Players and professional athletes should be removed from play after receiving a head-injury on the sporting field amid estimates only 10 per cent of concussions result in unconsciousness, according to an Australian physiotherapy researcher.

Professor Tony Schneiders, a physiotherapy and sports physiotherapy researcher and lecturer at Central Queensland University, said undetected injuries and concussions could increase the chance of players returning to the field, placing them at risk of another more serious injury.

Professor Schneiders said it’s important physiotherapists on the sidelines quickly identify the symptoms of concussion.

“Obviously diagnosing a brain injury is not something that we necessarily have within our scope of practice but looking out for the signs and symptoms associated with that in a general situation or in a sporting situation is really important for a physiotherapist to be aware of,” he said.

“It’s also important to be able to identify if someone does have a subdural hematoma or a bleed in the brain which could be catastrophic, as opposed to saying it’s just a head knock, treat it as a concussion.

“They need to be able to identify where perhaps that minor concussion can transgress and actually get worse and can result in more serious consequences for the athlete.

“That’s a difficult area because the trouble is the signs and symptoms that are associated with concussion are if not exact but very similar to the signs and symptoms with a subdural hematoma…until the symptoms get so bad and the athlete loses consciousness and obviously you realise that you are dealing with something more serious.”

Professor Schneiders, who will speak about concussion in sport at the September 19-21 Physiotherapy New Zealand (PNZ) conference, said initial signs are both cognitive and physical, from poor memory to slurred speech, loss of balance and coordination.

He said it’s vital physiotherapists take a conservative approach to head injuries, particularly when it comes to children’s and adolescent sport.

“Their brains are much more susceptible to damage and to ongoing problems than an adult brain, so even if we’ve had the inkling or thought that they might have sustained a concussion they should be removed from play and not returned to play until they have been checked over by a doctor,” he said.

“With the adult athlete, perhaps not as conservative, but certainly the consensus document on concussion guidelines at the moment do suggest that the player is removed from play despite what level of concussion they have, because the symptoms they have after concussion will change from person to person.”

Professor Schneiders said there has also been much hype and misconception around second-impact syndrome, where it's believed that two concussions in quick succession can result in serious and sometimes fatal consequences.

“Probably, all it is is a slower swelling of the brain which takes a while to manifest, so with the first knock they’ve had damage to the brain, which has caused it to swell or bleed, and depending on what damage occurs it can be quite catastrophic,” he said.

“In a lot of cases with head injuries that bleed or that swelling actually takes a period of time to start giving you symptoms because it needs to build up pressure in the brain, and that can take anything from minutes to hours in some cases.

“That’s why with concussion we always say if someone’s had a head knock or a head injury we must monitor them over a 24-hour period because there is the possibility, even though it’s quite slim, that it may not be a concussion it can actually be a more serious condition.”

Professor Schneiders said the misconception had worked to make athletes more aware about head injuries.

“I guess we have got a culture in this country, and particularly in collision sport culture, where there’s a bravado that athletes will continue to play….this actually puts a little bit more fear in them,” he said.

“You’ve got to debunk the myth in some respects but also still keep the football playing public aware that a head injury can be a very serious condition.”

More than 500 delegates are expected to attend PNZ’s Linking the Chain conference in Auckland.