Concussion and sport

In order to properly assess a concussion, several elements must be met:

• Medical examination:
  • Anamnesis
  • Neurological examination
  • Orthopedic examination of the cervical spine
• Clinical status of the player
• Assessment of the need for emergency imaging, including brain and spine imaging

The SCAT5 is a standardized concussion assessment tool. It is designed to be used by physicians and/or health care professionals. 

Be careful, the SCAT 5 is an evaluation tool but does not establish a diagnosis. It is possible to have a normal SCAT 5 and still have a concussion.

SCAT5 takes at least 10 minutes to complete properly.

SCAT 5 is performed at several points:

• Alarm signals
• Visible signs
• Evaluation of the memory
• Glasgow scale
• Evaluation of the cervical spine

• Patient Information
• Assessment of symptoms

• Orientation 
• Immediate memory
• Concentration

You can find the details of the SCAT 5 by downloading the pdf below:

These are the factors that increase the likelihood of having a concussion

• Loss of consciousness: Prolonged loss of consciousness (> 1 min) should be considered an aggravating factor
• Amnesia: retrograde amnesia may be a sign of severe damage
• Convulsions

• Children < 13 years old have different symptoms than adults 
• Children should not return to training or games until symptoms have completely resolved
• It is recommended to avoid the use of screens and especially video games

You will find the details of the Child SCAT 5 in pdf below:

Tests may be performed depending on the clinical examination performed. These may include:

• Brain scan or MRI
• Radiography of the cervical spine

These two markers are used in laboratory examinations:

• Apolipoprotein (Apo) E4 
• APOE gene promoter

After a concussion, many players complain of headaches. These pains are often related to dysfunctions in the cervical spine. Working on the cervical spine through mobilization and treatment of the surrounding soft tissues is mostly beneficial to patients.

Physiotherapy is very complementary to osteopathy and participates in the management of neck pain.

In the case of patients suffering from vestibular syndrome (vertigo, balance disorders, visual disorders), vestibular rehabilitation is very interesting. This is done by a physiotherapist specialized in vestibular rehabilitation.

Patients who are athletic find it very difficult to accept rest, low to moderate intensity weight training can be offered. Exercise should be stopped as soon as symptoms appear.
For children, no exercise should be considered until symptoms are fully resolved.

Exercises can be done to prevent this, such as neck strengthening exercises.

Medication may be prescribed by the physician to relieve the patient's symptoms.

Attention, when resuming sports (training or match), the patient must not take any medication that could mask his symptoms !

Most athletes recover within 7 to 10 days. If symptoms persist, further tests must be performed and it is essential to consult a specialist.

• 2nd concussion: the risk of having another concussion is greater once you have already had one. And the risk that the 2nd one will be more serious is also increased.
• Persistence of symptoms: in this case, it is essential to refer the player to a specialist in order to carry out more extensive examinations (neuro assessment, brain imaging, spinal imaging, etc.)
• Chronic traumatic encephalopathy (CTE): some studies show a link between repeated concussions and neurodegenerative diseases

Marie Messager
Osteopath for sports
78 - Versailles