Para athletes need better concussion protocols, experts say

Concussions in pro sports have been put under the spotlight in recent years, but one group of athletes still remains particularly vulnerable: para athletes.

Now, a group of medical experts is calling for a “heads up” on concussion in para sports, saying that its concussion testing remains inadequate in comparison to the revamped guidelines and protocols that have been put in place for other sports.

One of the more interesting sports to make its way into recent Olympic Games is football five-a-side for the visually impaired. Played on a smaller pitch with a narrower goal and boards, all players except the goalkeepers wear blinders to even the play and the ball is fitted with a noise-making device to allow players to locate it.

The play can be exciting and fast-paced yet it also produces more than its share of injuries and collisions. During the London 2012 Paralympics, for example, football five-a-side for the visually impaired had the highest incidence of injury of all sports.

Para athletes: concussions need a set of guielines…

“The sound of visually impaired footballers colliding as they ran for the ball resonated around stadiums and highlighted that an injury prevention programme is needed urgently,” reads a statement in the British Journal of Sports Medicine from an international group of experts including representatives from Canada and the United States. The group are now calling for more attention to be paid to concussions in para sports and the development of guidelines specific to concussion in para sports.

“It is time for the clinical and research community to put their heads together—figuratively—to help address this important but poorly understood issue,” says the group. “For this to be successful, urgent focus on Para athletes is needed within the broader academic and public discourse on concussion.”

As pro sports organizations like the National Hockey League and the National Football League continue to refine their guidelines for dealing with concussions, the international sporting community has joined in, with the International Conferences on Concussion in Sport putting forth recommendations for concussion protocols, saying all potential cases of concussion should undergo medical assessment of the elements such as an athlete’s mental status, cognitive functioning, balance and gait.

Yet, for the para athlete, applying such guidelines is not so simple. Assessing balance for paraplegic or amputee athletes, for example, requires its own approach, as does checking cognitive and mental factors for athletes with cognitive and/or communication impairments.

“Our understanding and guidelines regarding assessment, management and prevention of concussion in Para athletes is lacking,” say the editorial’s authors. “There are several Para sports in which the risk for concussion is elevated due to speed of play, impact potential, lack of protective equipment, including road cycling, ice sledge hockey and alpine downhill skiing.”

The report states that like able-bodied athletes playing many sports, para athletes are often prone to downplay injuries so as to “tough it out” or from fear of being remove from play. In particular, over the course of their lives, para athletes have often experienced significant medical conditions or trauma and thus can display a tendency to brush aside head or neck injuries suffered during play as being a small concern by comparison.

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