FOCUS Sports injuries 12 Reprinted from AustRAliAn FAmily PhysiciAn Vol. 39, no. 1/2, JAnuARy/FebRuARy 2010

Concussion is a common problem in many sports and recreational pursuits, especially those involving body contact, collisions or high speeds. In general practice, concussive brain injuries may present acutely following head trauma. More commonly, patients present some time after their head injury, either with ongoing symptoms or for medical clearance to allow them to return to play. Clinical management involves confirming the diagnosis, differentiating concussion from structural head injury, estimating the severity of injury and determining when the patient can return safely to competition. Recent figures from the united states of America estimate approximately 1.6–3.8 million cases of sports and recreation related traumatic brain injury each year.1 in the usA the majority of head injuries are observed in American football (incidence: 0.7–9.4 concussions per 1000 player hours),2,3 ice hockey (incidence: 1.5–6.0 per 1000 player hours),4,5 and soccer (incidence: 0.4–0.7 per 1000 player hours).6,7 common participation sports played in Australia, such as Australian Football league (AFl), rugby league and rugby union have among the highest rates of head injury of any team sports in the world. the reported incidence of concussion in these sports is 5.9–9.8 concussive injuries per 1000 player hours,8–10 which equates to an average of approximately five injuries per team per season. this represents a significant public health issue in active communities. over the past 8 years, international experts met on three occasions to address key issues in the understanding and management of concussion in sport;11–13 most recently in Zurich in november 2008.13 the consensus statement produced from the Zurich meeting provides an outline of up-to-date knowledge and best practice management guidelines on concussion in sport.13 the following article is an overview of the key concepts from this consensus statement, including an understanding of concussion and an outline of it’s potential risks and recommended management as applicable to the general practice setting. Traumatic brain injury and concussion traumatic brain injury (tbi) is a broad term that encompasses a spectrum of injuries to the brain resulting from trauma. on the Sports related concussion Management in general practic