• Concussion can be defined as a brain injury that arises from trauma to the head, neck or through an impulsive force to the head from elsewhere in the body.
• Concussion results in a disturbance of brain function and should be treated as a serious and significant injury with potentially fatal consequences.
•  ANY PLAYER WITH A CONCUSSION OR A SUSPECTED CONCUSSION SHOULD BE REMOVED FROM THE FIELD OF PLAY IMMEDIATELY AND SAFELY AND SHOULD NOT RETURN TO PLAY, TRAINING OR OTHER PHYSICAL ACTIVITY ON THE SAME DAY
• A player does not need to lose consciousness to be concussed
• The onset of symptoms can occur over minutes but can be delayed for hours
• The common symptoms of concussion include headache, dizziness, memory loss, disturbance of balance
• All coaches, parents, referees should familiarise themselves with the pocket concussion recognition tool to assist in identifying concussion.
• All doctors, physiotherapists and paramedics should familiarise themselves with the pocket concussion recognition tool and with SCAT 5 and Child- Scat 5 to assist in identifying concussions
• Most concussions (80-90%) resolve over a 7-10 day period but may persist for considerably longer
• It is very important to note that the symptoms of concussion in children and adolescents can be prolonged and can in certain circumstances last for weeks or months.
• Concussed players should not be left alone
• Concussed players should not drive, should not take alcohol and should be escorted home
• Players who suffer a concussion should consult with their medical practitioner before returning to play.
• The successful management of concussion is best achieved through physical and mental rest.
• Medical clearance is necessary in all players who suffer a concussion before they can return to play.
• There should be a graded return to training activity.
• Children and adolescents should not return to any activity until they have made a successful return to school/college.
• Return to play guidelines follows a stepwise approach outlined below.

Stages:

1. No activity – symptom limited physical and cognitive rest. Recovery is the objective.
2. Light aerobic activity – walking, swimming, stationary bike. Increase in heart rate is the objective.
3. Sport specific exercise – running drills. The objective is to add movements.
4. Non-contact drills – passing drills. The objective is to exercise, add coordination and cognitive load.
5. Full contact practice – This should be medically cleared. The objective is to restore confidence and assess functional skills by coaching staff.
6. Return to play.

Dr Alan Byrne

Medical Director
Football Association of Ireland