Concussion Prevention

Parents, coaches and athletes have a vested interest in concussion prevention. In the competitive world of professional sports it is now common practice to have a well-rehearsed action plan in place to deal rapidly and effectively with concussion.

The International Rugby Board (IRB) implemented the Pitch Side Concussion Assessment (PSCA) policy for the first time in the 2013 rugby season. Any player who has sustained a head impact has to leave the field for five minutes, during which time a standardized concussion assessment is conducted to determine whether any symptoms of concussion are present. The IRB has shown that the number of players suspected of concussion remaining on the field has been reduced from over 50% to 15%. Still too high by their standards. However, some of the countries that make up the 6 Nations are reluctant to adopt the PSCA for the 2014 competition. In the words of Dr Martin Raftery, medical officer for the IRB “5 minutes is better than none.” The Sports Concussion Programme agrees.

Approaches to Concussion Prevention

An effort has been made to prevent concussion in sport. At school level, where younger athletes are particularly vulnerable to concussion, these efforts are important.


Increased awareness of subtle behavior changes in children can alert parents to possible concussion. Mood swings, heightened emotions, restlessness, irritability, poor school performance and lethargy are common symptoms of concussion in children that should be identified as soon as possible.

Protective Equipment

Helmets are compulsory in certain high speed sports. Cycling, skiing and motorsports use helmets to reduce the chance of severe structural brain injury. However, protective headgear does not prevent or reduce the severity of concussion in sport.

The use of mouth guards has been shown to reduce dental injuries and maxillofacial injuries. Biomechanical studies (laboratory) demonstrated that mouth guards reduced impact forces applied to the jaw from being transmitted to the brain. Clinical concussion studies have not shown that athletes using mouth guards have fewer concussions.

Rule Changes

A number of sporting codes have introduced rules to avoid dangerous play. In 2012 the NFL banned players from using their helmets to impact players on the head or neck, whereas in rugby, spear tackles, where a player lifts and dumps a player on his head, is deemed a red card offense.

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