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28 May 2016

Transcript: AMA President Professor Brian Owler, 774 ABC Melbourne with Hilary Harper, 28 May 2016

Subjects: Release of AIS/AMA Position Statement and website on Concussion in Sport 

HILARY HARPER: If you or your child have ever had a concussion during sporting activity, you'll know how frightening it can be. It's confusing and painful, and difficult sometimes to work out if someone is okay. Well the AMA says we might be being a bit too easy going in our approach to concussion, and they're launching some new guidelines today. Professor Brian Owler is the AMA President, up until tomorrow, I think Professor Owler?


HILARY HARPER: Well congratulations on getting these guidelines out in a very timely fashion. What's the gist of them?

BRIAN OWLER: Well look, it's a website that's being launched in conjunction with the Australian Institute of Sport, and the aim was really to provide a resource, not for the top levels, but for parents and teachers and coaches of young people playing sport on a weekend or during the week. The guidelines basically provide some information from experts, from the institute, but also from a GP, emergency physician, and myself as a neurosurgeon, about what concussion is, also how to identify the symptoms and then how to manage it.

HILARY HARPER: And what are the symptoms?

BRIAN OWLER: Well, obviously everyone knows if someone is knocked out - it's very obvious - but not everyone actually is temporarily knocked out or loses consciousness. Often people get a hard knock to the head; they can become confused or disorientated. They can experience headaches, as well as nausea and vomiting. And sometimes those symptoms will clear, but then may return when people actually undertake further physical activity; when they start to train and those sorts of things. So, it can actually take quite a while for the symptoms of concussion to actually clear up. And the essence of it is that people should not be returning to play until they've observed at least some time on the sidelines, and allowed all of those symptoms to completely settle.

HILARY HARPER: And you're recommending 14 days after the symptoms have cleared. So that's not 14 days after the event, that's 14 days after you've stopped having symptoms.

BRIAN OWLER: That's right. If you go back too early, you risk a second concussion and as we know from many of the stories that we see in some of the professional athletes, they have to give up their sport if they have too many concussions. So it's better, particularly in a young person with a developing brain, to give it that time to allow all of the symptoms to settle, and then return to play - well return to train usually first, then return to play after that. 

HILARY HARPER: What are the dangers if, particularly a child does return too early and if you get a second concussion, is that more dangerous than the first one?

BRIAN OWLER: Well, there used to be a theory that if you had a second concussion that you could develop very severe brain swelling, and that would obviously be, could be fatal or an episode in emergency. I think the evidence is fairly slim for that. What we do know though is that the compounding effect of having one concussion and then another seems to be more severe. So it is always better to try and let the brain recover; let all of the symptoms clear before getting back out on the field.

HILARY HARPER: What are the highest risk sporting codes?

BRIAN OWLER: Well, obviously those where there's body contact, so rugby league, rugby union are the obvious ones. AFL certainly can - well we all know can get concussions served, but sometimes other sports such as soccer and more rarely things like cricket, and basketball, and those sorts of things. But a concussion can happen whenever anyone receives a blow to the head. Usually it's a sort of twisting blow, not a straight on blow. But we know that it happens quite regularly even during Saturday sport. And the thing is, that I think many people still struggle to know what to do. Now the main treatment is simply rest. But actually having all of that spelled out on a website that parents can access, that their coaches can access as well, and get some, I guess, guidance about the best way to manage things, I think is a very good resource for those people.

HILARY HARPER: And it's great to know that the AIS and the AMA are on the same page here and working together to get that information out. Do you think that kids' sports need specialist concussion doctors on hand? Like the professional codes do?

BRIAN OWLER: No I don't think it needs that level of supervision. I mean most games are without incident at all, but we know that it happens from time to time. I think people that are involved in sport, whether they be referees or coaches, or the parents of a player, need to be aware of these guidelines, need to be aware how to manage concussion, the signs that they need to be aware of, but maybe a sign of something more significant, and so that they can take the appropriate actions. But I don't think we need a doctor on the sidelines of every sporting ground where young people are playing around the country.

HILARY HARPER: In the States where college football, in particular, is big business, they're trialling helmet sensors and impact sensors. Do you think that's something we might one day see here?

BRIAN OWLER: Well, I don't think it's going to get to that. And I think there are two issues there as well. One is, a concussion is usually a one-off event that happens when someone receives a significant blow to the head. But there's this other issue, Chronic Traumatic Encephalopathy, which comes about particularly in American Football where they use their helmets and their heads almost like battering rams. And that repeated concussion, or repeated blow to the head, time after time, seems to add up over the career of the player, and that's this CTE that we've heard being discussed and talked about, particularly in America. There's some interest here involving players in, particularly in the professional levels of sport, but that is a different, somewhat different, issue to the issue of a management of concussion itself.

HILARY HARPER: Professor Brian Owler, AMA President. Congratulations again on getting these guidelines on concussion out just before you finish up your term, and thanks for joining us today.

BRIAN OWLER: Thanks Hilary.

28 May 2016
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Published: 28 May 2016