Posted on 2nd March 2023
· Raise awareness and profile of new UK-wide concussion guidelines for grassroots to elite equine sport and activities.
· Communication across the industry to educate and inform all participants on brain injuries/concussion, their severity and potential long-term harm and instigate a culture change to prioritise concussion recognition.
· Demonstrate a collective and collaborative approach to concussion across the equine industry.
· Demonstrate Government, general sport and the equestrian sector’s shared commitment to making sport safer for all participants at all levels.
· Connect the guidelines to wider work being undertaken as part of the Government’s Action Plan on Concussion and the existing good work being done across the sector to address the risks from concussion.
IF IN DOUBT, SIT THEM OUT
At all levels in all sports, if an individual is suspected of having a concussion, they must be immediately removed from activity.
CONCUSSION AWARENESS – Educational messaging about what concussion is, key facts, the seriousness of the condition (particularly on children and adolescents).
FOUR Rs- RECOGNISE, REMOVE, RECOVER and RETURN – The aim is to help everyone involved in equestrian sport – from grassroots to elite – to recognise the signs of concussion, remove people from activity where it is suspected they may be concussed and how to manage the critical phases post injury, rest and recover.
RETURN SAFELY – Ensure that it is understood that completion of a graduated return to ‘riding’ activity is important to reduce the risks of a slow recovery, further brain injury and longer-term problems.
Background: Concussion in sport
1. There is overwhelming evidence that participating in sport is beneficial for our health and wellbeing. Sport provides huge benefits to our physical health by reducing the risk of developing long-term conditions including heart disease, cancer, diabetes and musculo-skeletal disorders. And it is a powerful means of helping to prevent and manage mental health problems including depression.
2. However, participating in sport does carry the risk of injury and this includes, to varying degrees, the risk of concussion. A concussion is a brain injury, and all concussions are serious.
3. In this context, while the vast majority of people participate in sport safely, reducing the risks associated with concussion and making sport even safer for everyone is an ambition shared by both Government and the sport sector. Ultimately, we want more people to participate in sport and have a positive, enjoyable and safe experience.
4. British Equestrian’s guidelines and the upcoming UK Concussion Guidelines for Grassroots Sport are an important step forwards in managing concussion at all levels of equestrian sport and activity.
5. The new guidelines are designed to help those across all levels:
· RECOGNISE the signs of concussion,
· REMOVE anyone suspected of being concussed immediately,
· RECOVER to enable the body to mend ahead of a graduated return,
· RETURN to daily activity, education/work and ultimately, riding/equestrian activity.
Key points from the guidelines
6. The following summarises the key elements of the guidance:
· At all levels in all equestrian activity, if an individual is suspected of having a concussion, they must be immediately removed from “play” – IF IN DOUBT, SIT THEM OUT.
· Most people with concussion recover fully with time. However, a concussion is a brain injury and all concussions are serious – head injury can be fatal.
· Anyone with one or more visible clues or symptoms of a head injury must be immediately removed from competing or training and must not take part in any further sport or work activity, even if symptoms resolve, until they have been assessed by an appropriate healthcare professional or phoning 111. This should be sought within 24 hours of the injury.
· Completion of a graduated return to activity (education/work) and sport programme is important to reduce the risks of a slow recovery, further brain injury, and longer-term problems.
· If symptoms persist for more than three weeks (21 days), individuals need to be assessed by an appropriate healthcare professional – typically the individual’s GP.
1. Why have these guidelines been developed?
Concussion in any sport is a serious issue. While the vast majority of people participating in equestrian activities do so safely, we want to make sure everyone – across all equestrian sport and activity, and across the whole of the UK – is aware of how to recognise a concussion and what to do if they suspect someone is concussed. The most important message is: ‘If in doubt, sit them out’.
2. Who wrote the guidelines?
The guidelines have been developed by British Equestrian’s Ashleigh Wallace (Athlete Health Lead) and Anna-Louise Mackinnon (Chief Medical Officer) who are both international and industry experts in the field of sport-related concussion. As part of a wider member body working group, they incorporated the latest and most robust medical and scientific evidence to develop the guidelines.
3. Who are the guidelines for?
The guidelines are for everyone involved in equestrian sport and activity from school age upwards – participants, coaches, volunteers, parents, medical staff. The guidelines are particularly relevant at grassroots level where trained healthcare professionals are typically not available to manage concussed individuals.
4. Are the guidelines mandatory? How will they apply across different sports?
It is for BEF member bodies or equestrian organisations to oversee their respective sports/members/activities and as part of this, to put in place measures to manage the risk to participants at all levels. The guidelines are designed to provide a minimum best practice baseline for all sports across the UK. It is recognised that individual organisations may wish to build on this foundation with more specific guidance or rules which reflect the particular nature of their sports/activities.
5. How will the guidelines be communicated to relevant audiences?
British Equestrian and its member bodies will utilise the guidelines within their own sport-specific campaigns and communications to stakeholders at all levels including participants, coaches, venues, volunteers, officials and coaches.
More broadly, a range of Government departments and representatives from education and medicine have been engaged in the process and, when launched, the UK Concussion Guidelines for Grassroots Sport will be publicised through these channels to make sure schools, teachers and doctors are aware which endorses the concussion messaging.
6. What about the long-term effects of concussion? Should people be concerned about participating in sport where there is a risk of head injury?
There is overwhelming evidence that participating in sport is good for our physical and mental health. All sport carries the risk of injury including, to varying degrees, the risk of concussion. The guidelines are designed to help ensure that there is a consistent, evidence-based approach to the immediate management of concussion and graduated return.
There is currently no scientific consensus on a link between concussion and long-term neurodegenerative diseases and research is ongoing to understand this further.
7. Why don’t the guidelines go further e.g. mandating a minimum period of rest following a concussion?
The guidelines are designed to help ensure that there is a consistent, evidence-based approach to the immediate management of concussion and graduated return to activity (education/work) and equestrian sport. It is for member bodies to make decisions on any specific adaptations which may be required to reduce the risk of concussion in their particular sports.
Everyone is unique in their recovery from concussion. This is why completion of a graduated return to activity and sport programme is important to reduce the risks of a slow recovery, further brain injury, and longer-term problems.
8. Do the guidelines cover the use of protective equipment e.g. protective headgear etc.?
No. There is currently no firm evidence that protective headgear reduces the risk of concussion although it may reduce the risk of other harmful head injuries and riding in an up-to-standard riding helmet is fundamental to rider safety.
9. Will the guidelines be updated if new evidence becomes available?
The guidelines are based on the best scientific and medical knowledge available at this time, but the understanding of concussion is evolving all the time. As such, the guidelines will be reviewed and updated should new evidence emerge which necessitates any change.