • “Did your team win the last game?”

Things the player may complain of or what you may see

  • Knocked out
  • Headache
  • Dizziness
  • Feel dazed, 'dinged' or stunned
  • Loss of vision, seeing double or blurred, seeing stars or flashing lights
  • Ringing in the ears
  • Sleepiness
  • Stomach ache, stomach pain, nausea, vomiting
  • Poor coordination or balance, staggering around or unsteady on feet
  • Slurred speech
  • Poor concentration
  • Strange or inappropriate emotions (i.e. laughing, crying, getting angry easily)
  • Feeling generally unwell

When can a concussed player return to play or train?

It is very important that the player does not go back to Rugby League or any other sport if they have any concussion symptoms or signs.

Return to sport and activity must follow a step-wise Graduated Return to Play (GRTP).

They should not go back to Rugby League/sport until they have been cleared to do so by a doctor.

How long will it take to get better?

The signs and symptoms of a concussion often last for 7-10 days in adults but may last much longer, especially in younger players and children.

In some cases, players may take many weeks or months to recover. Suffering previous concussions may increase the chance that the person may take longer to recover.

Remember 'The 4 Rs'

  • Recognise the signs and symptoms
  • Remove the player from play
  • Recover fully before returning to sport
  • Return - only after following a Graduated Return to Play

 

What to do if you suspect concussion in a player

You must remove them from play right away. Continuing to play increases their risk of more severe, longer lasting concussion symptoms, as well as increases their risk of other injury:

  • You should not let them return to play that day
  • You should not allow them to be left alone
  • You should make sure they are seen by a health care practitioner as soon as possible that day
  • You should not let them drive

How is a concussion treated?

Concussion symptoms are made worse by exertion, both physical and mental. The most important treatment for a concussion is:

  • The player should not exercise or do any activities that may make them worse, like driving a car, reading, working on the computer or playing video games
  • If mental activities (e.g. reading, concentrating, using the computer) worsen their symptoms, they may have to stay home from work, college or school
  • If they return to activities before they are completely better, they are more likely to get worse, and to have their symptoms last longer

Once they are recovered, and cleared to do so by a healthcare practitioner they can start a step-wise increase in activities – see When can a concussed player return to rugby? . If possible, they should be seen by a doctor with experience in treating concussions.

Can it be anything more serious?

Anyone with a suspected concussion should be seen by a healthcare professional as soon as possible.

They will usually give instructions to the injured person to return to them or go to hospital immediately if they have a worsening of symptoms such as:

  • Drowsiness when normally awake or cannot be awoken
  • A headache that is getting worse
  • Weakness, numbness or decreases in coordination and balance
  • Repeated vomiting or prolonged nausea
  • Slurred speech, difficulty speaking or understanding
  • Increasing confusion, restlessness or agitation
  • Loss of consciousness
  • Convulsions
  • Clear fluid coming out of ears or nose
  • Deafness in one or both ears

Play well

Although it may not be possible to stop all concussions happening, there are some measures players can take that have the potential to reduce the number of concussions we see:

  • Ensure the playing or training area is safe, and the risk of serious head injury occurring is reduced.
  • Check ground conditions - do not play or train if the ground is frozen solid or rock hard due to drought.
  • Ensure all posts and barriers on or close to the pitch are protected with appropriate padding. Ensure correct tackle technique is performed consistently. If the head of the tackler hits the ball carrier there is a significant risk of concussion and/or neck injury. You should therefore ensure that you are able to perform correct tackle technique consistently.
  • Do not engage in dangerous play such as high, tip and spear tackles. Similarly do not tackle players in the air i.e. when jumping to catch the ball from kicks - falling from height increases the risk of concussion and neck injuries.

The information contained in this site is intended for educational purposes only and is not meant to be a substitute for appropriate medical advice or care. If you believe that you or someone under your care has sustained a concussion we strongly recommend that you contact a qualified health care professional for appropriate diagnosis and treatment. The authors have made responsible efforts to include accurate and timely information. However they make no representations or warranties regarding the accuracy of the information contained and specifically disclaim any liability in connection with the content on this site.