Dr Paul Bloomfield has a strong interest and many years of experience with sport related concussion. During  30 + years of professional sport involvement, he has seen and managed many concussions; he has also seen the significant evolution in the management of concussions over this period. Improving the identification and management of concussion at all levels of sport is a passion of his. Dr Bloomfield also strongly believes that all those involved in sport and in the identification and management of concussion need to be well informed and educated on the topic. In this regard, he has assisted with Sports Medicine Australia (SMA) and Australasian College of Sport and Exercise Physicians (ACSEP) education events.

 

Concussion is a brain injury. It is classed as a type of mild traumatic brain injury (mild TBI) without obvious structural injury to the brain such as bleeding or bruising. Concussion is also an evolving injury with symptoms and signs that can come and go and improve or deteriorate over time. Many of these symptoms and signs are not specific to concussion and more significant injuries such as brain bleeds must initially be considered.

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It is currently thought that concussion resolves spontaneously over time. However, how long the brain takes to fully recover is not completely known. What is known is that with appropriate supervised management, the effects of concussion can be minimised, and the acute condition usually resolves in most cases in a predictable time frame of less than 2 weeks in adults and less than 4 weeks for children and adolescents (18 years old and younger).

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Individualised management of each patient and each concussion is important as no two concussions are exactly the same. Initial rest (physical and mental) for 24 to 48 hours following a suspected concussion is however an important component of all concussion management. Adherence to this can help reduce the recovery period as exacerbation of concussion symptoms early on may lead to a prolonged recovery time-frame.

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Repeated concussions or those occurring more easily or frequently over time should also be managed more conservatively; there is ongoing debate and research within the medical community (and played out in the media) about the exact risks and causes of potential long-term brain injuries such as CTE and other degenerative brain conditions and these conditions do need to be appropriately considered by all sports at all levels of participation.

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Therefore education of all patients about the risks of their individual circumstances is something that should always be discussed in the individual management of their concussion.