The Australian Institute of Sport and Sports Medicine Australia have launched a new set of guidelines for dealing with concussion in both elite and community sport. The guidelines bring together the most contemporary evidence-based information on concussion for athletes, parents, teachers, coaches, and healthcare practitioners.

The concern about the implications of concussion on the brain of athletes has been growing in recent years. People from the wider sporting community have been calling for there to be more information about the importance of diagnosing and managing the condition promptly, safely, and appropriately.

While the guidelines contain many recommendations about on-field concussion management and identifying symptoms, the biggest changes relate to how concussion is managed after it happens.

Specifically, all players who sustain a concussion should be symptom-free for at least 14 days before restarting contact training. This was already the advice for children, but now applies to community sport too. And notably, all players should wait a minimum of 21 days after being concussed to return to competition.

To view the guidelines, go to the ‘Concussion and Brain Health Position Statement 2024’ and the ‘Australian Concussion Guidelines for Youth and Community Sport’.

What is concussion?

A concussion occurs through a collision with another person or object where biomechanical forces to the head, or anywhere on the body, make the brain hit the inside of the skull (HealthDirect). Note that concussion is often an evolving injury with symptoms changing over hours or days after the initial incident.

How to recognise concussion

Below are 20 symptoms listed in the Concussion Recognition Tool:

• Headache
• "Pressure in head"
• Balance problems
• Nausea or vomiting
• Drowsiness
• Dizziness
• Blurred vision
• Sensitivity to light
• Sensitivity to noise
• Fatigue or low energy
• "Don't feel right"
• More emotional
• More irritable
• Sadness
• Nervous or anxious
• Neck pain
• Difficulty concentrating
• Difficulty remembering
• Feeling slowed down
• Feeling like ‘in a fog’

Returning to training and competition

The guidelines provide clear indicators of when to see healthcare practitioners or when to go directly to the emergency department. (Refer to pages 6 and 7 of the guidelines)

The basic rule of thumb is rest for 14 days AFTER symptoms of concussion have subsided. After this period the person can go back to contact/collision training. After another 7 days of no symptoms the individual can return to competitive contact/collision sport. Each step should be in consultation with a healthcare practitioner. Return to learn and work activities should take priority over return to sport.

When it comes to young athletes, when in doubt, sit them out. A more conservative approach is always best. Children and adolescents take longer to recover from concussion than adults.