Tiger Dion Prestia went down in a sickening clash last weekend.

Injury of the Week – Dion Prestia

Tiger Dion Prestia went down in a sickening clash against Geelong this weekend.  It was immediately obvious that he had been concussed and left the ground dazed and groggy. A concussion does not always need to be so traumatic with less obvious incidents occurring that can sometimes be more difficult to identify in the untrained eye. Most players will miss a minimum of one game however some can miss weeks or even months following a concussion injury. In general adults will recover between 10-14 days and children within 4 weeks.

The nature of Australian Football is that it is a high contact sport. For every 1000 AFL playing hours there will be six concussions on average. The high contact rule aims to minimise the risk of sustaining a knock to the head however, players can still experience concussion from an accidental knock to the head, a fall onto the ground or even from heavy body contact as the brain experiences a whiplash type moment inside the skull.

Sports related concussion (SRC) is classified as a traumatic brain injury induced by forces transmitted to the head. Caused by a direct or indirect blow to the head along with an associated whiplash injury to the neck.


Diagnosis of a concussion is based on symptoms rather than medical scans. The injury to the brain during a concussion result in a functional disturbance rather than a structural injury that would be seen on an MRI.

Scans are however advisable to rule out any other injury to the brain or spine. It is very important that any concussion or suspected concussion be assessed by a medical practitioner.

Some of the most common indications, signs, and symptoms that concussion may be present include:

  • A player does not need to be knocked unconscious to suffer concussion. However, when they are, concussion is assumed until proven otherwise.
  • Player ‘just not feeling right’ or acting abnormally.
  • Headache, dizziness, nausea, neck pain
  • Drowsy, foggy fatigued
  • Poor balance, lack of concentration and co-ordination
  • Glassy eyes or blank stare

Interestingly, players who continue to play with a concussion are at a higher risk of another physical injury eg. ACL rupture. Concussions should be reviewed by a medical practitioner as soon as possible. If A player is knocked unconscious, show significant signs and symptoms, or whose symptoms deteriorate should be seen immediately through emergency. They may need scans to rule out a more significant brain injury.


Symmetry-Physiotherapy-concussionTreatment following a concussion is generally a period of physical and cognitive ‘brain’ rest for 24-48 hours. Thereafter an active recovery approach is adopted with a graded return to daily activities; School then onto sports related activities such training drills. Finally full contact training if symptoms are not exacerbated with a minimum of 24 hrs between each stage to assess and monitor their progress and ability to cope with returning to play.

A physiotherapist role following concussion is generally associated with the concurrent whiplash injury that occurs to the neck. A physiotherapist can help improve neck pain, restore neck movement, reduce muscle spasm, and assess and treat any balance disturbances or make referrals for further testing and management where required.

The physiotherapists at Symmetry have access to Concussion Specialists who are trained comprehensively in post-concussion assessment, treatment and guided return to daily activities. These specialists can help you get on your feet again after a head injury with the best possible care!

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For a detailed look at returning to sport following concussion read our article covering the AFL concussion Management Guidelines, read more…

We wish Dion Presita the best for a graduated return to the field.