Management of concussion for AFL Players

Sport related concussion is a topical injury particularly at AFL and NRL elite level, but an injury that can happen at any level of these sports.  The Ballarat Football and Netball league utilise “THE MANAGEMENT OF SPORT-RELATED CONCUSSION IN AUSTRALIAN FOOTBALL – With Specific Provisions for Children and Adolescents (Aged 5-17 Years): for trainers, first-aid providers, coaches, club officials, players, and parents” as their concussion management tool, released by the AFL in April 2021.

Many sports at the elite level are moving to the use of specialist doctors in Sports Medicine rather than general practitioners as team doctors.  Ballarat Sports Medicine physicians, Dr Greg Harris, Specialist in Sport & Exercise Medicine and Dr Bryn Savill, Registrar in Sport & Exercise Medicine, are both team doctors at elite level sport and conduct training at local AFL level for team trainers.

If you or your children have suffered a concussion injury or suspected concussion injury, both Greg and Bryn can assess your injury and provide specialist guidance for recovery and return to exercise, training and competitive sport.

Head impacts can be associated with serious and potentially fatal brain injuries. In the early stages of injury, it is often not clear whether you are dealing with a concussion or if there is a more severe underlying structural head injury. For this reason, the most important steps in initial management include:

• Recognising a suspected concussion;
• Removing the player from the match or training; and
• Referring the player to a medical doctor for assessment.

Any player who has suffered a concussion or is suspected of having a concussion (i.e. in cases where there is no medical doctor present to assess the player or the diagnosis of concussion cannot be ruled out at the time of injury) must be medically assessed as soon as possible after the injury and must NOT be allowed to return to play in the same match/training session. There should be an appropriately accredited first aid provider at every match and the basic rules of first aid should be used when dealing with any player who is unconscious or injured.

Important steps for return to play following concussion include:

• A brief period of complete physical and cognitive rest (24-48 hours);
• A period of symptom-limited activity to allow full recovery; and
• A graded loading program (with monitoring).
• Clearance by a medical doctor

Players should not enter the graded loading program until they have recovered from their concussion. Recovery means that all concussion-related symptoms and signs have fully resolved (for at least 24 hours) at rest and with activities of daily living, and they have successfully returned to work or school, without restrictions.

Any concussed player must not return to competitive contact sport (including full contact training sessions) before having moved through the graded recovery process and have obtained medical clearance.

The earliest that a player may return to play (once they have successfully completed a graded loading program and they have obtained medical clearance) is on the 12th day after the day on which the concussion was suffered.