Preventing and Dealing with Concussions

[Gerry Seymour]

I had asked @Tez3 to start this thread, but she hasn't replied - likely due to time zone differences or having a life or something, so I'm starting it.

I'd like to hear how those who use sparring - especially heavy sparring - in class protect students and themselves from concussions.

@Dirty Dog posted this in another thread:

Put 'em in play. Watch for hard knocks to the head. When a particularly hard one connects, watch for signs of concussion. If any show up, take 'em out of play and send 'em to the doc. When in doubt, take 'em out of play and send 'em to the doc. This goes for yourself too.

Either one (or BOTH) of these courses.
Heads Up Concussion
NfhsLearn

They're both free.

Peace favor your sword,
Kirk

I'm going through one of those now, and will likely get to the other tomorrow. Both seem centered around kids, so I'm looking to hear also about adults. It seems there's less risk for adults, but how much risk? And how much is "okay" (a subjective measure, I know)?

 

[Tony Dismukes]

One approach I like is drilling defense using lighter contact until the student becomes proficient enough to reliably protect him/herself against the majority of head shots before introducing harder contact.

 

[Tez3]

Sorry, I've been Girl Guiding and now it's almost bedtime! I will post in the morning when I've had a thunk.

 

[Runs With Fire]

In my school, we wear head gear during sparring. .No exceptions. To go further, no intentional head contact at any time. We used to allow head shots after first dan but that changed recently as:

approximately 90% of first dans are not legal adults.

stricter state regulations on concussions with school programs. (We do operate a school athletic martial arts program)

Management has become more liability wary.
Light contact is mandatory." Concussion Awareness Program" is posted in plain sight. If a shock to the head( strike or fall) is observed or suspected, student will sit out and be observed. If a concussion is suspected, or common concussion symptoms are observed, a trip to the doc and a doctor's note of no concussion is required to immediately continue training.

 

[paitingman]

I'm a big fan of light contact/casual sparring.

Even in light contact, headgear and mouth pieces are a must. Obviously same with heavy sparring.

The main things are communication and control. Make sure everyone can communicate and understand exactly whats taking place, what level their partner is at, what the goals are, and what intensity level things are going to be. Then the control to carry all that out.

The protective gear is the fail safe.
I also like to have one instructor other than myself on hand who has first aid/trauma training.

 

[Steve]

train BJJ.

 

[marques]

One approach I like is drilling defense using lighter contact until the student becomes proficient enough to reliably protect him/herself against the majority of head shots before introducing harder contact.

Essentially is that.

Hard sparring after they can defend themselves first in light, then 'medium' sparring. (Perhaps after a few years training - depends on the extension and kind of the allowed techniques, kind of protections...) AND with a specific purpose. For me, a few minutes each 3 months are more than enough. (Just for check-up how it goes under high speed and with some emotions in the mix). Fighters (competitors) would need more, I think.

I saw people here saying they use headgear (and it is found in many gyms). But as far as science can go, they only protect the skin of the head and not the brain (which takes longer to recover, if...). Mouthguard seems working better (but I never used..).

Also, I don't know if it is confirmed, but good neck muscles are potentially a good protection against concussions.

PS: I forgot a basic tip: low speed, at least for beginners. The defence will be easier. Good, they learn how to move properly. The offence will be harder. That's ok. They will repeat and get used to the proper technique even if it does not connect and will learn who to overcome faster opponents.

 

[Gerry Seymour]

One approach I like is drilling defense using lighter contact until the student becomes proficient enough to reliably protect him/herself against the majority of head shots before introducing harder contact.

Would you introduce "very light contact" to the head early, to help develop those defenses?

 

[Gerry Seymour]

Essentially is that.

Hard sparring after they can defend themselves first in light, then 'medium' sparring. (Perhaps after a few years training - depends on the extension and kind of the allowed techniques, kind of protections...) AND with a specific purpose. For me, a few minutes each 3 months are more than enough. (Just for check-up how it goes under high speed and with some emotions in the mix). Fighters (competitors) would need more, I think.

I saw people here saying they use headgear (and it is found in many gyms). But as far as science can go, they only protect the skin of the head and not the brain (which takes longer to recover, if...). Mouthguard seems working better (but I never used..).

Also, I don't know if it is confirmed, but good neck muscles are potentially a good protection against concussions.

PS: I forgot a basic tip: low speed, at least for beginners. The defence will be easier. Good, they learn how to move properly. The offence will be harder. That's ok. They will repeat and get used to the proper technique even if it does not connect and will learn who to overcome faster opponents.

Yes, I was going to reply to the comments about the headgear. Perhaps it helps from a legal liability perspective, but it looks like recent science points to it having little benefit. And the perceived protection may cause folks to give/take more head shots.

 

[Tony Dismukes]

Would you introduce "very light contact" to the head early, to help develop those defenses?

Absolutely. You need the feedback of contact in order to develop the proper defensive reflexes and to get the student psychologically comfortable with being hit. Just keep it light in the beginning.

 

[marques]

I just prefer to say 'low speed' instead of 'light contact' because light and fast, will produce a hard hit at some point, especially among beginners (the ones that have to think about 1000's things in sparring, up to the head defence). Low speed, at worst it will just push and says clearly "you got a hit". Light and fast may also produce hits that one didn't see, didn't feel and was absolutely unaware of that all the time.

I know when you say/think light you are not saying/thinking light and fast, but humans under adversity will push the limits, and if no one talks about the speed...

 

[KangTsai]

Last I read, headgear didn't really protect from concussions, just skull fractures, which are very rare occurrences in sparring. I do agree that mouthpieces are important, though.

 

[Runs With Fire]

Last I read, headgear didn't really protect from concussions, just skull fractures, which are very rare occurrences in sparring. I do agree that mouthpieces are important, though.

For us, head gear is an insurance requirement.

 

[Gerry Seymour]

For us, head gear is an insurance requirement.

Good point. I need to check what my insurer says about it.

 

[Runs With Fire]

I don't run a school, but I plan to eventually. Minors wear a full set of pads if they spar. Little kids don't spar. I don't think I can do head contact in youth classes. Maybe not until 18. But at least 16. A mouth guard but perhaps not headgear for adults in an adult only class.
At least this is what I think now. The insurance requirement previously mentioned is because of the majority of youth in the school. Don't know if it would be dropped in an adult only institution.

 

[msmitht]

Don't allow head shots or learn how to spot signs of a concussion and help head contact light.

 

[Gerry Seymour]

Don't allow head shots or learn how to spot signs of a concussion and help head contact light.

Not allowing head shots at all would almost inevitably lead to poor defense against head shots.

 

[Runs With Fire]

Not allowing head shots at all would almost inevitably lead to poor defense against head shots.

It sure does.

 

[Ironbear24]

Last I read, headgear didn't really protect from concussions, just skull fractures, which are very rare occurrences in sparring. I do agree that mouthpieces are important, though.

I would not want to spar without a mouthpiece. I heard horror storries of people getting uppercutted and they bite off their tongues.

 

[Tez3]

I saw people here saying they use headgear (and it is found in many gyms). But as far as science can go, they only protect the skin of the head and not the brain (which takes longer to recover, if...).

That's the thinking behind the current international amateur boxing authorities ruling that men's amateur fights are now to be conducted without headguards, for some reason they haven't stopped the use of headguards for women though. The brain will rattle around inside the skull whether or not a headguard is used. It's the brain hitting the skull that causes the bruising which of course is bleeding. The amount of bruising/bleeding depends on the blow received obviously but it's been shown in medical studies that even small blows overtime if repeated cause brain damage. It's been shown in footballers ( soccer) who head the ball a lot, especially in the 'old days' when the ball was a much heavier, thicker leather one which got even heavier in the wet.
One of the problems in boxing, MMA (as well as kickboxing, MT etc) and horse racing is that the participants in these cut weight, often causing dehydration. Jockey's especially cut weight permanently as they are always cutting, they have to weight the same at the end of the race as they do at the beginning, they will typically have up to ten rides a day plus riding out. Boxers and other fighters at least can eat and rink after the weigh in, on same days weigh ins which are common in the sections below the top ranks, they cannot however bring their hydration levels up to what it should be in that fairly short time. This leads to the fluid that should be around the brain being far less than it should, this is the real 'headguard' your brain needs but is often lacking in combat sports and horse racing. The outcome of course is that blows to the head are far worse than they should be. Jockeys of course do come off a lot, head injuries aren't always the result, a jockey this week here is now paralysed from the waist down after his horse fell, his back was broken but of course the dehydration question comes up again, our bodies have many fluids designed to help protect us including in the spine.

I would not want to spar without a mouthpiece. I heard horror storries of people getting uppercutted and they bite off their tongues.

Try sparring with your tongue on the roof of your mouth.


Many sports are now aware of the dangerous effects of concussion and the need to do everything to avoid them. One of the things England rugby are concerned about and this I think carries over into martial arts is the reporting of concussions from training and elsewhere. "To prevent recurrent concussions and the rare but potential risk of prolonged or severe injury, coaches, teachers and parents must encourage players to report concussions that occur during games and training sessions, and to report concussions that occur out of rugby. It is also essential that school and club coaches communicate between themselves if a player is concussed, and involve parents in these discussions." A KO in a fight may cause little damage but the accumulated damage from training may be the thing that tips it from being a minor concussion to a massive brain injury. Most people who turn up to fight in MMA fights ( again not the top rank though I'm not actually so sure) say they are fine, they don't ever mention a previous head blow, concussion or even a KO because they know they won't pass the medical. Often the medical is conducted by a paramedic or even a first aider with little knowledge of what to look for if there are indeed any signs to see. We need to educate people on the dangers of blows to the head, if a child bumps it's head at school/home etc which they often do we shouldn't then allow then to carry on in a martial arts lesson where the chance is they could get hit again. You might think a parent bringing a child in like that is unlikely you need to remember for many parents martial arts is babysitting! I know of children being brought in with S&D, chickenpox and a broken arm.
This is from an article on injury prevention in Rugby but I think it applies equally to martial arts.
‘The risk of injury will never be completely absent in rugby union but our understanding and perception of risk
needs to be carefully balanced against the recognised positive health consequences of playing rugby union.’ Simon Kemp, RFU

From here. http://www.bath.ac.uk/health/documents/basem/injury-prevention-in-rugby.pdf