CONCERNS over a lack of awareness over concussion in Scottish youth football has surfaced in a new study.

Research involving interviews with ten coaches found the majority had no knowledge of Scotland’s 'If in doubt, sit them out' initiative – the only sport-related concussion campaign in the world that has the backing of all sports and national government.

Risks include 'second impact syndrome' - when a blow causes swelling to the brain before it has recovered fully from an earlier injury.

The syndrome happens when a blow causes swelling to the brain before it has recovered fully from an earlier injury.

Young people fall into the high risk group if they have suffered a concussion because their brains are not fully mature.

Led by the University of Stirling, the researchers believe their research may point to a wider unfamiliarity with the policy among those who play a key role in recognising head injuries in players.

Alongside low levels of awareness of Scotland’s national campaign to protect the head in sport, any knowledge of concussion of those involved in the research had come from the media or social media, rather than specific training or guidance delivered through their sport, the new study says.

The guidelines brought in state that inall levels in all sports if an athlete is suspected of having a concussion, they must be immediately removed from play.

The Herald:

No-one should return to play on the same day with suspected concussion and all head injuries should be assessed by a healthcare professional Those who are suspected of being "knocked out" or have persisting symptoms such as headache, vomiting or unusual behaviour, need to be reviewed in an accident and emergency ward.

And any player with a second concussion within 12 months, a history of multiple concussions, players with unusual symptoms or prolonged recovery should be assessed and managed by health care providers with experience in sports-related concussions.

Dr David McArdle, head of the University of Stirling Law School, said: “This small study has shown us that awareness of 'If in doubt, sit them out' was far more limited than we had anticipated. With no meaningful knowledge of the initiative, coaches who are faced with a child who had received a bump to the head are not using the guidance to inform their decisions about what to do next.

“The policy was a fantastic, positive step forward in the discussion around concussion, putting Scotland at the forefront of progress around the issue, but it may be that more needs to be done to ensure coaches implementing the practice on the ground are aware of it so it can be as effective as possible.”

The researchers said the study sought to gauge coaches’ awareness of more immediate, short-term damage including ‘second impact syndrome’ – when the brain swells rapidly shortly after a person suffers a second concussion before symptoms from an earlier concussion have subsided.

Their findings are based partly on interviews undertaken in October 2018, which found that only one had heard of the 'If in doubt, sit them out' guidance which had launched earlier that year to encourage coaches, parents, players and others to recognise when a concussive injury may have been sustained.

And they believe the lack of meaningful understanding demonstrated by the group of coaches based at a mix of girls’ football clubs in central Scotland, may point to a "wider unfamiliarity".

Dr McArdle added: “The problem is that if even a ‘minor’ sports-related concussion is followed by another head-knock before it is resolved, the second impact can prove very serious. We want people, particularly youngsters, to stay active so ensuring coaches have an understanding of concussion guidance allows everyone to take part in sport in as safe an environment as possible.

“As we look towards organised physical activity in a post-Covid world, there may be more potential opportunities to engage people in a range of public health and safety messages including a renewed focus on concussion.”

The study comes three weeks after one of the UK's foremost brain injury experts told MPs that football’s concussion protocols were a shambles, according to one of the UK’s foremost brain injury experts.

Professor Willie Stewart, from the University of Glasgow, who is a leading campaigner on the need to protect players from the risk of concussion and brain disease said that he could not understand why the sport had chosen not to follow rugby’s path in introducing temporary substitutions and therefore allowing a longer period of time for a potential concussion to be assessed.

He also expressed concern that there was a lack of research into head impacts in women’s sports, given the increased risk to women of concussion, saying: “I don’t think we’re giving it nearly enough attention.”

In February, it was announced that Scottish football clubs were to be able to substitute players who receive a head injury, regardless of the number of subs already used.

From March 6, concussion substitutes were to be allowed on a trial basis following a vote by the 42 clubs of the Scottish Professional Football League (SPFL).

The new rule, allowing each club to make a maximum of two concussion substitutes per match, was to apply for the remainder of the 2020/21 season.

When a concussion substitute is used, the opposing team has the option to use an additional substitute for any reason.