As we welcome the football season having started, and the rugby season just around the corner, the topic of concussion and its management is once again in the spotlight.

Whilst focus is often on the media high profile sports it should be remembered that any contact sport activity can result in a concussive head injury. The burden within cycling and horse riding is also significant.

As Chief Medical Officer for British Cycling – one of my big areas of focus has been us putting in place really robust processes for concussion diagnosis and management. Building on my extensive previous experience in rugby – me and my doctor colleagues at BC have published research in this area and we are leading on policy implementation across the sport at an international level.

Whilst all of the above is good news, there remains a lot of work to be done. The burden of concussion in recreational and adolescent sport is still unknown and knowledge of concussion management by both GPs and Hospital Doctors remains way off where it needs to be.

That is why, if you experience a concussion (or think you may have done), it’s essential you get assessed and managed by a doctor with experience in the field. This was our motivation for launching the Liverpool Concussion Clinic at R4P.

As well as leadership and input from me – the clinic gives access to other health professionals with expertise in this field including physiotherapy and neuropsychology.

So, what do we know about concussion, and what are we still learning?

1.      Its an injury to the brain. Like any other injury therefore you need an accurate diagnosis, appropriate investigations, and a robust management plan.

2.      Unlike other injuries, however, it can present with a huge variety of symptoms. Concussion can affect your concentration, emotions, memory, balance and vision. It’s not just about headaches. X-rays and scans often don’t reveal the injury’s extent and frequently don’t help the management.

3.      Just like other injuries – it’s really important that rehabilitation progression is based on functional markers and not on arbitrary time points. This is not just about return to your sport but potentially about return to your work and studies as well.

4.      If you return to your sport whilst still suffering the effects of a concussion your risk of a joint, tendon or muscle injury is increased. Also, of course, your technical ability and performance will be compromised.

5.      Whilst research is ongoing around saliva or blood test markers to help the diagnosis and management – we’re still some way off having these commercially available.

All the above help stress the importance of getting concussion management right as soon as it is potentially diagnosed. So, whether you’re a professional sports team looking for help with difficult cases or an individual with concern – please get in touch.

Picture of Dr Nigel Jones

Dr Nigel Jones



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