It’s a weekend tradition for countless families Australia-wide. Regardless of the sport; soccer, hockey, rugby, AFL or netball, the beaming faces, dirty knees and grazed elbows are the stuff of memories that will be retold, and increasingly exaggerated, as the years go by. But this innocence has been shattered with recent reports outlining the long term damage that can be caused by one of the most common sports injuries, concussion.
The emergency department of Sydney Children’s Hospital, Randwick treated 53 children for concussion during 2013. Paediatric Emergency Staff Specialist Dr Rebecca Nogajski describes it as an injury to the brain following a mild head injury. “Early on symptoms may include altered levels of consciousness, headache, confusion, dizziness and memory loss of events surrounding the injury,” she says.
While the vast majority of concussions will get better on their own over several days, Dr Nogajski recommends rest for the brain and body to recover. “Physical exercise and activities that require concentration such as video games, text messaging and schoolwork may cause fatigue and make symptoms worse and delay recovery. Children and adolescents with concussion need more time to recover than adults,” she urges.
In the first study of its kind in Australia, the long term effects of concussion were recently examined. The brain activity of 40 retired Australian rules footballers who had suffered more than two serious concussions were investigated for abnormalities. Conducted by researcher and neuroscientist Dr Alan Pearce from Deakin’s School of Psychology, the results discovered a reduction in fine motor control, slower reaction times and abnormal changes in brain function when compared to people the same age who had never played contact sport.
For our young sports stars, concussion management is particularly important, as it’s an injury that’s more prevalent in junior sports than in any other group of athletes according to Sports Medicine Australia CEO Nello Marino. “It’s generally accepted that fewer than 20 per cent of concussed children are diagnosed with concussion, with fewer still seeking medical attention,” he states.
Not only is concussion more common in junior sport, it can be more dangerous. “Children have significant physical, physiological and development differences that place them at long term risk if sports concussion is not managed appropriately. Concussion may take longer to recover in younger children and therefore a more conservative approach to management is required in this group,” Marino says.
The NRL and AFL have recently introduced comprehensive concussion management plans that assist in the diagnosis and treatment of concussion, as continuing to play while symptomatic can increase the risk of further injury. The never say die heroics of our professional footballers who play on regardless of injury is an out-dated attitude that the medical fraternity agree needs to be reversed as it’s a philosophy that has also filtered down to our juniors. “From the top level down we need education as well as a cultural shift of not "shaking it off" or keeping quiet with junior players. Following a hard tackle, bump, or a heavy landing that results in a junior player looking confused or dazed, they need to be taken off and assessed immediately and if there is doubt, then they can't be let back on. Running back on the field concussed should not be seen as doing their team-mates a favour,” Dr Pearce says.
Toni Faint’s son Jake, 13, has always played contact sport. Rugby has always been his sport of choice, but he has recently also taken up boxing. Toni says she feels sick watching Jake box, but continues to do so to support her son. “I don’t think concussions were ever my main concern though. In some ways I think he’s actually safer boxing than playing rugby as he wears head protection and is trained to defend himself,” she says.
Like many mums, the recent media coverage has shed light on a topic that most of us don’t fully understand the long term risks of. “I know Jake doesn’t worry about it. Possibly wearing head gear should be made compulsory,” she says.
But it’s a fine line between protection and interfering. “I would not have picked either sport for my son, but he has a right to play sport with his friends or achieve his sporting dreams.”
Dr Pearce agrees saying that excluding children from contact sports may actually be doing them a disservice. “The current rate of childhood obesity and inactivity is a very real concern. If children are not allowed to play sports with contact, then we could be creating a whole other issue. Concussions can happen as accidents, it’s just the management of concussions that needs to be addressed,” he says.
“Parents should still encourage their kids to play the sports they love. They just need to ensure they play it safely, and that if they do get any head trauma they need to be assessed by a medical practitioner before returning to play.”