From the Ground to Recovery: New Concussion Guidelines

With community football commencing in the next couple of weeks you may or may not be aware of the new concussion guidelines. On the 1st of March, the AFL announced the new developments in relation to the return to play protocols in the concussion guidelines for all levels of Australian Football, including community football.

The new community football guidelines state the earliest a player suffering a concussion can return to play is on the 21st day post the concussion incident providing that medical clearance has been given. It is important to note that day 0 is the day on which the concussion is sustained. 

 So what to do if you or your child sustains a concussion?

The return to play protocol consists of three distinct stages.

1.     Rest (24-48 hours)

• Period of relative rest for 24-48 hours.
• See medical professional to confirm diagnosis.
• Able to engage in activities of daily living immediately following the injury.
• Reduce screen time in the first 48 hours.
• Able to use simple painkillers such as paracetamol to manage symptoms.

2.     Recovery

• Encouraged to participate in activity- commence light physical and cognitive activity.
• Start with simple day-to-day activities such as walking, watching TV and reading.
• Progress slowly back to full work/school load.
• Progress to light aerobic exercises- slow jogging/cycling, no resistance training.
• Progress to moderate aerobic exercise- medium pace jogging/cycling, no resistance training.
• Minimum 2 days before progressing to high intensity aerobic exercise- sprinting, can commence gentle resistance training.
• No team training drills at this stage.
• This stage is variable in length between individuals – can take days to weeks.

3.     Graded return to training and play- minimum duration of 14 days 

• Players can only enter this stage once they have fully recovered from their concussion. This means that all concussion-related symptoms and signs have fully resolved (for at least 24 hours) at rest and with intense physical exertion. They have also successfully returned to school/work without restriction.
• Graded loading that allows an incremental increase in physical and cognitive load – requires careful monitoring for recurrence of symptoms.
• Start with non-contact training. Can complete full team training sessions but non-contact activities only. A minimum of 2 training sessions with no consecutive days of football to allow for appropriate rest and recovery.
• If the player remains completely free of any concussion-related symptoms they are able to progress to limited contact training. This means that they are able to participate in drills with incidental and/or controlled contact (including tackling).
• Not able to return to full contact training sessions without having a medical clearance- can only be made by a medical doctor.
• Once returned to full contact training able to return to play if remains completely free of any symptoms and the player is confident to return to play.
• Many children and adolescents will require longer than 3 weeks before a full return to play.

Flow chart from: https://play.afl/sites/default/files/2024-03/Four-Stages-of-Graded-Return-To-Play.pdf

The guidelines:

The guidelines state a minimum period of 24 hours for each step of the progression and if any symptoms recur during the graded return to training and play stage, the player must go back to the previous symptom-free step.

 These guidelines may seem like a lot but as someone who has experienced a concussion it is important to follow the guidelines. In the community, it sometimes overlooked the impact that a concussion can have on our everyday lives. When I was making my way through the protocol, I had to repeat the day of light aerobic exercise as I had a headache after jogging one lap of the footy oval.

 A team effort:

Concussion is everyone’s responsibility. At times It can be brushed off or people are frustrated with the automatic 21 days off if you sustain a concussion. There is a growing concern regarding the potential long-term consequences of concussion so it is important to take these moments seriously and take care of yourself and others.

~ Natasha Symons
Physiotherapist

You may find these other PMPP blogs interesting:

https://portmelbournephysio.com.au/whiplash/
https://portmelbournephysio.com.au/inseason-strength-training/
https://portmelbournephysio.com.au/pre-season-training/

Consussion Australia: https://www.concussionaus.com.au