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Steve Smith is still recovering from a hit to the neck. What is concussion and what does the latest research say about kids, concussion and sport?

Russell Gould and Grant McArthur, August 20, 2019 7:00PM Kids News

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Steve Smith of Australia is struck by a delivery from Jofra Archer of England during day four of the second Test at Lord's Cricket Ground on August 17, 2019 in London, UK. Picture: Getty Images media_cameraSteve Smith of Australia is struck by a delivery from Jofra Archer of England during day four of the second Test at Lord's Cricket Ground on August 17, 2019 in London, UK. Picture: Getty Images

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Australian cricketer Steve Smith is “feeling good” but won’t play in the third Test against England, which starts on Thursday.

He suffered concussion after a blow on the back of the neck by a Jofra Archer bouncer* on Saturday and missed the last day of the second Test.

media_cameraAustralia and England players check on Steve Smith, who lays on the pitch after being hit in the head by a ball on August 17, 2019. Picture: AFP

Though he passed a series of concussion tests and was cleared to continue batting, he woke on Sunday morning with a “bit of a headache and a feeling of grogginess”.

He will need to pass daily tests with no signs of concussion before he is allowed to do any training.

Generally accepted medical guidelines require a five-day break after a concussion diagnosis*.

Smith's frightening blow

Footy, rugby union and rugby league players are more often in the news for concussion than cricketers, because these are contact sports and there is a high risk of collision either between players, or of a player’s head with the ground.

Several AFL players including Western Bulldogs premiership hero Liam Picken have retired recently because of complications caused by head knocks.

St Kilda’s Paddy McCartin has suffered a number of head knocks and is on the Saints’ long-term injured list.

New research also raises concerns about the concussion dangers for kids of non-contact sports such as riding a bike, horse or skateboard.

We look at what concussion is and how to keep as safe as possible without missing out on your favourite sport.

media_cameraLiam Picken (left) of the Bulldogs slips out of a tackle by Callum Mills of the Swans during the AFL match between the Sydney Swans and the Western Bulldogs at the SCG in Sydney on Thursday, June 8, 2017. Picture: AAP

WHAT IS CONCUSSION?
The skull’s job is to protect your brain. If you hit another player or the ground hard with your head, the brain can move back and forward within the skull, causing injury to the brain.

Concussion symptoms may not be obvious until hours after the injury. Concussion symptoms may include:

  • Difficulty staying awake
  • Headaches or migraines
  • Forgetfulness or memory problems
  • Vomiting
  • General unwell feeling, or feeling a bit ‘off’
  • Dizziness
  • Confusion, slurred speech or unusual behaviour
  • Blurred or double vision

Source: AFL

CONCUSSION SAFETY
If you hit your head or something hits your head, tell an adult what happened. Give as much detail about the accident as possible.

If someone shows one or more of the concussion symptoms listed above following a head injury, they should be checked by a doctor. Symptoms may not appear for 24-48 hours after the injury.

Children should not go to school or exercise until completely symptom free and cleared by a doctor to do so.

Source: The Children’s Hospital at Westmead

Cowboys v Rabbitohs media_cameraSouth Sydney Rabbitohs trainer signals a concussion to the sidelines while Greg Inglis lays on the ground during an NRL match against the North Queensland Cowboys, Townsville, in 2016. Picture: Zak Simmonds

KIDS AND CONCUSSION
Children are more likely to suffer serious head injuries riding a bike or skateboard than playing footy or other contact sports, according to new Australian research.

A study of almost 9000 children who ended up in hospital emergency departments with head injuries found more than a third had been hurt while playing sport.

Concerns about concussion have recently focused attention on team contact sports such as Aussie rules and rugby.

But the Murdoch Children’s Research Centre-led study found the highest rates of traumatic* brain injuries came from recreational* sports including cycling, skateboarding and horse riding.

While the community is increasingly aware of concussion in sport, lead researcher Professor Franz Babl said it was also important to gain a better understanding of the severity of intracranial* injuries.

“There were not that many serious injuries, but the serious injuries were in unexpected areas such as bicycle riding and other non-contact sports,” Prof Babl said.

“I think you just have to be aware that bicycle riding, or scooter riding, or horse riding in particular have a risk of more severe injuries because of the force involved.”

The study examined children aged 5-18 who presented to 10 emergency departments across Australia and New Zealand between 2011 and 2014. It found that 80 per cent of the injured were male.

Results published in the Medical Journal of Australia reveal that of almost 9000 childhood head injury patients, 3177 had been playing sport when they were hurt.

Of those suffering serious traumatic brain injuries, 20 had been riding a bike, eight were skateboarding, seven were riding horses and three were playing baseball or ­softball.

While various football codes accounted for some of the highest rates of children fronting up to emergency departments, Aussie rules, rugby and non-specified* football accounted for only one serious case each, while soccer had no major head injuries.

Emily Robinson and Mouthguard media_cameraEmily Robinson, rugby star and a member of the national team the Wallaroos, with her mouthguard. Picture: Chris Pavlich

HELMETS AND MOUTHGUARDS
There is disagreement between medical experts about whether helmets help prevent concussion.

The Queensland Brain Institute advises that hard helmets (such as those worn by cricketers) are good for protecting against brain injury.

But helmets don’t do a good job protecting the brain against all types of head impact. Scientists believe that most concussion is caused by rotational* movement, when the head is struck at an angle.

Though direct impact causes bruising, rotational movement causes the brain to twist, which can cause serious injury.

The AFL advises players wear helmets after injury such as to the face or fractures* of the skull.

It strongly recommends players wear mouthguards for all games and training sessions at all levels of the sport. Mouthguards can prevent injuries to the teeth and face.

There is some scientific evidence that mouthguards may prevent concussion or other brain injuries in AFL.

Collingwood v Western Bulldogs media_cameraSt Kilda’s Paddy McCartin (wearing the helmet) in a contest with Richmond’s Alex Rance at Etihad Stadium during the 2018 AFL season. Picture: Michael Klein

GLOSSARY

  • bouncer: a way of bowling that makes the ball bounce high
  • diagnosis: assess symptoms and decide on what is causing them
  • traumatic: to do with a physical injury
  • recreational: for fun, rather than competition
  • intracranial: inside the skull
  • non-specified: general; not one type mentioned
  • rotational: turning
  • fractures: breaks

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QUICK QUIZ

  1. List four symptoms of concussion.
  2. What should you do if you hurt your head?
  3. According to the study, are girls or boys more likely to hurt their heads?
  4. In the study results, how many major head injuries were from soccer?
  5. When should footballers wear mouthguards?

LISTEN TO THIS STORY

CLASSROOM ACTIVITIES
1. Head injuries
On a blank page, rule up a table with three columns. In the first column, list the following sports:

  • AFL
  • CRICKET
  • RUGBY
  • SOCCER
  • SKATEBOARDING/
  • SCOOTER RIDING
  • HORSE RIDING
  • BIKE RIDING

Label the second column POSSIBLE INJURIES and the third column SAFETY MEASURES.

Complete the column, listing the dangers of each sport that could lead to concussion or a more serious brain injury, then some possible safety measures that could lessen the risk of a head injury.

Time: allow 25 minutes to complete this activity
Curriculum Links: English, Health and Physical Education, Critical and creative thinking

2. Extension
In the study referred to in the Kids News article, 80 per cent of the injured children presenting at emergency departments were male. Write a paragraph giving your reasons as to why this may be the case.

Time: allow 10 minutes to complete this activity
Curriculum Links: English, Health and Physical Education, Critical and creative thinking

VCOP ACTIVITY
Design a poster for your schoolyard duty kits. It should include all the information needed for a teacher to spot a concussion, but might also include some questions they need to ask the student to find out more. Everyone needs to stay calm in serious situations, and sometimes having things written down helps to keep the situation clear.

Make sure the poster is clear and informative and the questions are relevant and direct.

Your vocabulary and punctuation will be important for clarity and structure.  

HAVE YOUR SAY: Have you or any of your friends ever been checked out for concussion?
No one-word answers. Use full sentences to explain your thinking. No comments will be published until approved by editors.

Extra Reading in explainers