'If in doubt sit them out' - landmark concussion guidance for grassroots sport published


The first-ever UK wide concussion guidance, developed by an expert panel of domestic and international clinicians and academics in neurology and sports medicine, has been published today.

The guidance is intended to provide information, both for the general public and for individuals participating in grassroots (non-elite) sports, on how to recognise, manage and prevent concussion affecting players in sports.

Key points from Concussion Guidelines

The strapline of 'if in doubt sit them out', makes clear the importance of immediately removing from play any individual suspected of having a concussion. The guidance states further that no one should return to sport within 24 hours of a suspected concussion. During this time that person should not:

  • Be left alone
  • Drive a motor vehicle
  • Drink alcohol

Such a person must also be assessed by an appropriate onsite Healthcare Professional or contact the NHS 111 help-line before they can participate in any further exercise or work activity.

The guidance also identifies "red flag" symptoms including loss of consciousness, amnesia or difficulty speaking. In the presence of such symptoms, the player must receive urgent medical assessment onsite or in a hospital Accident and Emergency (A&E) Department.

Moreover, the guidance states that whilst anyone with concussion can undertake easy activities of daily living and working, there should be no return to sport before 21 days from injury. Anyone with symptoms that last longer than 28 days should seek medical advice from their GP.

Much needed change

The guidance has come at a time of increasing awareness and concern around the long-term effect of head injuries on players in contact sports. Indeed, an ongoing lawsuit from former professional rugby and football players who are taking legal action against the games' governing bodies, claiming they suffered brain injuries playing sport, has recently grown to 378 claimants. These former players have alleged that the games' governing bodies had acted negligently in failing to take adequate action to protect players from permanent injury caused by repetitive concussive and sub-concussive blows.

An important step forward 

An understanding and awareness of the prevention and treatment of concussion is especially important in grassroots sport where trained medical professionals are less likely to be routinely present. This guidance is therefore an important step in ensuring that player safety is a priority and dealt with properly in order to avoid the disastrous consequences that concussion injuries can lead to if not managed correctly.

As Headway's chief executive, Luke Griggs put it, the guidelines are an important step but they need to be accompanied by a full public health campaign.

"This cannot start and stop with a document put on a government website or emailed to clubs...this has to be a hearts and minds campaign to get people to understand the very important reasons for these guidelines."

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‘If in doubt, sit them out’ is the strapline, making clear no-one should return to sport within 24 hours of a suspected concussion.
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