Safeguarding our young athletes: New Concussion Guidelines for Grassroots (Non-Elite) Sports
Concussion in children’s sports is a serious issue. The first UK-wide Concussion Guidelines for Grassroots Sports seeks to help players, coaches, parents, schools, National Governing Bodies and sports administrators identify, manage and address the issue. The guidance focuses on what should be done if any person is suspected of having a concussion while playing sport, with the emphasis on “if in doubt, sit them out” meaning that anyone with a suspected concussion should be removed from play immediately.
Understanding concussions: what you need to know
Concussions are a type of brain injury that can occur when the head is hit forcefully, such as by a basketball or football, or when the body receives a powerful impact that causes the head to move abruptly, such as in a rugby tackle. They can lead to symptoms like headaches, dizziness, mood disturbances, and difficulties with thinking and sleeping. Contrary to widespread belief, loss of consciousness is not a prerequisite for diagnosing a concussion. However, it is important to note that anyone who has been knocked out has experienced a concussion.
Why protecting children is vital
Children and young people are particularly vulnerable to concussions, and their recovery may take longer compared to adults. Evidence suggests that children, and in particular teenagers, are more likely to suffer a concussion than adults, and younger children are at increased risk of concussion because their heads are disproportionately larger compared to the rest of their bodies. Children’s and teenagers’ brains are still developing, and important neural connections are still being made. If this process is disrupted, it can have long term problems. Additionally, children and young people are more susceptible to dangerous complications, especially if they have a second impact before fully recovering from the first.
The key elements of the guidance
The concussion guidance focuses on swift action when dealing with suspected concussions:
- Immediate removal: If a child or young person is suspected of having a concussion during a sport, parents and coaches must ensure their prompt removal from play, regardless of whether their symptoms have resolved.
- Healthcare assessment: It is vital to have the child or young person assessed by a healthcare professional within 24 hours of the injury. If any of the ‘red flags’ mentioned in the guidance are present, the player should receive an urgent medical assessment. Red flags include loss of consciousness, drowsiness, memory loss, confusion, irritability, unusual changes in behaviour, and difficulties with speaking, reading, or writing.
- Rest and care: For the initial one to two days following the suspected concussion, it is crucial to allow the child or young person to rest. During this time, they should not be left alone for the first 24 hours. Adequate rest is an essential component of the recovery process.
Gradual return to school and sport
Once the child or young person has rested and undergone a medical assessment, the guidance provides a graduated return plan for their safe resumption of normal activities and sports. The timing of their return to sport will depend on the severity of the injury.
Children can return to school even if they still experience mild symptoms, as long as the symptoms are not severe or worsening. They can gradually participate in light exercise that poses no risk of head impact.
However, if returning to school exacerbates their symptoms, it is recommended they rest until the following day.
The guidance emphasises that children and young people should not return to sports competition within the first 21 days after a concussion to avoid the risk of a second impact. Only when they have been symptom free for 14 days, including any training, can they safely resume playing the sport.
Limitations and future considerations
While the guidance provides essential advice to parents, coaches and players, outlining the crucial steps to follow when dealing with concussions, it is important to acknowledge its limitations. Primarily it focusses on post-concussion management rather than prevention. Avoiding concussions altogether is a complex issue that requires broader strategies beyond the scope of the guidance. However, by ensuring that children and young people are removed from play after a suspected concussion and do not return to playing a sport too soon, parents, coaches and players can reduce the risk of further injury.
Maya Englesberg is a solicitor in the Child Brain Injury Team.
