Sports Injuries Report

Concussion is an area of growing importance in the sporting world due to recent research
that highlights damaging short-term and long-term effects, including CTE. This has been
addressed by the Concussion in Sport Australia Position Statement (first released in 2018 and
most recently updated in 2024) which outlines evidence-based information relating to the
recognition and management of concussion. To demonstrate your understanding of
Concussion in sport, provide a response to the following questions. Please ensure you use
in-text referencing to support your response and include a reference list.

1. Outline how the SCAT-6 is used to assess and diagnose concussion. Analyse the
various components of the SCAT-6, linking to your understanding of what concussion
is and how is the athlete affected. Evaluate the SCAT-6 as an important tool in the
management of concussion? What limitations are there around its use? How can
these limitations be addressed? (500-600 words)

The SCAT-6 is used to assess and diagnose if an athlete had suffered a concussion whilst
participating in their respective sport. The SCAT-6 is used during and after games in a
controlled environment within 72 hours of the injury. The first component of the assessment
is to evaluate if there are any ‘Red Flags’ happening to the athlete, some of these include
seizure or convulsion, loss of consciousness, vomiting or severe headaches. These ‘Red Flags’
are all signs of serious concussion and mean that the athlete should have an ambulance
called and should be taken to a hospital immediately.

There are two separate parts to the SCAT-6. The on-field quick assessment and off-field
longer assessment. The on-field assessment is used to determine if an athlete needs to be
removed from play for further assessment, the off-field assessment. The first part of the off-
field assessment is assessing the symptoms of the athlete e.g. headaches, nausea, blurred
vision etc. The athlete is to rank these on a scale from 1 (minor/no symptoms) to 6 (severe
symptoms). All of the symptoms that are assessed are all reported by the athlete themselves
and there is no way that the assessor can tell if these symptoms are affecting the athlete.
This means that one of the limitations for this part of the SCAT-6 is that the athlete has to
report these symptoms and can lie very easily to make their results favour them being able
to play the following week.

The second part of the SCAT-6 is the cognitive assessment which assesses the memory and
concentration of the athlete. The SCAT-6 contains word memory questions as well as
number concentration questions which aim to assess if the frontal lobe of the brain has
received any trauma. The frontal lobe is responsible for high-cognitive function such as
problem solving, memory and emotional expression (Hammond, 2023). This part of the
brain is located at the front and is the most commonly injured part of the brain. A limitation
of this is that if baseline testing is not taken then it is hard to determine how the athlete
would score without concussion symptoms.
The final part of the SCAT-6 is the Coordination and Balance tests. The assessments consist
of measuring different balancing positions such as one leg at a time or in a tandem stance
and being able to walk heel to toe for 3 metres as quickly as possible. This part of the
assessment is to check if there is any trauma to the cerebellum which is the back of the
brain controlling balance and coordination (NDBC, 2021). The limitation to this last part of
the SCAT-6 is similar to the Cognitive part where no baseline test can cause false
assessments. As each athlete is individual in their balance and coordination baseline
assessments are crucial to getting accurate results.

2. Explain what return to play protocols are. Provide a brief justification of the
importance of return to play protocols. (150-200 words)

Return to play (RTP) protocols are the gradual increase in the demands of the athlete,
physically and cognitively, that need to be taken to return to playing sport following a
concussion. If symptoms flare up again such as headaches during exercise the athlete has to
go back a step until they are completely symptom free. They are mandatory protocols that
differ slightly between sports that assure that an athlete has recovered properly from an
injury in order to minimise the chance for long term injuries or secondary injury. When
speaking about head injuries such as concussion there is strict protocols in all contact sports
that give guidelines on athletes returns.

The SCAT-6 in the previous question is used throughout the recovery by assessing the athlete
at different points of the return to play process. The RTP protocols are put into place to stop
secondary head injuries such as Secondary Impact Syndrome (SIS) which occurs when “an
athlete that has sustained an initial head injury and then sustains a secondary head injury
before symptoms associated with the first have fully cleared” (Clarke, 2024). SIS can lead to
catastrophic brain swelling which is usually fatal and this is one of the main reasons that RTP
protocols for concussion are so strict and extensive. RTP protocols are also found to help
with the prevention of long term head trauma issues such as Chronic Traumatic
Encephalopathy (CTE). CTE is caused by repeated head trauma that causes dementia,
depression and other mental issues (IUSM, 2024). The importance of mandatory RTP
protocols is crucial to try to prevent head trauma issues such as SIS and CTE.

3. Respond to the statement below, indicating if you agree or disagree and providing
evidence to support your view. (400-500 words)

The increased scrutiny around concussion, including taking a conservative approach to

management and mandatory stand down time from sport is warranted given the
potential long-term effects for the athlete.

I agree with the statement that increased scrutiny around concussions, including
conservative management and mandatory stand-down time, is warranted given the
potential long-term effects on athletes. Concussions are now understood as more than just
"getting your bell rung," with substantial research linking them to serious long-term
cognitive, physical, and emotional consequences, especially when mismanaged or
compounded by repeated head trauma.

There is clear evidence of the potential long-term cognitive effects of concussions,

particularly when athletes are not given adequate recovery time. Studies show that
concussions can lead to lasting brain changes that impact memory, concentration, and
processing speed. In cases of multiple concussions, or repeated head trauma, the risks
multiply significantly. Chronic Traumatic Encephalopathy (CTE), for example, has been linked
to repeated head injuries and has become a well-known risk for athletes in contact sports
like football, boxing, and hockey. CTE is associated with severe symptoms, including memory
loss, impaired judgment, and aggression, often appearing years after the last head injury.
This makes it clear that the conservative approach to concussion management, including
stand-down periods, is essential to reducing the risk of these permanent and debilitating
conditions (Philip, 2023).

Secondly, the impact of concussions on mental health further supports the need for
stringent protocols. Research has found a link between concussions and an increased risk of
depression, anxiety, and even suicidal ideation. Athletes often feel pressure to return to play
too soon, which can exacerbate these mental health risks by increasing the likelihood of
reinjury or prolonged symptoms. By instituting mandatory stand-down periods, sports
organisations create a safer environment that prioritises long-term well-being over
immediate performance. Such policies may also help to reduce the stigma or “tough it out”
mentality surrounding concussions in sports, encouraging athletes to report symptoms and
seek help without fear of losing their position or playing time (Ryan, 2024).

The complex and often unpredictable recovery timeline of concussions means that
conservative management is not only necessary but crucial for each athlete’s unique needs.
Unlike many injuries, where recovery is more predictable, concussion symptoms and
recovery times can vary widely. Athletes may experience symptoms for days, weeks, or even
months, and the risk of Second Impact Syndrome (SIS) adds weight to the argument for
longer stand-down periods. The brain requires sufficient time to heal, and research suggests
that allowing athletes to return to play prematurely can hinder recovery and elevate the risk
of future concussions. A conservative, individualised approach that emphasises rest and
gradual return-to-play protocols can help ensure that athletes recover fully before they are
exposed to further risk.

The increased scrutiny, conservative management, and mandatory rest periods for athletes
with concussions are justified. The potential for severe long-term effects, cognitive
impairment, mental health issues, and heightened risk of further injury, demands that sports
organisations adopt policies that prioritise the health and safety of athletes (Bennet, 2024).
As research continues to expose the risks associated with concussion mismanagement, it is
evident that a careful, conservative approach to recovery is essential for protecting athletes’
futures.
References
Bennett, H 2024, Concussion in sport: Why making players sit out for 21 days afterwards is a
good idea, Conversationedu, viewed 02 November 2024, <
[Link]
afterwards-is-a-good-idea-222504 >

Denner, M 2023, What is SCAT6 or Sports Concussion Assessment Tool 6? | Complete

Concussions, Completeconcussions, viewed 02 November 2024, <
[Link]
concussion-assessment-tool-6/ >

Philip, S 2023, New device can diagnose concussions using AI, [Link], viewed
02 November 2024, < [Link] >

Ryan, P 2024, One in 10 AFL players ignore concussion symptoms, The Age, viewed 02
November 2024, < [Link]
[Link] >

Schatz, P., Corcoran, M., Kontos, A. P., & Elbin, R. (2020). Youth Soccer Parents’ Perceptions
of Long-Term Effects of Concussion . Developmental Neuropsychology, 45(3), 110–117.
[Link]

The Healthline Editorial Team 2018, Frontal Lobe: Functions, Structure, Damage, and
More, Healthline Media, viewed 02 November 2024, < [Link]
body-maps/frontal-lobe >

What Part of the Brain Controls Balance? - NDBC of Minnesota 2021, National Dizzy &
Balance Center, viewed 02 November 2024, <
[Link] >

What is CTE? | Traumatic Brain Injury | IU School of Medicine 2024, IUSM, viewed 02
November 2024, < [Link]
chronic-traumatic-encephalopathy >