I was contacted by a group, Brain Injury Australia, Australia’s peak brain injury advocacy body representing, through its Member organizations in each of Australia’s States and Territories, the needs of people with a brain injury, their families and careers. More specifically Nick Rushworth the Executive Officer; he was seeking information from this side of the Pacific about concussions. Brain Injury Australia is attempting to get as much information as possible to create a policy paper on sport-related concussions for the government. As Nick put in a later email;
The Australian Government is expecting Brain Injury Australia to be able to evidence that it has consulted widely in regards to the policy paper’s contents, so anything you can do to distribute my email as far and as wide as you can I would really appreciate.
So I am asking for all of your (athletic trainers, doctors, researchers, parents, coaches, et al) help on this one. You can either answer the below questions in the comment section or you can email your responses to me and I will pass them along to Nick, his deadline is the 27th. Here are the questions he has posed (please only answer not critique the question);
- It seems to me that, if there are two kinds of concussion (at least, if you exclude “subconcussions”) – those that are observable (in their effects on the player) and those that are not (where assessment and diagnosis relies almost entirely on the player both knowing and recognizing the effects of concussion and being prepared to disclose them) – then, in the case of the latter, can you identify any innovative programs of player education in concussion, proven capable of removing obstacles to disclosure; the heroic culture of “playing through” injury, fear of exclusion from play, fear of letting the team down etc.?
- Perhaps the policy paper’s core working hypothesis is that awareness of, and compliance with, “best practice” concussion assessment and management is poorer the further one ventures from professional (salaried) sport, into amateur, school, junior sports. If true, who do you believe should bear the responsibility – and the cost – of this player health and welfare; specifically, education in, and provision of testing materials in concussion assessment, management, and ensuring compliance with return-to-play guidelines?
- In regards to 2., Brain Injury Australia would be very interested to hear from you about any local examples of concussion assessment and management programs from amateur, school, junior sports utilizing, say: non-clinicians/ volunteers/ parents; demonstrably effective, yet user-friendly, concussion assessment and recovery tools; and compliance regimes for return-to-play etc.
- Are you able to identify any innovative, and successful-demonstrable, concussion prevention initiatives; in areas such as, say, equipment, playing technique, rules changes?
- Some education materials use “concussion” and “[mild traumatic] brain injury” interchangeably (for example, that the former is a class of the latter). Some advocates for player health and welfare argue for sole use of the latter; that it more truthfully represents the nature of the injury. Others argue the two injuries are qualitatively different, and that use of the latter term will not only discourage player disclosure of concussion but also player participation in these sports. Do you have a view on these issues?
- Many sports commentators have noted the increasing size, with musculature, and speed of players in the collision sports. Some have suggested the increasing forces involved also increase the potential for a greater number, and severity, of concussions in these sports. Do you share this view? If so, or if not, why?
- More than 1,000 former gridiron players are involved in some 54 lawsuits against the National Football League. The lawsuits generally allege the League knew, or should have known, about the long-term neurological consequences of repeated concussions. What, if any, effects do you think this litigation, and the media coverage of concussion in former gridiron (and ice hockey) players, is having/ will have on the development of concussion policy in sport in North America?