Concussion occurs when there is an impact to the brain. It is common among rugby players and, contrary to popular belief, does not systematically lead to loss of consciousness.
Practicing a sport like rugby exposes players to certain risks, such as concussion. It can cause changes in the state of consciousness, visual disturbances or some balance problems. “In 50% of cases, the concussed player remains on the playing area. He wants to continue playing because he is motivated. However, this motivation is also linked to neurological disturbances caused to the frontal lobewhich is used to implement strategies and become aware of dangers. The player cannot consider the negative consequences of the concussion. He doesn’t have the reflex to get off the field.” explains Dr Jean-François Chermann, neurologist, specialist in France in concussions among athletes.
What is a concussion?
“Concussion is a alteration of neurological functions occurring following an impact transmitted directly Or indirectly to the brain, answers Dr Jean-François Chermann. It is characterized by clinical signs associated with this impact and movement of the brain inside the skull. “The brain is surrounded by meninges which insufficiently protect it during blow/countercoup movements following a direct or indirect impact“recalls the neurologist.
“In the world of sport, knockout represents 15% of concussions”
“In the sports world, knockout represents 15% of concussions. In 80% of cases, the patient does not lose consciousness.” Concussion therefore does not systematically lead to loss of consciousness.
What are the symptoms of a concussion?
Symptoms of concussion are immediate (and most often transient). “In 80% of cases, the patient does not lose consciousness.” A series of symptoms can appear:
- Headaches, cranial pressure;
- Difficulty concentrating;
- Nausea, vomiting;
- Sensitivity to light;
- Dizziness;
- Sleep problems, fatigue;
- Mood alteration: irritability, nervousness, emotionality;
- Feeling like you’re in a fog;
- Confusion, drowsiness, difficulty thinking;
- Amnesia: difficulty remembering events that took place before or after the head impact;
- Insomnia.
Symptoms of a concussion can occur several hours after impact. “More rarely, they are delayed by a few days and in 5% of cases, the symptoms are irreversible“confesses the neurologist. “The concussion is sometimes very atypical, like the automaton syndromewhich translates into a player amnesia on the field. He does not remember what he does there, even if the memory of the gestures is not affected. He doesn’t know where he is or who he is playing against. He doesn’t remember the score, but knows the rules of the game, etc.” describes the specialist.
How long do the symptoms last?
“In the majority of cases, the symptoms of concussion disappear within 15 days for adults, and within a month for children”, indicates the neurologist. You should know that the Women and children may have symptoms that may last longer.
“In rugby, tacklers are the most at risk”
“This phenomenon can be explained by less cervical musculature than in men. Hormones could also play a role in the duration of symptoms.”
Concussion: risky sports (rugby, handball)
According to Doctor Chermann, “all sports are at risk, especially handball, rugby, hockey and football. Finally, footballers are less at risk of concussion than rugby players; however, football remains the sport most affected given the number of players licensed. In rugby, it is especially the tacklers who are most at risk of having a concussion.
What are the risks of after-effects?
Concussion is a mild traumatic brain injury (TBI). The latter is distinguished from moderate TBI, which can cause cerebral hemorrhage. These bleeding moderate TBI are visible on medical imaging exams, unlike concussion lesions. There is also severe TBI, which plunges the patient into a deep coma.
“The players must leave the field”
“Players must get off the field in the event of a concussion. Otherwise, they risk being hit again. If they stay on the field, the short-term risk is injury or a prolongation of the signs of concussion.” Of the protocols have been developed, with the participation of Dr Jean-François Chermann, allowing the player to leave the playing field very quickly. “We went from 50% of players continuing to play the same day, despite being concussed, to 15% thanks to everything we have put in place, which represents enormous progress.” About the long-term consequences, neurologists emphasize the importance of sub-concussions, much more numerous (several thousand in a career), “like the repeated tackles in rugby, headers in football, receive repeated small shocks… Indeed, recent studies show, for example, that the life expectancy of footballers is increased, but also that they are more people suffer from a degenerative diseasewhich remains the main risk.”
According to the neurologist, the wearing a helmet in rugby only presents little interest.
► Wear a mouthguard: “On the other hand, the wearing a mouthguard is very important, because this protection helps dissipate the intensity of the impact. The player then has less risk of developing a concussion.”
► Muscle strengthening: Muscle strengthening at the neck level also allows for better absorption of shocks, but alsoavoid whiplash.
Thanks to Doctor Jean-François Chermann, neurologist in Paris and specialist in concussions in athletes.