Sports Physician Assessment

Although the emergence of technology has enhanced our approach to the assessment of the concussed athlete, clinical evaluation remains essential if we are to truly individualise concussion management and return-to-play decisions. Updated protocols published in 2023 form the basis of our assessments.

The sports physician with Sports Concussion South Africa countrywide have experience in treating athletes from school to international level. In addition, each Sports Concussion Centre has an established network of consultant neurologists, neurosurgeons, radiologists and neuropsychologists. This multi-disciplinary approach, co-ordinated by the sports physician, will allow for the most appropriate decision to be made for that individual.

The clinical assessment begins field side and is followed up with several serial medical consultations that may or may not include a computer test.

Important Assessment Criteria

A thorough history from the player and witnesses (family, team mates, coaches & referees) trying to elicit mechanism of injury, signs of concussion & immediate management:

Previous concussion history

  • Number of episodes
  • Dates
  • Management of each

Co-existing medical conditions

  • Attention Deficit Disorder
  • Depression
  • Medical Conditions

22 symptom analysis and scoring

  • At time of injury
  • At time of consultation
 

Neurological & Medical Examination

  • Sensory
  • Motor
  • Co-ordination
  • Assessment of any co-existing neck injury

Balance & Visual Field Assessment

  • Static
  • Dynamic

Cognitive Assessment

  • Immediate Recall
  • Delayed Recall
 

Decisions are then made regarding the need for:

  • Brain imaging (CT/MRI scans).
  • Neurosurgical opinion.
  • Hospital admission or home discharge.
  • In depth clinical neuropsychological assessment.
  • Follow-up consultations.
 

Ongoing education of the injured player is essential and, particularly in the acute stages following injury, it is preferable to have a family member present to explain the nature of the condition, the assessment protocols and the return-to-play process.

The final consultation will clear the player based on the combined clinical findings and computer analysis. The player is then presented with a return-to-play programme.

No player should be cleared for play without seeing a medical doctor & following the recommended step-wise management protocol.

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