About Us


The HeadSmart™ Sports Concussion Programme provides an end-to-end sports concussion solution for grassroots schools and clubs to the same standard as professional teams. Children and weekend warriors’ brains are no less important than high-earning athletes.

HeadSmart™ is your “insurance policy” for that clash of heads during a sports event. Our programme ensures over 97% accuracy in sports concussion diagnosis and return-to-sport results. The world’s leading sports concussion programme is mobile, versatile, affordable and easy to use. Understanding your duty of care to all your players, HeadSmart™ reduces liability and culpability.

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Mission statement

The HeadSmart™ Sports Concussion Programme aims to convert the current guidelines on concussion in sport into a format that is practical, accessible and easy to understand for parents, coaches, teachers, athletes, players, allied health professionals. The mission of the programme is to bridge the gap between scientific knowledge on concussion and concussion practices carried out at grassroots by converting knowledge into a form that an “end user” can understand and apply in different concussion situations.

When your child has sustains a head injury playing sport, your doctor is not at the sideline. Visible concussion signs can be short-lasting. When you see a doctor later, your child looks normal. But they are not …! There is uncertainty. Concussion symptoms that can’t be seen are still there. Symptoms can take 7 – 28 days to go away. 1 in 10 concussions take even longer to get better. HeadSmart™ provides peace of mind to parents, coaches and medical staff. We have the latest technology, in partnership with Cogstate, to monitor brain function recovery. HeadSmart™ is the world’s first fully mobile concussion management system. There when you need help. Using the latest online technology, HeadSmart™ provides a powerful system that is seamless and easy to use. We will give you the tools to help you know what to do and where to go. You are able to record the information that your doctor wants to know.

Our key objectives:

Existing Members



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concussion test
concussion treatment
concussion assessment
sports concussion
brain injury
brain damage
brain concussion
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concussion app
concussion regcognition
concussion test
concussion assessment
sports concussion
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brain injuries
brain damage
concussion treatment
concussion recovery
concussion assessment
concussion test
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Neuropsychology
Neuropsychology
Neuropsychology
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concussion symptoms
concussion symptoms
concussion symptoms
Signs of concussion
Cognitive test
Post concussion
Sports doctor
Neuropsychological testing
Head concussion
Head concussion
Head concussion
Head injury
Head injury

Head Injury Protocol

READY
Football concussion
READY
Football concussion
READY
Football concussion
READY
Football concussion
RECOGNISE
Head injury concussion
RECOGNISE
Head injury concussion
RECOGNISE
Head injury concussion
RECOGNISE
Head injury concussion
REFER
Neuropsychological tests
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Neuropsychological tests
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Neuropsychological tests
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Neuropsychological tests

Cognitive function impairment
Cognitive function impairment
Cognitive function impairment
Cognitive function impairment

Membership Benefits

Concussion management
Litigation protection
concussion test
Litigation protection

Lawsuits in the concussion space are happening on a regular basis in the US. It’s only a matter of time before a lawsuit is instituted against a school or club in Australia for negligent sports concussion management. The HeadSmart™ Sports Concussion Programme understands the critical interventions required for a school or club to mitigate risk against claims and acts as defence to careless concussion practices.

Concussion laws in the United States are based on three key principles, and neglecting anyone of those constitutes breaking the law. The law states that schools and clubs should provide effective education programmes to athletes, players, coaches, trainers, physio’s and all other staff involved in the sport.Indeed, many sports concussion litigation cases have targeted an oversight in providing basic concussion education. Secondly, any athlete or player witnessed to sustain a head injury or report a head injury, should be removed from the game or event immediately and seek medical attention. The third key principle emphasises that all concussed athletes and players should be cleared to return to their sport by a medical doctor only.

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Find a doctor
Litigation protection
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Find a doctor

The Accident Compensation Commission (ACC) in New Zealand showed how distributing a concussion information card to coaches and trainers had a profound “cost saving” benefit. In the communities that received the card, the time to medical contact after a head injury was reduced on average 33% (6 days to 4 days), which produced a $ 690 000 cost saving for the ACC.

The take home message here is: see a medical doctor as soon as possible after a head injury. Make sure of an accurate head-injury diagnosis. In so doing, the socioeconomic cost of the concussion is reduced dramatically as there are likely to be less concussion-related complications.

HeadSmart™'s custom-designed FirstResponderTM Concussion Recognition App comprises a nationwide Google map location network of medical doctors who are competent to treat concussion. Download the App today. Get access to our network and have potentially less costly concussion-related issues after a head injury.

Brain injuries
Education
Education
Neuropsychology
Education programme

HeadSmart™ invests significant time and resources into online education and social media awareness. Schools and clubs under the HeadSmart™ banner have access to an ongoing annual education and awareness programme. The education programme focuses on changing attitudes towards concussion and translating this into a change in on-field and off-field behaviour towards the concussion paradox. The end result should be improved-reporting concussion symptom reporting.

Concussion symptoms
CogState measures
CogState measures
CTE
CogState concussion assessment

HeadSmart™ understands the critical importance of individualised concussion management for each athlete or player. By comparing a post-concussion computerised brain function assessment to baseline screening prior to the season, medical staff can accurately track cognitive change from normal. Making the diagnosis at the time of injury and also being able to track cognitive recovery during the post-concussion period is crucial. Schools and clubs as HeadSmart™ members receive the value-add of free CogState concussion assessments as part of their membership for the year.

Concussion symptoms
Brain monitoring
Brain monitoring
Signs of concussion
Long-term brain function monitoring

Many athletes and players report suffering the long-term after-effects of repeated, poorly managed head injuries and concussions during their playing days. Again, many may seek compensation for damages and losses incurred while playing at your school or club. HeadSmart™ securely stores all CogState computerised concussion assessments in cloud-based servers which comply with national privacy laws, have been subjected to security and performance testing. Your information is completely confidential with us. The concussion specialists at HeadSmart™ are in a position to alert you to assessment reports showing either deteriorating or prolonged impairment of brain function in an athlete or player at your school or club.

Cognitive test
Specialist E-consulting
Cognitive test
Specialist E-consulting
Cognitive test
Specialist E-consulting


Cognitive test
Specialist E-consulting
Mouthguards
Specialist E-consulting

Renowned sports concussion specialist, Dr Ryan Kohler, medical director at HeadSmart™, is always on hand to provide important medical advice and / or perform remote area consulting via conference call as a cost effective service to all HeadSmart™ members.

Concussion
Risk profiling
Risk profiling
Concussion
Risk profiling

Prior to the season, it is very important to understand an athlete or player’s baseline symptom profile, their past concussion history and the presence of any co-existing modifying factors. This information may affect the management decisions. HeadSmart™ uses an effective mobile documenting system that all physio’s and doctors can use to screen athletes and players before a season or tour and conveniently have all that information available when a head injury occurs away from home base.

Sport injury
Back to school
Back to school
CTE
Back to school

Before returning to exercise, HeadSmart™ advocates that athletes and players have returned comfortably to activities of daily living. In addition, the importance of participation in school for learning and work for earning an income, have to take priority over exercise initially. Being able to document that an athlete or player is coping with the memory and concentration demands of a full day of work or school, is a realistic goal in the context of concussion recovery.

In reality, once this is achieved, a staged exercise progression can begin. It is impractical to tell an athlete or player to rest completely. The brain never truly rests. Responsibilities and activities in life make that ideology a pipe dream. In the early stages of concussion, perform school and work to levels that do not worsen the way you feel with concussion (symptom load).

Concussed
Back to exercise
Back to exercise
Post concussion
Back to exercise

Athletes or players are often “champing at the bit” to get back to their respective sports after concussion. The challenge is to hold them back long enough to tick all the head injury protocol boxes, yet no longer than necessary just to satisfy a rule or guideline, which has no scientific basis, stipulating a set time away from the sport. As mentioned earlier, HeadSmart™ advocates a scientific and objective approach to individualised concussion management. Focusing performing on balance and co-ordination skills early on does not increase heart rate or blood pressure and is therefore a relatively safe way of having the athlete or player pro-actively starting their concussion recovery. Exercise rehabilitation can start soon after the injury. Make sure that the exercise load is below the level that would worsen symptoms.

Head injury
Clearance certificate
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Medical clearance certificate

In line with the third key principle of United States, an athlete or player, who has been diagnosed with concussion, must be medically cleared by a qualified medical doctor before starting contact training drills.

Testimonials

Brain injury Preston Campbell
Former NRL halfback and fullback

The Sports Concussion Programme is a national sports concussion programme reaching out to all aboriginal communities – giving them the tools to help those who get concussed. Tell your mates about what this programme can do for them.

Brain injury Stephen Ng
Matrix Boxing Gym

This is a massive step forward not just for our club but for our sport in managing the return to contact work more accurately and helping manage the brain health and wellbeing of our fighters during and long after competition.

concussion test Steve Devine
former All Black player

All our brains are the same, they are soft jelly that needs time to recover.Get all the help you need for concussion by joining Doc Kohler and his team Sports Concussion Team.

concussion assessment Elton Flatley
Former Queensland Reds player

The Sports Concussion Programme tells you exactly what to do before injury and what to do after injury – download all the Apps that you may need and get your brain function checked before it’s too late.

sports concussion Patrick Lambie
Super Rugby player

After being late tackled and concussed against Ireland 3 months ago, I struggled to start exercise again. Dr Kohler and the HeadSmart™ Sports Concussion Programme helped me with my return to exercise programme with specialist advice that I would not necessarily have had


Meet The Team

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Loss of consciousness
Dr Ryan Kohler
Medical Director
Loss of consciousness
Dr Ryan Kohler

Dr Kohler, an Australian and South African specialist in sports injuries and sports concussion, in 2012 founded the HeadSmart™ Sports Concussion Programme. Working as the medical director for the programme, Kohler prepares and overviews all content presented on the HeadSmart™ Sports Concussion Programme website. Prior to publication of all concussion content on the website, Kohler consults with a copywriter to make sure that the language is easily understandable by medical and non-medical persons alike. No other person is permitted to modify that content. Content is reviewed for readability within Microsoft Word using: Flesch Reading Ease and Flesch-Kincaid Grade Level.

Dr Kohler is the founder and current co-director of the South African Sports Concussion Programme and was responsible for the implementation of the South African Rugby Union’s (SARU) concussion management protocol in 2001.
Kohler graduated from the University of Cape Town Medical School in 1997 and completed a Master’s Degree in Sports Medicine at the University of Cape Town and South African Institute of Sport in 2003. Over a 7-year period from 2004 – 2010, Kohler gained invaluable experience as senior team physician for the Stormers Super Rugby team, Western Province Currie Cup team and as team physician for the South African Rugby Union.

Following that, Kohler worked at the Australian Institute of Sport for 4 years (2011-2014) as a sports physician gaining valuable experience in working with Australia’s Olympic and Paralympic elite athletes.
In 2015, Dr Kohler opened practice on the Gold Coast of Australia, Dr Kohler Sports Injuries Specialist, which has a large focus on the management of sports concussion, seeing between 450-600 sports concussion per year.

Expertise
Dr Kohler is a Fellow of the Australasian College of Sports Physicians (FACSP), American College of Sports Medicine (FACSM), the Faculty of Sport and Exercise Medicine in the United Kingdom (FFSEM UK) and Fellow of the International Federation of Sports Medicine (FFIMS). He has several publications in the field of concussion and has presented at national and international conferences on the topic of concussion in sport.

Concussion
Dr Manny Pohl
Corporate strategy
Sports concussion
Dr Manny Pohl

Dr Manny Pohl is the Chairman and CIO of investment house EC Pohl & Co which he founded in June 2012. Dr Pohl is the managing director of Flagship Investments Limited. With over 29 years of investment and corporate strategy experience, Dr Pohl has served on the boards of several major corporations in his native South Africa and his adopted home Australia. He has extensive experience in the funds management industry both in Australia and the UK.

Sports concussion
Reg Williams
Corporate Governance
Sports concussion
Reg Williams

Mr Williams is an experienced businessman across a number of industry sectors with a particular interest in sport and corporate governance, strategy and risk management matters. Reg has been involved with the HeadSmart™ business from its inception and continues to provide strategic guidance to Dr Ryan Kohler and his team.

Impact concussion
Dr Geoff Brooke
Corporate strategy
Sports concussion
Dr Geoff Brooke

Dr Geoff Brooke founded GBS Venture Partners in 1996 and has 30 years’ venture capital experience. In January 2014, he stepped back from day to day operations at GBS and is now Special Adviser to the firm and its funds. Geoff was formerly President of Medvest Inc., a US-based early-stage venture capital group he founded with Johnson & Johnson. Geoff's experience includes company formation and acquisitions, as well as public listings on the NYSE, NASDAQ and ASX exchanges. He has been a founder, executive, director and chairman of private and public companies and has an extensive international network. Geoff now works with a number of Australian and US companies, helping them reach their full potential. From 2009 until 2015, he was an independent director of the Victoria Workcover Authority (Worksafe).

Geoff is licensed in clinical medicine by the Medical Board of Victoria, Australia and his post-graduate work was in anaesthetics/intensive care. He earned his Bachelor of Medicine/Surgery from the University of Melbourne, Australia and a Masters of Business Administration from IMEDE (now IMD) in Lausanne, Switzerland.

Loss of consciousness
Ryan Botha
Legal
Sports concussion

Mr Botha has extensive experience in corporate law, corporate strategy and sports law since obtaining his Master’s degree 13 years ago. Having owned and managed large legal firms, Ryan brings extensive experience and valuable knowledge to the HeadSmart™ Sports Concussion Programme and is key to planning, partnership and sponsorship agreements, as well as liability advice and user confidentiality focus. In a rapidly expanding field, sports concussion and how it impact all sectors of the community has been a keen interest of Ryan’s in recent times allowing the implementation of practical strategies for HeadSmart™’s focus on community concussion management.

Concussion
Janet Nicolson
General Manager
Sports concussion
Janet Nicolson

Janet provides brings a wealth of valuable administrative and accounting knowledge to the HeadSmart™ Sports Concussion Programme. Integral to the smooth day to day running of the business, Janet efficiently manages both internal and external general managerial tasks. Janet has undergone additional training in business management and accounting. Her skill set ensures that HeadSmart™ customers receive only the best in professional advice and service.

Sports concussion
Bronte Behns
Marketing Graphic Design
Sports concussion
Bronte Behns

Bronte brings incredible creativity into the graphic design, digital media, print design and marketing role with the HeadSmart™ Sports Concussion Programme. After graduating from Griffith University with a degree in Digital Media and Marketing, Bronte has gained broad experience in the corporate sector in the last few years. In addition, Bronte has a special interest in social media marketing and content design, thus growing HeadSmart™ brand awareness.

Impact concussion
Yujun Wang
IT Manager
Sports concussion
Yujun Wang

Yujun graduated from Bond University with a Master’s Degree of Information Technology. Experienced in web development, server administration and IT projects management, Yujun manages the HeadSmart™ Sports Concussion Programme servers. HeadSmart™ uses the web-based CogState sports concussion test which can be customised user requirements. The iPad version is soon to be released.

FAQ

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What is concussion?
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What is concussion?

Concussion is an injury to the brain that occurs as a result of an impact to the head or body. Any impact to the head of sufficient force can cause structural brain injury, which can be seen with the naked eye on brain scans. Or the impact can cause concussion, which is an injury to brain nerve cells that does not necessarily show up on brain scans. Concussion is a disturbance of brain function which manifests in different athletes or players in many different ways.

The fundamental change to the concussed brain is a slower speed to take in and processes information. The delay in reaction time that occurs is caused by damage to nerve cells (neurons). Therefore, the message signal that is transmitted along the damaged nerve, transmits much slower.

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The nerve cells can be damaged by a direct blow to the head, which causes the brain to rotate and/or move forward and backward. Indirect impact to the body can transfer an impulsive force to the brain and have a similar outcome.

Looking at how the brain nerve cells dysfunction in a more detail gives further understanding into the condition. The brain rapidly decelerates in the skull with impact causing changes to the pattern of neuron conduction, glucose metabolism, membrane protein expression and brain blood flow. The net effect of these changes is an energy shortage for the brain. An indirect marker of the brain’s energy balance is N–acetylaspartate (NAA). NAA is measured using proton magnetic resonance spectroscopy (MRS) and can be used as an index of metabolic recovery after concussion in athletes.

NAA levels have been found to be decreased for up to 30 days after concussion - long after the athlete reports to feel well and most likely has returned to sport. This phenomenon may put the brain at further risk of a second concussion if a second head impact occurs during this window of vulnerability.

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Loss of consciousness is uncommon and occurs only in 10 - 20% of concussion cases. If managed correctly, recovery from concussion may take 10 - 14 days. 10 - 15% of athletes or players may take longer to recover (weeks to months). The group of athletes or players who take longer to recovery should be managed by a multidisciplinary team of concussion specialists.

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Do you lose consciousness?
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Do you lose consciousness?

What are the key signs that an athlete or player displays when sustaining a head knock? It’s important to recognise these signs and remove the athlete from the playing environment immediately. These signs may be quite subtle and careful observation is needed to recognition.

concussion test Download the FirstResponder Concussion Recognition App today

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How does concussion feel?
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How does concussion feel?

Athletes or players may feel symptoms after a head injury and not necessarily recognise what they are feeling as concussion. It may be necessary to specifically ask the athlete or player the following checklist of symptoms after a head knock. Should an athlete or player exhibit one or more of these symptoms, they require an immediate concussion assessment by a qualified medical doctor. The constellation of concussion symptoms includes;

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It is important to bear in mind that sports concussion cannot be diagnosed at one point in time. Symptoms can evolve over time and serial assessments must therefore be performed, so other conditions that can mimic concussion are ruled out.

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Are there complications?
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Are there complications?
Recurrent concussion
Delayed recovery time
Post-Concussion Disorder (PCD)

Post-concussion disorder is a group of conditions that can produce prolonged symptoms for an athlete or player after concussion. Little is known of why the physiological changes persist and why it affects some people and not others. Assessment of the athlete should determine whether the symptoms are indeed the physiological effects of the concussion or are the symptoms related to a co-existing neck injury, mood disorder, migraine history or an inner ear disorder (vestibule-ocular injury). A specialist in concussion management will be able to make the definitive diagnosis and plan specific treatment.

Second-Impact Syndrome (SIS)

Experiencing a second concussion before the symptoms of the first concussion have resolved, can prove fatal. With SIS, the brain usually swells rapidly due to its inherent vulnerability following the first head or body blow. The secondary event, together with the altered levels of brain chemicals typical of concussion, can hamper the brain’s ability to self-regulate the amount of blood flow to the brain. SIS can result in increased cerebral blood volume and rapid brain swelling, particularly amongst young athletes. Diffuse cerebral swelling (DCS) may be a more accurate descriptor for this rare condition which could relate to genetic susceptibility rather than impact alone.

Chronic Traumatic Encephalopathy (CTE)

CTE is a progressive neurodegenerative disease of the brain which has been linked to persons with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic sub-concussive hits to the head. The repeated trauma to the brain triggers a progressive degeneration of the brain tissue. Memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia have all been shown to be possible symptoms of the disorder. The onset of disease can begin long after the last brain trauma, and has typically only been diagnosed after the death of the athlete or player. Recently, a study in the USA has utilized brain scan technology to develop a potential test for CTE. At this stage, no definitive cause and effect relationship has been found between concussion in sport and CTE. Research is ongoing in this area both in Australia and the United States.

HeadSmart™ sports concussion tests can quickly and effectively detect concussion after an injury, allowing for immediate removal from play and referral to a medical doctor.

Neuropsychology
Is baseline screening important?
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Is baseline screening important?
RISK PROFILING

A baseline computerised screening is a brain function assessment that is routinely used to establish normal thinking ability in an athlete or player. The results of a baseline screening can be compared to the results of an after-injury computerized brain function test to assist in the diagnosis of concussion and plan recovery.
A computerised baseline screening typically evaluates the athlete or player:

Concussion

Baseline computerised brain function testing is important for the following reasons:

Concussion outcomes can be unpredictable. Athletes and players participating in contact and collision sport should have a CogState baseline test before injury. This practice improves the ability of doctors to manage athletes back to sport safely. Objective information about the athlete’s brain function is one part of the overall care.

International team physicians find baseline and after-injury computerised testing very helpful. Individualized comparisons of brain function improved the accuracy of return to play decisions. Players self-reporting of their symptoms is subjective. The team physician is therefore relying on the honesty of the player when asked to answer questions about having concussion symptoms. The objective data that the CogState test provides is an invaluable piece of the return to play puzzle.

Concussion symptoms
What to do in first 48 hrs?
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Signs of concussion
What to do in first 48 hrs?

The first 48 hours post-concussion are vital in minimizing health risks from concussion and ensuring an optimal recovery timeframe.

During this period parents, coaches, teachers and other responsible adults are encouraged to monitor the athlete or player as closely as possible for the onset of signs of more severe complications.

The risks of epidural hematoma and subdural hematoma may manifest hours or even days after the head trauma.

If the athlete or player is unconscious, basic first aid principles apply. Protect the player’s neck and secure an open airway. Urgent hospital referral is necessary for any player who has lost consciousness as a result of a blow to the head or body.

Do’s

Don’ts

Head trauma red flags

What to do on the first night as a parent or guardian?
Uninterrupted sleep is thought to be the best medicine for concussion symptoms. The only time it’s recommended to periodically wake the patient to monitor symptoms is if there was loss of consciousness or amnesia at the time of the trauma, or the signs of concussion such as headaches, vomiting, dizziness or sensitivity to noise and light are still present. In this context, checking to see that the athlete or player is rousable once during the night, is sufficient.

Read the full article here: http://bit.ly/2csDddL

Head injury
If scan is normal?
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Post concussion
If scan is normal?

A normal brain scan does not exclude concussion. All that a normal brain scan indicates is that there is no structural injury to the brain. Concussion cannot be seen on a CT or MRI scan, therefore clearance cannot be given to a player to return to sport on the basis of a normal CT or MRI scan.

While baseline, side line and remote concussion tests can reliably assess brain function pre and post- concussion, they are not designed to detect structural damage within the brain. Instead, brain imaging can be used to assess whether there is swelling or bleeding of the brain.

Consider conducting brain scans if the athlete or player displays any of the following signs;

In addition, the following groups of sportspersons are at heightened risk of brain injury;

There are several brain scans currently available based on different technologies and techniques.

CT Scans
A CT or computerised tomography scan is one of the best techniques to evaluate bleeding or swelling of the brain within the first 24 to 48 hours post-concussion. It is also preferred over an MRI to detect skull fractures, as it is faster, more affordable and easier to perform. A disadvantage is that it cannot show microscopic damage to neurons and brain function disturbance.

MRI Scan
A magnetic resonance imaging (MRI) scan is arguably the more appropriate imaging procedure 48 hours or longer after an athlete or player has suffered head trauma. It is particularly accurate in detecting traumatic lesions of the brain and does not expose athletes or players to radiation. Changes in white matter tracts, degraded blood products or small capillary bleeds around nerve cells can also be identified on MRI.

DTI Scan
Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique which provides a calculable measure of the often subtle changes within the white matter tissue of the brain following concussion. These changes may provide clues as to why concussion manifests with certain neurological symptoms. Despite showing tremendous potential, DTI may not be applicable to the routine evaluation of concussion.

Post concussion syndrome
Who should you see?
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Concussion Test
Who should you see?

An athlete or player with a head injury must see a medical doctor as soon as possible to make an accurate head injury diagnosis of concussion.

It is important to bear in mind that concussion cannot be diagnosed at one point in time. Symptoms can evolve over time and serial assessments must therefore be performed over time, and other conditions that can mimic concussion should be ruled out.

Concussion treatment
Should I use medicine?
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concussion
Should I use medicine?

One of the most prevalent symptoms of concussion, present in almost 90 percent of cases, are headaches. Pain relief in the early stages post injury is known to assist a normal recovery process by making the athlete or player feel better. The only analgesic medication recommended by health care professionals for the safe and effective treatment of early concussion headaches is paracetamol.

An initial period of rest (24-72 hours) combined with safe, effective pain relief is the best first aid for the symptoms of concussion.

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When to start school?
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concussion assessment
When to start school or work?
COGNITIVE REHABILITATION PROGRAMME

Students or workers recovering from concussion can worsen their symptoms by attempting full school or work days, normal homework and testing too early in their recovery. A delay in testing, less school hours and frequent breaks between classes, would be appropriate. Wait until the learner has minimal symptoms and near normal concentration before increasing the load on the brain. Limiting the use of computers, mobile phones and television viewing soon after concussion, can allow recovery at a normal speed. A similar approach to managing the load on the brain in children can apply for adults returning to work after concussion. However, no studies have yet provided guidelines on a clear return to work progression for adults. Remember, it’s not possible to speed up brain cell recovery beyond the normal healing rate, but you can slow it down.

HeadSmart™ members receive individualised school and work progression guidelines.

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When to start exercise?
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When to start exercise?
Exercise Rehabilitation Programme 2017

Deciding when an athlete or player is ready to start exercise an art and not an exact science. Once an athlete or player is back to hours at school or work, start a balance and postural stability re-training programme. A progression to light aerobic exercise can follow the initial static balance and co-ordination re-training. 23 - 81% of persons report dizziness and balance problems in the first few days after concussion and 16 – 18% of concussed athletes may have ongoing dizziness for 3 months. Hence, the importance of balance training.

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Concussed athletes also have an increased risk of lower limb injury following concussion. This finding in recent studies is proposed to be caused by impaired body position sense and awareness. Balance drills should continue for months after the athlete or player is back at sport. Physical Therapists are in an excellent position to supervise, individualize and adapt this form of rehabilitation. Balance training programmes are effective at treating dizziness and improving balance after head injury.

Once symptoms of concussion have disappeared and the athlete or player is feeling their normal selves, coping at full work or school and has progressed through an element of balance training, start light non-impact loading aerobic exercise and progress through a number of stages, ending with high intensity sports specific exercise activity.

It is very important that an athlete or player be evaluated by a medical doctor and cleared before starting high risk or contact training activity, and not simply return on their own time.

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Stage Exercise Progression
1 Balance & co-ordination drills Reaction time and co-ordination programme as prescribed by physio or trainer If a low number of symptoms are present, may start Stage 2
2 Light cardiovascular exercise Light jogging for 10-15 minutes, swimming or stationary cycling at low to moderate intensity. No weights training If no symptoms, start Stage 3 after minimum of 24 hours. If symptoms occur, rest 24 hours & repeat Stage 2
3 Impact loading cardiovascular exercise Individual running drills and skills without contact. No weights training If no symptoms, start Stage 4 after minimum of 24 hours. If symptoms occur, rest 24 hours & repeat Stage 2, then progress
4 Sport specific non-contact training More complex training drills. May start progressive (low level) weights training If no symptoms, medical certificate required before Stage 5. If symptoms occur, rest 24 hours & repeat Stage 3, then progress
5 Sports practice Full contact practice following medical clearance certificate being handed to the club or school sport master Player, coach, parent to report any symptoms to medical doctor. If symptoms occur, then medical doctor to review
6 Sports game Unlimited sport participation Monitor for recurring symptoms or signs

concussion test
Concussion symptoms
Need doctor's clearance?
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Brain injuries
Need doctor's clearance?
CONCUSSION CLEARANCE CERTIFICATE

Once an athlete or player has completed the 4 Stages of exercise progression prior to contact training, a medical doctor should re-assess the case. The medical doctor needs to review copies of the after-injury CogState test performances in comparison to the baseline scores. In addition, review evidence of the athlete or player feeling completely well during the 4 exercise progression stages. The athlete, player, parent or guardian should take full responsibility for the final decision to return to contact training based on the medical advice given.

sports concussion
Can concussion be prevented?
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Brain damage
Can concussion be prevented?

Parents, coaches and athletes have a vested interest in concussion prevention. In the competitive world of professional sports, it is now common practice to have a well-rehearsed action plan in place to deal rapidly and effectively with concussion. An effort has been made to prevent concussion in sport. At school level, where younger athletes are particularly vulnerable to concussion, these efforts are important.

Education & awareness
Increased awareness of subtle behaviour changes in children can alert parents to possible concussion. Mood swings, heightened emotions, restlessness, irritability, poor school performance and lethargy are common symptoms of concussion in children that should be identified as soon as possible.

Rule Changes
A number of sporting codes have introduced rules to avoid dangerous play. In 2012 the NFL banned players from using their helmets to impact players on the head or neck, whereas in rugby, spear tackles, where a player lifts and dumps a player on his head, is deemed a red card offence.

mouthguard
Do mouthguards help?
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concussion assessment
Do mouthguards help?

The use of mouth guards has been shown to reduce dental injuries and maxillofacial injuries. Biomechanical (laboratory) studies demonstrated that mouth guards reduced impact forces applied to the jaw from being transmitted to the brain. Clinical concussion studies have not shown that athletes or players using mouth guards have fewer concussions.

Brain injury
Does headgear help?
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concussion test
Does headgear help?

Helmets are compulsory in certain high speed sports. Cycling, skiing and motorsports use helmets to reduce the chance of severe structural brain injury. Protective headgear does not prevent or reduce the severity of concussion in sport.

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How common is concussion?
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concussion recognition
How common is concussion?

Concussion can occur in virtually any sport. Concussion is notoriously under-reported. Actual numbers are potentially much higher than currently thought. 1.6 to 3.8 million concussions occur in sport every year in the United States. In Australia, the probability of being concussed while playing in any of the football codes is approximately 1 in 7.

Below are reported rates of concussion in a range of sports;

AFL (community, junior, elite):

Rugby League:

Rugby Union:

concussion recovery

In wheelchair basketball:

In the United States:

Sport / 1000 hours exposure
1. Horse Racing (amateur) 95.2
2. Taekwondo (competition) 50
3. Mixed Martial Arts 48.3
4. Horse Riding (jumps) 25
5. Kick Boxing 19.3
6. Horse Racing (flats) 17.1
7. Boxing (professional) 13.2
8. Rugby League 14.4
9. Rugby Union (junior) 10.1
10. Rugby Union (professional) 9.1
11. Rugby Union (amateur) 5.1 - 7.9
12. Aussie Rules 4.1
13. Rugby Union (sevens) 3.01
14. Soccer 0.5
15. Basketball 0.4
16. Wrestling 0.4
17. Field Hockey 0.2
18. Gymnastics 0.2

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