Many self-confessed ‘sports nuts’ pride themselves on knowing every rule, player and statistic of their favourite sport – typically using their sporting knowledge to win a Saturday afternoon argument in front of the television when the game is on.
But how much does the same fan know about the anatomical intricacies that cause their favourite player to be forced from the field with ten minutes left and the score locked at 12-12?
We’ve all heard the phrase ‘HIA’ discussed during an NRL game, but what exactly does that mean?
The term HIA refers to what is known as a head injury assessment. The HIA assessment is used to provide early recognition and subsequent treatment of traumatic brain injuries – most commonly, concussion.
Concussions are a medical condition and require immediate medical attention. Concussion involves a disruption in nervous system activity, with a section known as the reticular activating system, found in the brainstem, believed to be involved. Put simply, the reticular activating system is a network of nerve pathways that inevitability controls a person’s level of consciousness.
(AAP Image/Dan Himbrechts)
While there are no structural changes within the brain after a concussion, functional alterations that ‘stun’ the nervous system occur, resulting in possible signs of amnesia.
Typically, a player may experience anything from headache, blurred vision, fatigue, memory loss, nausea and/or decreased balance. Such symptoms may not seem all that serious, but total recovery typically takes 7-14 days and shows why your favourite player might not be able to return to the park for the next game – let alone the current one.
The SCAT3 is a common tool used by club doctor’s to help assess the presence of concussion during HIA testing. SCAT3 refers to ‘sports concussion assessment tool’ and examines things such as level of consciousness, cognitive ability, memory, symptoms present and balance and coordination.
When the results of the SCAT3 assessment suggest concussion, the player is ineligible to return to the field.
Playing on with concussion may seem brave, however, the risk concussion poses should not be taken lightly. Any potential concussion should be reviewed by a qualified health professional and treated with the urgency of any other medical condition.
After all, what is the point of a long rugby league career if you can’t remember it?
Luke Vella
Roar Rookie
That's the thing with stuff like concussion - you can still have residual functional disturbances even though you may feel fine. According to a document by the NRL there are 5-7 concussions per team per season. So that's anywhere from 80-112 players in any one season suffering from concussion. I think mandatory head gear could help lessen the impact of the blow, however, there's always going to be some sort of coup- contrecoup (from the brain moving forwards and backwards into the skull and causing brain contusions) injury due to rapid deceleration upon impact of a tackle. It's a dangerous sport, I'm not sure that can ever really be altered in any significant manner especially without taking anything away from the essence of the game we all love
The Barry
Roar Guru
Agreed that they need to come off for assessment. I got knocked out a few times back in my playing days. You could never really tell which would have the greatest effect. Once I got knocked senseless, was out cold for a while, didn't know what day it was, no way I could continue playing but bounced back pretty quickly. Another time I had a 'little one' and finished the game but was crook for a couple of days.
Luke Vella
Roar Rookie
I'm not sure where it can be improved to be honest. I definitely wouldn't want to be a trainer trying to assess them whilst the player is denying anything is wrong and the crowd are praying you don't take them from the field. Maybe third party trainers/doctors but then that's an issue too because they won't know the player's history as well as a club trainer/doctor would. I think due to the nature of concussion they really do need to be taken from the field for assessment. Because the onset of symptoms can be up to a few hours after the incident occurs, so you really need good assessment skills as to determine whether the player is suffering in any way. It's tough when you're trying to combine sheer brutality and athleticism with physical health issues.
The Barry
Roar Guru
By the way I think the biggest confusion comes from the role that trainers play in this process. Trainers do not administer the HIA on the field. They are supposed to see if there are any signs of concussion and if so remove the player from the field to have the assessment, which can be a tough gig for the trainer. There are also a series of signs / symptoms where players HAVE to come off for an HIA. There is no discretion to be shown by trainers or club medical staff. These include loss of consciousness, falling to the ground without protecting oneself, lying prone on the ground and stumbling. I think this is a difficult role for the trainer and a process that not all fans understand. What are your thoughts? Would you like to be in the trainers shoes even with your additional training? Can the process be improved?
The Barry
Roar Guru
Fair enough mate - it was a good beginners guide. My comments definitely came across more harshly than I intended.
Luke Vella
Roar Rookie
Hey mate, Well I am a qualified registered nurse so I'd assume I'm atleast somewhat qualified. Was writing the article last night after my shift and was obviously trying to be as basic as possible so that it could become a conversation piece for people who may not be in-the-know regarding concussions in sport. Would have figured any errors like that would have been fixed up by the editor's as mentioned. -
The Barry
Roar Guru
Yeah it was harsh. Unintentionally so though. I was just mucking around...I probably needed a couple of ??? to show that. In my head it wasn't meant harshly but it doesn't read well. Sorry Luke...
Matt H
Roar Guru
Harsh Barry. One grammatical error doesn't negate an entire article. The heading did say 'for beginners' after all. I'd hate someone to be reviewing all my comments for spelling mistakes. It wood bee terrabull. Maybe the editors could have picked that one up. It's not like the article is 1000 words long.
The Barry
Roar Guru
Fourth paragraph in you refer to an "HIA assessment" in other words a head injury assessment assessment. Not sure of your qualifications to be explaining the process. I'm just off to enter my PIN number into an ATM machine and do an EFT transfer.