Concussion
Hi everyone,
It has been a long while since my last blog, and I hope this article finds all the readers enjoying summer and in good health both mentally and physically. This week I wanted to discuss the topic of concussion within the GAA. My background has been predominantly based in the world of rugby union, both as a player and as a physiotherapist, in varying capacities from amateur to professional. During this time I have encountered many differing forms of concussion, from the ‘bit of a headache’ to loss of short term memory, from a player running the wrong way on a rugby field to a complete loss of consciousness and convulsive seizure. In any form, this can be a trying condition to treat, especially when the players and managers are unaware of the potential devastating effects of returning a player to play before they are cleared and have passed the Graduated Return to Play Protocol (GRTP).
Within the GAA, there are of course, guidelines that determine when a player can return to play following concussion, and I have placed the link above for all those whom want to read it. Under their guidelines, a player over the age of 18 is able to return to the field of play once they have completed the GRTP over the course of 7 days. There is no mandatory stand down period advised by the GAA, even though within the medical profession, the stand down period is 2 weeks minimum, depending on symptoms. Furthermore, this stand down period may be increased if the player has sustained other factors regarding their concussion ie. Duration of symptoms (>10 days), Amnesia, Prolonged loss of Consciousness (>1 minute). I would like to know how the GAA can advocate the use of their guideline when this guideline is not following the best evidence based clinical practice?
Due to the discrepancies between the medical professional approach and the GAA approach, there is now a ‘grey area’ where players are declaring themselves fit to management based on time rather than following the GRTP as directed by the GAA. I have found that players are now trying to hide the fact that they have indeed sustained a concussion, even though they have spent the night in hospital under neurological observations following confusion, amnesia and tiredness after a head clash or similar incident on the field of play. And, if the truth be told, it is only the physiotherapist or other medical professional who actually cares about the welfare of the player. I believe that, if given the opportunity, the management staff of a football team would risk playing a player post concussion if it meant the difference between winning and losing an important (or not so important) match. So, if the player nor the management have the insight to know what a risk they are taking then why would a physio care either?
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