Dear Players and Members,

Welcome to the new Physiotherapy at Vandals Information Section. Over the forthcoming months you will find various bits of information that you will hopefully find helpful and informative.

The first bit of information that we want to put across is a very important issue, and one that we need to very aware of as Players, Coaches, Parents and Friends. CONCUSSION. This is a huge topic in the rugby world at present, with rugby recently been classified as the second highest incidence of concussion behind american football.

Please find below excerpts from the IRB Player Welfare website that define concussion and the rules that allow a player, young or old, to return back to rugby safely. Please read carefully. For a full version of the IRB Player Welfare Concussion Guidelines you can go the following link:-
http://www.irbplayerwelfare.com/?documentid=3

If you have any concerns or questions regarding this issue please feel free to ask any of the physiotherapists at the club.

What is concussion?
Concussion is a complex process caused by trauma that transmits force to the brain either directly or indirectly and results in temporary impairment of brain function. Its development and resolution are rapid and spontaneous. A Player can sustain a concussion without losing consciousness. Concussion is associated with a graded set of clinical signs and symptoms that resolve sequentially.

CONCUSSION MUST BE TAKEN EXTREMELY SERIOUSLY.
Concussion producing forces are common in Rugby; fortunately most of these do not result in concussion. There is widespread variation in the initial effects of concussion. Recovery is spontaneous often with rapid resolution of signs, symptoms and changes in cognition (minutes to days). This could increase the potential for Players to ignore concussion symptoms at the time of injury or return to play prior to the full recovery from a diagnosed concussion. This may result in a more serious brain injury or a prolonged recovery period. The potential for serious and prolonged injury emphasizes the need for comprehensive medical assessment and follow-up until the concussion has fully resolved. Returning to play before complete resolution of the concussion exposes the Player to recurrent concussions that might take place with ever decreasing forces. We have concerns that repeat concussion could shorten a Player’s career and may have some potential to result in permanent neurological impairment. Players must be honest with themselves and medical staff for their own protection.

Where Graduated Return To Play (GRTP) is NOT managed by a Medical Practitioner (GP)
There may be extreme situations where a Player does not have access to a Medical Practitioner (GP) to diagnose concussion or to manage the GRTP. In these situations if a Player has shown signs of concussion that Player must be treated as having suspected concussion and must not play until at least the 21st day after the incident and should follow the GRTP process outlined in Diagram 3. Other Players, coaches and administrators associated with the Player should insist on the guidelines being followed.

If a Player has been diagnosed with concussion by a Medical Practitioner (GP) but does not have access to a Medical Practitioner to manage the GRTP that Player must not play until at least the 21st day after the incident and should follow the GRTP process.

Children and adolescents
Whilst the guidelines apply to all age groups particular care needs to be taken with children and adolescents due to the potential dangers associated with concussion in the developing brain. Children under ten years of age may display different concussion symptoms and should be assessed by a Medical Practitioner using diagnostic tools. As for adults, children (under 10 years) and adolescents (10 – 18 years) with suspected concussion MUST be referred to a Medical Practitioner immediately. Additionally, they may need specialist medical assessment. The Medical Practitioner responsible for the child’s or adolescent’s treatment will advise on the return to play process, however, a more conservative GRTP approach is recommended. It is appropriate to extend the amount of time of asymptomatic rest and /or the length of the graded exertion in children and adolescents.
Children and adolescents must not return to play without clearance from a Medical Practitioner.

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