Lessons to be learned from rugby’s approach
Failure to properly manage the risk of concussion at grass roots level could lead to a drop in sports participation, Scotland's Chief Medical Officer has warned.
Writing in the British Journal of Sports Medicine with leading experts in sports medicine and science, Dr Catherine Calderwood writes that, if properly managed, the relatively low risk of concussion should not stop people from playing sport, or allowing their children to take part. But she warns that a failure to promote good quality advice and information throughout amateur sport could lead to lower participation.
The article is co-written with Dr Willie Stewart of Glasgow's Queen Elizabeth University Hospital, an advisor to World Rugby and leading expert on brain injuries in sport, and Dr Andrew Murray a Sports and Exercise Medicine consultant with the University of Edinburgh. They call for more collaboration between sports, to ensure that good concussion management is always present at grass-roots level.
For many sports, concussion management policy appears directed purely at elite level, and overlooks amateur level. A notable exception in global sports is world rugby, which has specific concussion management protocols for each level of the game from elite to grass roots.
Dr Calderwood and colleagues comment that while there are understandable concerns over sports concussion, there remain considerable health benefits in partipation in sport. The solution to managing sports concussion is not to cease sport, but to better inform and manage the injury.
As an example of how this might be achieved, the authors highlight Scotland's recently launched Scottish Concussion Guidance, a unique approach to the issue where common guidelines were created for all grassroots sports and activities for the management of concussion, from Aerobics to Zumba and everything in between, including rugby and football.
Dr Calderwood said
"As doctors, our first concern is always the health and wellbeing of the people we look after. Participation in rugby, and in sport offers considerable benefits to physical and mental health, and we are keen to promote sport and an active lifestyle in Scotland. The last thing I want is for parents to stop their children from taking up sport because of the fear of concussion. We must all work together to stop this from happening.
"The launch of the Scottish Concussion Guidelines highlights that we are working hard to educate players, and all those involved in sport, about the dangers of concussion, and we will continue to do so. The clear message is 'if in doubt, sit them out.'"
Dr Willie Stewart from the Queen Elizabeth University Hospital in Glasgow, an advisor to World Rugby and leading expert on brain injuries in sport added:
"Understandably there are concerns around immediate and long term risks of sports concussion. However, these risks are relatively small and there is also no doubt whatsoever about the many benefits of partipation in sport. Through promoting better recognition and management of concussion we would hope to have a win-win situation; all the benefits of sport, with even lower risks from concussion."
Dr Andrew Murray, a Sports and Exercise Medicine consultant with the University of Edinburgh added
"The fact that concussion has been recently discussed in the Scottish Parliament shows the importance and high profile of this issue. Regular physical activity may be the best present we can give our children, on average they will live seven years longer, be happier, and get better marks at school, so we must encourage this. But you only get one brain. We are lucky in Scotland that major action is already being taken to improve knowledge on concussion, and plans for further action will help. World Rugby have succeeded in making the game safer by changing laws and sanctions in relation to tip tackles, and the scrum, helping decrease neck injuries, and it is welcome they are looking at further changes to make the game enjoyed by so many even safer."
The full editorial written for the British Journal of Sports Medicine authored by Dr Calderwood, Dr Murray and Dr Stewart can be seem here: http://bjsm.bmj.com/content/early/2015/09/24/bjsports-2015-095393.full.pdf?keytype=ref&ijkey=TvhvPMuSw6G3mIb