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Sport'Fear of reporting concussion': understanding cricket's concussion policy

15:05  19 august  2019
15:05  19 august  2019 Source:   theage.com.au

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'Fear of reporting concussion': understanding cricket's concussion policy© AP Australia's Steve Smith recieves treatment after being hit on the side of the neck in day four of the second Ashes Test.

When Steve Smith was hit on the side of his neck by a ball and collapsed, the crowd at Lord’s Cricket Ground fell silent midway through the fourth afternoon of the second Test on Saturday. But for the concussion management team, it's a situation for which they are well prepared.

For many watching, the incident brought back memories of the 2014 Sheffield Shield match at the Sydney Cricket Ground, when Phillip Hughes was struck by a ball. He never regained consciousness and died two days later.

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As Smith lay on the ground, the Australian and England team medical teams rushed onto the field and started carrying out a series of on-field assessments. They then guided Smith off the field for further tests, while Marnus Labuschagne replaced the Australian batsman under recently implemented concussion substitution rules.

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Smith passed concussion testing and returned to bat. But after his condition deteriorated overnight, he didn't take to the field on day five.

Smith's return for the third Ashes Test at Headingley later this week is uncertain. While he remains hopeful, his return will depend on the results of future assessments.

What is Cricket Australia’s concussion policy?

Cricket Australia’s concussion and head trauma policy outlines how blows to the head or neck must be handled, including when a concussion substitute may be used.

Following a hit, players are to undergo an on-field assessment, in which medical personnel will check for dizziness, amnesia, altered balance or uncontrolled falls.

If a concussion is suspected, the player will be taken off the field for further assessment under the SCAT5, or the sport concussion assessment tool - fifth edition, and computer-based neuropsychological assessment known as CogSport tests.

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The former is used across a variety of sports, by organisations such as the Olympics and FIFA.

SCAT5 testing involves a physician or licensed healthcare professional taking a comprehensive background check of the athlete, an immediate memory test, a balancing examination, a memory test and coordination tests.

Dr Adrienne Withall from the School of Public Health and Community Medicine at the University of NSW said while the SCAT5 is a good measurement, it relies on players self-reporting their symptoms. This can lead to players shaking off a concussion.

“I believe there is a fear of reporting concussion, with people being scared,” she said. “They are worried they will be pulled out of doing what they love.”

Taking this into account, she said Smith should be “applauded” for his openness.

"It’s a great role model position that he has is," she said. "The culture [of concussion] is changing, the team isn't disadvantaged through your concussion."

Associate Professor Michael Buckland from the University of Sydney said there has been a significant shift in sporting codes to identify and manage concussion in the last ten years, particularly as the long-term effects become more well-known.

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“We are more in turn with what we need to pick up and [be] looking out for," he said.

Neck guards - recommended or mandatory?

There had been little research into the use of the guards before Hughes' death in 2014, but following the incident, British manufacturer Masuri developed StemGuards, a protective attachment.

Under CA’s concussion policy, the guards are recommended to “provide additional protection for the vulnerable neck/occipital area of the batsman”.

Smith tried using the clip-on attachment in the nets when it was launched in 2015 but felt the guard was uncomfortable and irritating. But following Saturday’s incident, Smith has said he will rethink his stance.

Cricket Australia's sports medicine chief has revealed the governing body is working towards having mandatory neck guards on helmets within the next year.

Pictures: Shots from the second Test of the 2019 Ashes series

'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
'Fear of reporting concussion': understanding cricket's concussion policy
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Rogers won't knock CA concussion approach.
Chris Rogers, who once missed a Test because of delayed concussion, says Australia are trailblazers in terms of concussion testing and protocols in cricket. " Rogers didn't complete a CogState test, the computerised program which compares results with a baseline performance and was responsible for one of Smith's red flags at Lord's on Sunday. It is one example of how the governing body has improved its approach to concussion, especially since Phillip Hughes' tragic death in 2014.

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