As this is National Winter Sport Traumatic Brain Injury awareness month, I thought it would be useful to write about concussion, particularly in relation to winter sport. I have mostly experienced concussion in the context of sport – especially rugby and hockey — but it can occur at other times and potentially in all sports.
At the last Winter Olympics in PyeongChang, concussion was seen in a number of athletes, especially those in skiing or snow-boarding events1,2. A recent article from Canada3 described the incidence of head injuries as between 0.77−3.8÷100,000 ski visits; interestingly most were in beginner to intermediate level skiers. In children, the most common reason for admission to hospital was head injury. In snowboarders, the rate of head injury was 6.5÷100,000 visits. The increase in speed combined with a lack of control was the biggest risk for injury.
Concussion is a very topical and emotive topic in sports, but there is a lot of misinformation and misconceptions out there that I wanted to address.
Concussion is a (minor) traumatic brain injury.
Helmets protect you from concussion.
You do not have to be knocked out to have a concussion.
After a concussion you should have physical and cognitive rest and avoid alcohol.
The good news though, is that most people will recover happily from a concussion. Early diagnosis is key and the best person to see is a Consultant in Sport, Exercise & Musculoskeletal Medicine.
They assess you by taking a thorough history of your lifestyle, habits and activity levels as well as performing a clinical examination after which they collate all the findings on an internationally recognised document4 used to record concussion tests in athletes. This comprehensive test examines all areas of brain function – from memory, recall, cognition, balance and fine motor skills.
Most people should rest from all sporting activity after experiencing concussion but can then be guided on a graduated return to their activity or sport with a concussion specialist. If necessary, other healthcare professionals can be brought in to help aid the recovery, such as Physiotherapists, Strength and Conditioning Coaches or Neurologists.
Although you should recognise a concussion and get seen as soon as possible, there is no reason why in the right hands, you can’t make a full recovery.
Dr Dan Brooke is a Sport, Exercise and Musculoskeletal Medicine Consultant who specialises in concussion management. He has looked after professional athletes with concussion for many years and helps guide them to a safe return to sport. He supports professional rugby players including international players and those in the England U20 squad, professional hockey players and Olympic athletes. He is the chief medical officer for British Skeleton and has travelled with Team GB as the chief medical officer to the 2017 European Youth Winter Olympics.