The risks of concussion from school sports are vastly underestimated, ranging from disrupted or impaired education to serious and sometimes even fatal consequences, according to a leading surgeon.
Dr Willie Stewart, consultant neuropathologist at Southern General Hospital in Glasgow, has helped launch a Scottish campaign with the potentially life-saving message: “If in doubt, sit them out.”
The campaign follows the death of Benjamin Robinson, who died at the age of 14 after sustaining double concussion during a school rugby match in Northern Ireland in 2011. His parents have been raising awareness of the dangers throughout the UK.
Although deaths from this so-called second impact syndrome (SIS) are very rare, it can affect brain function in various ways and the second blow could follow the first by several weeks.
The symptoms of concussion in general can be subtle, Dr Stewart says, and a combination of ignorance and bravado means it too often goes unrecognised or untreated. The problem is compounded by high-profile cases of professional athletes continuing to play with concussion.
Dr Stewart explained: “People with concussion are not in a position to decide whether to play on. It’s like giving a drunk the keys to the car and saying, do you feel fit to drive?
“It is very under-recognised. The last Rugby Football Union survey suggested five incidents per 1,000 player hours. That’s a considerable underestimate because one study from New Zealand has suggested that for every one reported, another three or four go unreported.”
The campaign, which is backed by the Scottish Rugby Union, Scottish Football Association and SportScotland, has produced leaflets for coaches, teachers and parents on how to identify concussion and what steps to take.
This guidance has been sent to every school and sports body in Scotland, with online materials available too.
The most common symptom of concussion is headache, and other effects include blurred vision, unsteadiness, vomiting and memory loss. Mood swings are also frequent.
Dr Stewart cited a survey of teachers showing one in three would choose to let a pupil stay on the sports pitch even if they suspected concussion. Only one in five realised it was also vital to curb all cognitive activity, from homework to reading, watching television or using a mobile phone, until the symptoms subsided.
“It’s an educational issue as well as a welfare one. As a kid you only get one crack at some of these exams and if you’ve blown it because you’ve had a concussion and nobody’s looked after you properly, that can affect your whole life,” Dr Stewart said.
Shona Robison, minister for sport and Commonwealth Games, said: “‘If in doubt, sit them out’ is a potentially lifesaving message that will help keep children as safe as possible. Sport leads to a better, healthier and longer life. Let’s not undermine this by gambling on a head injury.
“From grass roots and school coaches to the elite athletes who set the example for all – it’s vital that people at all levels of sport understand the signs, and the dangers, of concussion.”