Making rugby safer through science and protocols: Understanding and managing concussions in contact sport

In the past, diagnosing a concussion relied on just two criteria – loss of consciousness and amnesia. Now, with over 2src criteria, the science of head injuries has evolved. Dr. Jon Patricios, co-lead author of the latest international consensus statement on concussion in sport, delves into the nuanced signs and management of concussions. While there are no current biomarkers, advancements in research hold promise. With evolving rules and protocols, the sports world is safer, but concussion risk remains inherent.

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By Jon Patricios*

Two decades ago there were only two criteria used to diagnose concussion. Jon Patricios, a sport and exercise medicine physician and co-lead author of the latest international consensus statement on concussion in sport, discusses the science of head injuries and some of the protocols adopted by World Rugby to make the game safer.

What is concussion?

Concussion is a traumatic brain injury that occurs as a result of a force that’s transmitted to the brain. It manifests as a functional change in the way the brain operates. Most are transient and resolve completely if recognised and managed appropriately. 

Usually, we don’t see structural changes in the brain in the case of a concussion. In other words the brain scans look normal. And so what we have available to us, what I call the visible wound, is the changes in brain function. 

That’s what we as medical professionals treating concussion look for, what we assess and what we manage. 

What are the obvious signs of concussion?

Things like loss of consciousness, or a seizure, clear disorientation, or inability to walk or poor coordination. 

When I started working with professional rugby players in 1995 as a rugby team doctor there were only two criteria which classified you as conc