THE CONSEQUENCES OF CONCUSSION: Second Impact Syndrome

In the world of contact sports, players tend to report a team member had his ‘bell rung’ or ‘got dinged’ when referring to concussion. Many concussions occurs without the individual losing consciousness but researchers have determined that even the seemingly minor ‘bell ringing’ in the course of play, can cause lasting physical and mental injury.

A serious series of brain injury events have been identified which researcher’s term ‘second impact syndrome’ or SIS. SIS occurs when an athlete suffers a mild head injury, returns to the field of play too soon and sustains a second blow to the head without the brain having recovered from the initial trauma. If the second injury occurs during ongoing symptoms from the first impact, the result can be a catastrophic, rapid rise in pressure with the brain. The result is paralysis, mental disability, epilepsy and even death.

SIS can affect any age group and any athletic level of competition. Those at risk are players who fail to report their initial concussion, do not ensure adequate recovery time and are not fully aware of the risks.

E.g, a teenage football player was pulled from the field of play after sustaining a minor concussion which left him momentarily unconscious. He suffered headaches throughout the week, never received follow up from his Doctor and returned to play to following week. During the game, the player made a seemingly harmless tackle and did not loss consciousness. However 10 minutes later, he collapsed into a fit before losing consciousness, the result of uncontrolled brain swelling.

Many players fail to realise that most concussions occur without a loss of consciousness. As a result, players may not realise that a persistent headache indicates that the athlete’s brain has not yet resolved from the first blow.

To minimise further tragedies, players should follow this basic guide after any sort of concussion and always seek a Doctors review despite severity.

Severity

Mild (no loss of consciousness, confusion and memory loss limited to less than 15 minutes)

First Concussion: May return to play if asymptomatic by 15 minutes

Second Concussion: May return to play after 2 weeks; if asymptomatic for the previous week

Third Concussion: Terminate season, may return to play next year if asymptomatic

Moderate (loss of consciousness for less than 5 minutes, confusion and memory loss last more than 30 minutes)

First Concussion: May return to play after 1 week of being asymptomatic

Second Concussion: Wait 4 weeks before returning to play if asymptomatic for 1 week prior. Consider terminating season

Third Concussion: Terminate season, may return to play next year if asymptomatic

Severe (loss of consciousness longer than 5 minutes, confusion and memory loss longer than 24 hours) May return to play after 1 week of being asymptomatic

First Concussion: Wait 4 weeks before returning to play if asymptomatic for 1 week prior. Consider terminating season

Second Concussion: Terminate season, may return to play next year if asymptomatic

Additional information :

Sharon Stage is Marketing Manager for Ergoworks, specialists in physiotherapy and ergonomic assessment. Contact Ergowork’s Sydney City Physiotherapist clinic for pain and injury diagnosis and physio treatment.