Take what happens on the field seriously

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Playing sport, although fun, can have significant consequences in terms of injury. It is the clear identification of such injury, and its appropriate immediate management, that continues to allow us to have fun and success on the field. I was reminded of this recently when my 11-year-old son ran out onto the field for his first ever game of Australian football. All went well for the first 10min until he found himself in an unfortunate and accidental collision with another player that led him to a state of unconsciousness on the ground. To my surprise from the sideline, play continued around him, no-one really seemed concerned (except of course me), and his team proceeded to score a goal and celebrate. On recognising what had happened, I raced out onto the ground and within 5s he had gained consciousness but clearly had no idea where he was or how he got there. On recognising the symptoms and significance of the event, I removed him from the field and ran through a series of tests and confirmed concussion. What surprised me further was the encouragement of many around him (mainly adults) to simply give him a rest and get him back on the field after half-time. Needless to say, I did not follow this advice but rather went down the path of appropriate medical management – he thankfully recovered in a very textbook like manner. By the time his next game came around several weeks later he played a brilliant game and received the best-on-ground award.

On reflecting on the situation, I was not that surprised at the response of others encouraging him simply to continue playing. Afterall, most people involved in community and club sport have not been educated in the symptoms of concussion, nor the significance of such episodes – that is clearly something we all need to work on. Whilst this venting may simply appear to be some form of self-indulgence or perhaps “therapy” for a frustrated Editor (and father), the strong message here is that immediate management of sporting injuries is paramount to the successful recovery and further enjoyment of sport. It is incumbent on all of us in some manner to ensure appropriate education of the millions of volunteer sport coaches and officials around the world – without them sport would not exist!

Whilst I will not go into detail regarding any of the papers we have included in this issue, I do want to highlight two papers. The first, by Schneiders and colleagues in New Zealand, Sweden, and the United States, looks specifically at concussion – see there is a link to my earlier rant. The research examined neurological screening for sport-related concussion and emphasised the importance of standardising footwear and testing surface when assessing motor performance tests as part of concussion screening. The second paper, by Teramoto and Bungum from the United States gives the big tick to participation in elite sport. In reviewing the literature on mortality and longevity of elite athletes they demonstrated that elite endurance (aerobic) athletes survive longer than the general population, most likely due to lower cardiovascular disease mortality.

I finish this Editorial on a very sad note – that is the untimely passing of one of our Editorial Board members, Dr Johann (Hans) Edge. Hans will be remembered as a rising research star in his field and someone who contributed significantly to the Journal of Science and Medicine in Sport. It is only appropriate that we include an Obituary in this issue as well as a paper in which Hans was a co-author (Adaptations to skeletal muscle with endurance exercise training in the acutely fed versus overnight-fasted state).