Concussion

CONCUSSION RECOGNITION AND MANAGEMENT - INFORMATION FOR NON MEDICAL PROFESSIONALS

What is a Concussion?
Concussion is a traumatic brain injury that interferes with normal brain function. Concussion is caused by a biomechanical force or hit, to the head or body, transmitted to the brain. One may be concussed with or without loss of consciousness.
Concussion is an underdiagnosed condition which is important to recognise and manage appropriately. While diagnosis needs to be done by a health care professional, any person can assess whether concussion has occurred using the Concussion Recognition Tool (CRT5). It is a good idea to print out this document and keep it available when working with or around horses.
Please also make sure to seek professional advice whenever concussion is suspected.

Protective headgear is an essential element of protection against a number of head injuries. For additional information on protective headgear, please click here.

For health care professionals, more detailed information on concussion is available here.

CONCUSSION MANAGEMENT
Concussion management is very important to make sure that all symptoms have cleared before return to riding. This is because further damage may occur if the brain receives additional impacts before it has fully recovered from the initial concussion episode.
Key principles:

1.  Any athlete with concussion or suspected of having a concussion should be evaluated by an appropriate* health-care professional that day.
2.  Cognitive judgement, balance and coordination are impaired in concussion injury. The athlete must not return to riding a horse on the same day
     of a concussion.
3.  Any athlete with a concussion must follow the stages of return to riding outlined below.

Stages of Return to Riding:
If at any of the stages indicated below the athlete becomes symptomatic, he/she should revert to the first stage of activity for 24 hours before attempting again to move on to the next stage.

1.  Rest - No activity, complete cognitive and physical rest, do NOT Ride a horse. Once asymptomatic proceed to stage 2.
2.  Progress to light aerobic training (walking, jogging), no resistance training.
3.  Progress to sports specific exercise, e.g. riding on the flat, hacking.
4.  Gradually increased training intensity.
5.  Full training when symptom free.
6.  Back to equestrian competition after completion of the Concussion Return to Play form by an appropriate* health care professional.
*Health care professional experienced in the management of sport concussion in line with the International Concussion in Sport Group Guidelines.

FOR FEI OFFICIALS: CONCUSSION MANAGEMENT AT FEI EVENTS
The FEI's Concussion Policy includes:

• A flow chart outlining the process to follow at FEI Events in order to determine whether a concussion should be suspected following a fall or heavy blow, and the next steps that should be taken.
• Copies of the CRT 5, SCAT 5 and Child SCAT 5 tools
• The FEI Return to Play form, to be used by FEI athletes who have been diagnosed with concussion, in order to confirm their fitness to compete to their National Federation once the steps to recovery have been successfully followed.