This week, I’ve been fielding a lot of questions about the recent Herald Sun coverage (also picked up in the Adelaide Now) on a new concussion detection tool, BrainEye. You can read the article here:

🔗 BrainEye app delivers 100% concussion detection rate 

 Naturally, I was curious to dive into the new research backing this product: 

 Clough, M., Bartholomew, J., White, O., & Fielding, J. (2025)
Investigating the utility of the BrainEye smartphone eye tracking application and platform in concussion management. Sports Medicine – Open, 11(1), 24. 

Optimism vs. Reality: The Big Picture 

Let’s start with what’s promising: 

• Objective data in eye movement and pupil response is increasingly recognised as a key part of the concussion puzzle. 

• Having rapid, accessible tools could help in environments where expert clinicians aren’t available pitchside. 

• BrainEye’s attempt to move this tech onto a mobile device is a logical step forward in usability. 

But here’s the catch: 

• The study only tracked 11 concussed players, all of whom were already clinically diagnosed using standard tools like SCAT6. So, the real-world added value of BrainEye in this context remains unclear. 

• Two of the four test domains weren’t usable in this setup. 

• It’s not yet known if the smartphone-only app (without the infrared hardware used in the study) can deliver the same data quality. 

• Implementation was low—just 3 of 10 clubs actually used the tool post-concussion, citing logistical barriers. 

Where We Stand at Your Brain Health 

At Your Brain Health, we’ve been using several high-resolution, oculomotor tests as part of a multimodal brain health screen for over three years. And that’s just one part of our toolkit. 

We’re not just assessing injury—we’re tracking recovery and guiding referral pathways for: 

• Vision and vestibular therapy 

• Cervical dysfunction 

• Cognitive and balance rehab 

• Psychological wellbeing 

• Improved performance 

We’re also capturing longitudinal data across elite and community cohorts, helping athletes, clinicians and clubs make truly informed decisions. 

We welcome new tech that brings value—but we also believe in specific validation and transparency in research fundings, and clear distinctions between marketing hype and clinical utility. 

Innovation in concussion care is essential—and it’s exciting to see oculomotor testing get the attention it deserves. But tools like BrainEye needs more independent research (2 authors of this study were part of the company in this case), broader usability testing, and clearer real-world application pathways before they can claim a central role in sideline or recovery protocols. 

We’re always open to integrating new tools into our platform. But until then, we’ll continue to focus on delivering the most comprehensive, evidence-informed brain health assessments available.  

The ISEH Concussion Clinic Joins the Your Brain Health Network

Located on Tottenham Court Road, the Concussion Clinic at the Institute of Sport and Exercise Health (ISEH), led by Prof. Loosemore, has officially joined the growing Your Brain Health network. This international network already includes Prof. Jon Patricios’s clinic in Johannesburg, South Africa. Both Loosemore and Patricios were co-authors of the most recent Concussion in Sport Group Consensus Statement and played instrumental roles in the development of the groundbreaking SCOAT6 (Sports Concussion Office Assessment Tool 6). Their shared expertise ensures that patients have access to care informed by the latest global standards.

The ISEH Concussion Clinic is one of the leading centres in the country for concussion diagnosis and management, offering pioneering technology and treatments that set it apart. What makes this clinic exceptional is its unique ability to treat children as well as adults with concussions—a vital service. From young athletes to professionals recovering from injuries, the clinic combines advanced diagnostic tools with personalized care plans to ensure optimal recovery.

Prof. Loosemore’s expertise in the pathophysiology of brain injuries, backed by decades of research, means patients receive care rooted in science and tailored to their individual needs. Whether it’s the result of a sports injury, an accident, or a fall, this clinic is redefining what’s possible when it comes to managing concussions.

Meet Professor Mike Loosemore MBE

If you’re wondering what makes Prof. Loosemore such a trailblazer in his field, here’s the lowdown:

Areas of Expertise: Diagnosis and treatment of concussion, musculoskeletal injuries, and sports injuries; exercise as a tool for disease prevention and management.

NHS Base: University College London Hospitals.

Private Practice: ISEH and The Portland Hospital.

Prof. Loosemore’s groundbreaking work has earned him an MBE for services to Sports Medicine, alongside numerous awards like the Sir Robert Atkins Award and the David Hemery Award. With a PhD in the Pathophysiology of Boxing Injuries, he’s at the forefront of concussion research and has dedicated his career to improving care for athletes, children, and anyone dealing with injury.

Beyond the clinic, Prof. Loosemore’s influence extends globally. He’s traveled with national squads to the Olympics, Commonwealth Games, and World Championships, using his expertise to help athletes perform—and recover—at their best.

Your Brain Health today launches a global campaign calling on all sports clubs, schools and other sporting organisations to appoint a Concussion Officer responsible for overseeing head injury protocols.

The initiative, which already has the backing of sports stars, coaches, medics, charities, concussion campaigners and grassroots organisations, including Datchworth RFC, calls on governing bodies to embrace an open conversation about concussion and facilitate the push for increased safeguards.

Become a Concussion Officer Today

Similar in principle to a club Fire Warden or Safeguarding Officer, which have been widely adopted by sports clubs and associations in recent years, a concussion officer would be nominated by each organisation and take responsibility for ensuring protocols and best practice are followed.

Speaking about the initiative, Your Brain Health (YBH) Chief Operating Officer and current Welsh Fire Lead Physiotherapist David Bartlett, said:

‘Sport is an incredible force for good—it builds physical fitness, mental resilience, and lifelong friendships. But to keep sport safe and accessible for everyone, we need to take concussions seriously. Appointing a Concussion Officer ensures that when head injuries happen, they’re managed properly, and allows participants to recover fully and return to enjoying the sports they love.’

While the sports field would seem the most likely place for a child to sustain a concussion, or mild traumatic brain injury as it is also referred, school playgrounds see an estimated 27,000 diagnosed cases in Australia alone each year.

‘Schools have a duty of care to ensure these injuries are managed appropriately. Without clear protocols, concussions can be missed, leading to long-term health consequences. A Concussion Officer ensures that no child falls through the cracks and that brain health is treated with the seriousness it deserves.’

YBH, with the backing of Concussed Media and other concussion awareness groups, believe the campaign will help clubs and sports organisations achieve:

• Better protection for clubs / schools
• Better health outcomes
• Better performance
• Peace of mind of players / parents
• Increase participation
• Improve reputation of organisation

The RFU was criticised for attempting to reduce the tackle height in the amateur game in 2023, but former Datchworth First XV captain Stu Young believes the reluctance of referees to penalise head high tackles, which have always been illegal under the game’s laws, is the biggest stumbling block to progress.

‘Massive hits to the head are either just given as a penalty or 10 minutes in the sin bin and then they come back on,’ Young said. ‘It’s not really achieving what I assume the RFU want to do which is to lower the height of tackles and therefore lower the amount of head knocks.

‘If the referees were a bit more on it (prepared to give red cards) that might have more of an impact than just saying ‘we’re going to lower the contact area from shoulder height to sternum’.’

Another Datchworth stalwart, Warren Sullivan, who coaches the junior section and is current Chairman, is concerned the mounting threat of legal action has caused some parents to become overcautious. He wants a renewed focus on coaching the tackle, where most concussions occur.

‘People have got scared,’ Sullivan said. ‘they’re more or less throwing the baby out of the bathwater.  A lot of parents don’t want their kids to play rugby anymore but I think a lot of it’s unfounded.

‘We need to improve tackle technique across the game. It doesn’t help seeing the professionals tackling so upright.’

Risk Factors: The Inside and Outside Story

When it comes to concussion, there are external factors—like the rules of the game, training schedules, or protective gear—and internal factors, which are more about what’s happening inside the brain and body.

Both matter, but internal factors seem to be the bigger piece of the puzzle when it comes to why one concussion can make future ones more likely.

Let’s take a look at the breakdown of some of the key internal factors that might contribute to the Six Nations concussions this season.

What’s Next?

Every concussion tells a story—and every recovery is a chance to learn. The more we understand the factors behind increased concussion risk, the better we can protect athletes. At Your Brain Health, we’re committed to being part of the solution.

By contributing to global research and refining clinical practices, we’re helping clinicians and athletes make smarter, evidence-based decisions. Whether it’s through new insights into brain health, targeted rehab, or innovative training approaches, we’re working toward a future where athletes can thrive without sacrificing their long-term brain health.

For those looking to stay ahead of the curve, our courses dive deep into the latest research, offering actionable strategies for managing concussions at all levels of sport.

The bottom line? Knowledge is power. And with the right tools, we can give athletes the support they need to play smarter, recover better, and protect their most valuable asset: their brain.

It is often purported that the growing band of brothers and sisters championing the need for improved athlete welfare through a more caring culture in professional sport are blind to its number one imperative: winning.

Those of us in rugby who have spent decades calling for greater protections for players as the sport’s risk profile has sky-rocketed have been labelled ‘soft’ or ‘not rugby people’ while the mere mention of ‘player welfare’ is snarled at in certain quarters as evidence of an invidious woke culture creeping into the game.

It is, of course, utter tosh. But that does not stop those whose interests are best served by ignoring the long-term health and wellbeing of those we cheer on from the stands parroting the same old tired lines.

Call for change and be prepared to be shot down by some uneducated but very loud voices. Such is life today, I suppose.

Professional sport is a tough world. Anyone who has been within a cricket ball’s throw of a sports dressing room or training ground knows that. No quarter is ever asked, let alone given.

In the wrong hands, it can be a world where machismo reigns, bullying can fester and being honest about emotions or personal health can be sacrificed on the altar of protecting a contract or your place in the starting line up. Short-termism reigns. The future? It can wait.

Meanwhile, in schools sports, players and parents themselves can be their own worst enemies when pushing for faster return to play times.

Medics can also be pressured into burying their morals by coaches and owners more interested in today than tomorrow while those calling for improved workplace culture are dismissed as romantics who don’t understand the cold, hard reality.

Brain health inevitably suffers as concussions are denied and mental-health problems hidden.

I’m here at the invitation of Your Brain Health, an Australian owned company on a mission to improve the education of medics and physiotherapists around the world about the importance of better concussion management,  brain health awareness and improved brain function.

Critically, they are seeking to take the guesswork out of return to play protocols following a concussion, where historically decisions have been made either by the subsistence of demonstrable symptoms, or even worse, on the athletes word.

“When we’re treating an athlete with a hamstring injury there are tests we perform so we know precisely when it has returned to full function,’ YBH’s chief operations officer and current Welsh Fire physio David Bartlett tells me.

“Just because the patient is symptom free does not necessarily mean that hamstring has recovered. The same is true of brain injuries but historically we haven’t treated them with the same levels of objectivity and reasoning as other parts of the body.”

Bartlett and his YBH team, include experienced physiotherapists Simon Shepard and Emma Edwards, a chartered physiotherapist and member of the jockey injury management team which looks after professional jockeys on the racecourse, have been invited to the yard by Dr Simon Gillson, a close confident of O’Brien’s founded Concierge Medical and has worked at the yard for nine and a half years.

Gillson describes the concussion risk in racing as ‘an occupational hazard’.

“It would basically be impossible for a jockey to go through their career without sustaining a concussion,” Dr Gillson explains.

“I think the stats on fallers have changed over the years. It used to be one in 10 races you expected to fall off as a race rider. I think that might be down to one in 20. They’ve (authorities) have improved jumps safety and other things which is great and there’s improved equipment but you are still having rotational injuries, you’re falling at speed, horses are rolling on top of you, being kicked in the head, the neck, the chest.

“So your chances of getting through any lengthy career without having a significant head injury and concussion are, I would say, a zero. I mean, absolutely zero.”

Edwards nods in agreement.

“When it comes to testing for concussion so much has been based on some fairly basic orientation questions. As a physiotherapist something I’ve looked at is eye movements, as being something that even when someone’s denying having a concussion, you can pick up on eye movements. It provides an objective measure to tell a jockey, ‘this is what I’ve seen, do you think you’d be safe, seeing the stride to the fence, and making the right decision in that split second?

“More often than not they’ll put their hand up and go, ‘actually, now you’ve said that, I’m not really feeling 100%’.

“They’re not stupid. They know their every move is being scrutinised. They just want to perform well.”

The plan, with O’Brien’s blessing, is for all 37 of his yard staff to undergo a ‘multimodal’ baseline screening of their brains by the Your Brain Health team, with tests ranging from balance, and reaction times to a digital evaluation of the vestibular ocular motor system.

From force plates to measure balance, to a reaction mouse, to the use of a VR headset, the key thing seems to be the use of technology to provide better quality data.

“With multiple functions the brain is a complex organ and what we are doing is not going to cover everything.’ said Shepard. ‘However, put this data alongside other tests and clinical examination, and it may well lead to better understanding, better decision making and a personalised approach to care.”

The tests are carried out in a highly professional but light-hearted manner, which puts the jockeys and yard staff at ease and encourages them to take a full part in the testing. The participants seemed genuinely interested in both the testing and the reasons that sit behind it.

I undergo the tests myself and am pleasantly surprised to read the graph afterwards which shows my eye tracking to be in pretty decent order.

Much more importantly, the presence of the YBH team indicates a shift in mindset which is looking to place the brain health of staff far higher up the priority list than it has been historically in horse racing. It is forward thinking in every sense.

It also has the added benefit of potentially improving the performance of jockeys who after all, need great balance, great eyes and great decision making, if they are to optimise their performance and that of their prized equine assets.

“It’s been shown in cricket there is a correlation between certain helmet strikes and a drop in batting averages,” Bartlett explains.

“By generating more objective data, and adding a ‘gamification’ element, not only do we see better compliance than with historic testing, but we are also being able to identify individuals function, and as such ensure a return to performance, rather than trying to ‘beat’ the system and return before they are ready.”

Improved athlete welfare and improved performance. Now that really is something worth going the extra yard for.

World-Leading Speaker Lineup

Ahead of the Game will bring together an extraordinary panel of experts, including:

• Catherine Bishop, former World Champion rower, Olympic silver medalist, and author of The Long Win. Catherine will share her unique insights on the role of sport in fostering resilience and long-term success.
• Professor Willie Stewart, one of the world’s leading authorities on concussion research, from Queen Elizabeth University Hospital.
• Professor Mike Loosemore MBE, a pioneer in sports medicine from the English Institute of Sport.
• Dr. Lisa Ryan, head of the Department of Sport, Exercise, and Nutrition at Atlantic Technological University and an expert in youth sports safety.

The event will be co-hosted by Sam Peters and former Mail on Sunday sports editor Alison Kervin OBE, who together spearheaded the paper’s Cudlipp Prize nominated concussion campaign. The pair will lead the evening’s discussions with their unparalleled expertise in sports journalism and safety advocacy.

Former professional rugby players Nick Greenhalgh and Sam Smith will join Kervin for the second panel of the evening, alongside current Welsh Fire Physiotherapist David Bartlett and professional cricketer Tom Kohler-Cadmore.

Join Us to Shape the Future

Whether you’re a parent, coach, athlete, educator, or policymaker, this event is your chance to join a critical conversation about the role of sport in schools and the measures needed to make it safer for everyone who plays.

Event Details:
📍 Venue: St Paul’s School, London
📅 Date: February 12, 2025
🕒 Time: 1815-2200

Tickets are limited, so reserve your spot today to be part of this landmark event. Together, we can help shape a brighter, safer future for school sports.

Book your tickets here!

By Associate Professor James McLoughlin.

I have been asked recently my opinion about disappointing recent research with regard to the effectiveness of neurocognitive and VR eye-tracking tests in diagnosing concussion.

I could rant on about research methodology, types of tests, samples sizes and patient selection criteria. However, the answer to this complex question is simple – bad research questions!

The One-Test Wonder: Not So Wonderful

Imagine trying to determine if someone is drunk based solely on how well they can say the word “pineapple.” Sure, it might work for the extreme cases, but most people are going to skate by with a “pineapplish” that sounds about right. Concussion tests that focus on just one aspect—like memory recall or a basic visual task—are like this “Say pineapple” trick. They’re simplistic, easy to beat, and maybe not reflect the types of brian injury. I think sometimes sports are more concerned with convenience than accuracy.

The brain is far too crafty for these kinds of “gotcha” questions. A concussed person might nail the “What’s the score?” question but still struggle to walk in a straight line or remember why they went into the kitchen five minutes ago (and okay, to be fair, the latter could just be normal).

Multidimensional Problems Need Multidimensional Solutions

Here’s a radical idea: if concussions affect your brain in multiple ways, maybe—just maybe—we should assess them in multiple ways. Crazy, right? A strong concussion evaluation should involve balance tests, cognitive tests, eye tracking, and even mood assessments. It’s like forming a crack team of experts to tackle a complicated heist. Each one has their specialty, and together, they might just figure out what’s going on.

Plus, let’s be real: the stakes are high. A misdiagnosed concussion isn’t just a “fail” on the medical professional’s part—it could mean a person goes back out into a contact sport, takes another hit, and ends up with serious long-term damage. Concussions aren’t something we can afford to get wrong.

Pioneering Technology for Rehabilitation

In an exciting development for physiotherapy and neurological rehabilitation, Your Brain Health, has partnered with innovative tech firm HeadX to introduce HeadX Kross to the healthcare market. This collaboration centers on a new, state-of-the-art, head-mounted laser system designed specifically to enhance and support physiotherapists in their rehabilitation programs.

The new laser technology aims to revolutionise the way therapists can work with patients recovering from neurological and musculoskeletal injuries, including concussion. The HeadX Kross head-mounted laser device, offers precision targeting and hands-free operation through a cross-haired laser, providing therapists a novel tool to target both the brain and cervical spine.

Designed with input from academics, engineers, and rehab specialists, the device integrates a head-mounted wearable cross-haired laser, opening new doors for hands-free, real-time applications during physiotherapy sessions.

What’s Next?

Currently in the pilot testing phase, this device is expected to launch widely within the next year. With trials underway, Your Brain Health and HeadX are confident that this technology will set new standards in physiotherapy and neurorehabilitation.

For therapists interested in the launch of HeadX Kross, they can join the waiting list here. UK Therapists can also pre-order at a discounted rate!

As the medical community continues to push the boundaries of rehabilitation science, partnerships like this pave the way for innovative therapies that can profoundly impact patients’ lives. The future of rehabilitation is here, and it looks brighter than ever.

Persistent symptoms

Many people will experience symptoms after a concussion beyond 4 weeks. These are ‘persistent symptoms’ that will require help from health professionals. Up to 25% of people still experience symptoms at 3 months(Polinder et al. 2018), and with those who attend hospital after concussion, nearly 12% of children and 31% of adults experience symptoms beyond 3 months, with more than 50% still report some symptoms at 12 months(Machamer et al. 2022).

We estimate that 36,000 people in Australia

90,000 people in the UK

And 470,000 people in the US will experience persistent symptoms each year!

Academic Performance in schools.

1 in 5 children will suffer a concussion by the age of 10.

• A history of concussion in the past 12 months was significantly associated with a higher risk of poor academic standing during the same period.
• Young people hospitalized with concussion had 30% higher risk of not reaching the national minimum standards for numeracy, 40% higher risk for reading.
• In years 3-9, hospitalisation with concussion leads to 64% higher risk of not completing year 11 and 75% not completing year 12.(Lystad et al. 2022)
• Concussion leads to an increased risk of mental health issues with to a 2-fold higher risk of suicide. (Fralick et al. 2019; Ledoux et al. 2022)
• Children who have previously suffered a concussion are four times more likely to sustain another concussion (Fitzgerald et al. 2022)
• Concussion results in a 65% increase in lower limb injury for up to one-year post-concussion (Avedesian, Covassin, and Dufek 2020)
• There is increasing interest in the role in concussion recovery and sporting performance too.

What about employment?

• Concussion is associated with reduced income. For those who attend emergency, 17% were still not working at 12months, however this improved if support is provided within the first 3 months (Gaudette et al. 2022)

Avedesian, Jason M., Tracey Covassin, and Janet S. Dufek. 2020. “The Influence of Sport-Related Concussion on Lower Extremity Injury Risk: A Review of Current Return-to-Play Practices and Clinical Implications.” International Journal of Exercise Science 13 (3): 873–89.

Daneshvar, Daniel H., Evan S. Nair, Zachary H. Baucom, Abigail Rasch, Bobak Abdolmohammadi, Madeline Uretsky, Nicole Saltiel, et al. 2023. “Leveraging Football Accelerometer Data to Quantify Associations between Repetitive Head Impacts and Chronic Traumatic Encephalopathy in Males.” Nature Communications 14 (1): 3470.

Fitzgerald, Melinda, Jennie Ponsford, Natasha A. Lannin, Terence J. O’Brien, Peter Cameron, D. James Cooper, Nick Rushworth, and Belinda Gabbe. 2022. “AUS-TBI: The Australian Health Informatics Approach to Predict Outcomes and Monitor Intervention Efficacy after Moderate-to-Severe Traumatic Brain Injury.” Neurotrauma Reports 3 (1): 217–23.

Fralick, Michael, Eric Sy, Adiba Hassan, Matthew J. Burke, Elizabeth Mostofsky, and Todd Karsies. 2019. “Association of Concussion With the Risk of Suicide: A Systematic Review and Meta-Analysis.” JAMA Neurology 76 (2): 144–51.

Gaudette, Étienne, Seth A. Seabury, Nancy Temkin, Jason Barber, Anthony M. DiGiorgio, Amy J. Markowitz, Geoffrey T. Manley, and TRACK-TBI Investigators. 2022. “Employment and Economic Outcomes of Participants with Mild Traumatic Brain Injury in the TRACK-TBI Study.” JAMA Network Open 5 (6): e2219444.

Ledoux, Andrée-Anne, Richard J. Webster, Anna E. Clarke, Deshayne B. Fell, Braden D. Knight, William Gardner, Paula Cloutier, Clare Gray, Meltem Tuna, and Roger Zemek. 2022. “Risk of Mental Health Problems in Children and Youths Following Concussion.” JAMA Network Open 5 (3): e221235.

Lystad, R., A. McMaugh, G. Herkes, G. Browne, T. Badgery-Parker, C. Cameron, and R. Mitchell. 2022. “The Impact of Concussion on School Performance in Australian Children: A Population-Based Matched Cohort Study.” Journal of Science and Medicine in Sport / Sports Medicine Australia 25 (November): S36–37.

Machamer, Joan, Nancy Temkin, Sureyya Dikmen, Lindsay D. Nelson, Jason Barber, Phillip Hwang, Kim Boase, et al. 2022. “Symptom Frequency and Persistence in the First Year after Traumatic Brain Injury: A TRACK-TBI Study.” Journal of Neurotrauma 39 (5–6): 358–70.

Polinder, Suzanne, Maryse C. Cnossen, Ruben G. L. Real, Amra Covic, Anastasia Gorbunova, Daphne C. Voormolen, Christina L. Master, Juanita A. Haagsma, Ramon Diaz-Arrastia, and Nicole von Steinbuechel. 2018. “A Multidimensional Approach to Post-Concussion Symptoms in Mild Traumatic Brain Injury.” Frontiers in Neurology 9 (December): 1113.