Over the past decade, research has linked traumatic brain injury (TBI) and repetitive head impacts with neurodegenerative disease. Links with Dementia and Chronic Traumatic Encephalography (CTE) in particular ha dominated headlines, but links between head impacts and MND (also known as ALS) remains less clearly understood.

In October 2025, a major UK population study published in JAMA Network Open in October 2025 attempted to clarify this relationship using national electronic health records.

What the Research Found

Zhu et al. (2025) analysed health records from 342,760 adults, including over 85,000 individuals with documented traumatic brain injury.

Three findings stand out.

1) A higher observed risk of MND after TBI

Individuals with a history of TBI showed approximately a 2.6-fold higher risk of later receiving an MND diagnosis compared with matched members of the general population. In absolute terms, 69 of 85,690 people with TBI developed ALS (about 0.08%), while 81 of 257,070 matched controls developed ALS (about 0.03%).

At face value, this appears alarming, and it is easy to interpret this as evidence that brain injury causes MND, but the story is more nuanced.

2) No difference in disease timing or survival

The researchers found no difference in age at diagnosis or age at death between people with and without prior TBI.

If traumatic brain injury were directly accelerating disease progression, we might expect earlier onset or shorter survival. That was not observed.

3) The risk was confined to the first two years

The finding that deserves the most attention, is that increased risk existed only within two years after the injury. After that period, risk returned to baseline levels.

This led researchers to propose a concept many outside academia rarely hear discussed: reverse causality.

What is Reverse Causality?

MND often develops silently before diagnosis. Early symptoms can include subtle weakness, coordination changes, or balance issues long before disease is recognised.

Zhu et al. (2025) suggests that, in some individuals:

• early, undiagnosed MND may increase falls or accidents
• those events result in a recorded traumatic brain injury
• the neurological disease is diagnosed months or years later

In other words, the injury may not be causing the disease; the disease may be contributing to the injury. This distinction matters enormously for athletes, governing bodies, and public perception.

What This Means Sport

The current evidence does not prove that traumatic brain injury causes MND.

What it does show is an observable association, a strong possibility of reverse causality and significant gaps in long-term data.

The journeys of Rob Burrow and Doddie Weir increased awareness of MND in the public eye and Lewis Moody’s diagnosis reminds us that this is not a historical conversation, but an ongoing one. Rugby has already implemented meaningful change; increasing concussion awareness, introducing stricter protocols, appointing independent match-day doctors, enforcing graduated return-to-play pathways, and adapting laws to reduce head contact. Each represents a step forward.

Yet we are only at the beginning of understanding brain health across an athlete’s lifetime. The next breakthroughs may not come from looking harder at the brain in isolation, but from understanding the wider system around it, how forces move through the body and brain in different sports, how athletes adapt over time, and how subtle changes accumulate long before symptoms appear, and monitoring all known risk factors that influence brain health  both during and well beyond an athletes sporting career.

Brand new Evidence is now changing our approach!

Three high-quality studies published in 2025 mark a strategic shift in concussion rehabilitation. Collectively, they demonstrate that early, structured oculomotor therapy — particularly vergence and accommodative exercises — is both safe and effective in accelerating recovery after sport-related concussion.

The CONCUSS Trial – Alvarez et al., 2025 (BJSM)

The CONCUSS randomised clinical trial was the largest to date to evaluate vergence and accommodative therapy for concussion-related convergence insufficiency. Compared with usual care, participants receiving targeted vision therapy showed significant improvements in near-point convergence, symptom severity, and reading performance.
This study validates vergence/accommodative therapy as a priority evidence-based, neuro-optometric intervention, not merely an optional adjunct to general rehabilitation.

Haider et al., 2025 (Applied Sciences)

Haider and colleagues trialled a self-guided oculomotor rehabilitation program for adolescents early after concussion. Exercises were simple, short, and home-based, focusing on smooth pursuit, saccadic, and convergence control. The results were impressive: participants who began these tasks early recovered visual symptoms more rapidly and reported better functional outcomes than those in usual care.
Crucially, the study confirmed that early oculomotor training is feasible, safe, and well-tolerated, supporting a paradigm shift toward active early management with foundation exercises rather than just delayed visual rehabilitation.

Trbovich et al., 2025 (Journal of Neurotrauma)

Trbovich and colleagues conducted a randomised controlled trial of Brock string vision therapy for individuals with receded near-point of convergence (NPC >5cm) following concussion. Even with a short protocol, participants achieved measurable improvements in convergence and symptom reduction compared with controls.
This trial suggests that structured vergence exercises, long used in vision therapy, can be effective tools within mainstream concussion rehabilitation programs.

Our Updated Clinical Approach

We are evolving our concussion rehabilitation guidance to reflect this evidence.

– Continue sub-threshold aerobic and cervico-vestibular rehabilitation as foundational elements.
– Introduce very basic early oculomotor and vergence exercises such as near–far focus, smooth pursuits, saccadic training and even Brock string when tolerated.
– Maintain clear and early referral pathways to orthoptists, and ophthalmologists for complex or persisting visual deficits.
– Use longitudinal tracking — such as vestibular-ocular assessment tools within ScreenIT — to monitor recovery trajectories and guide rehabilitation progression.

This updated approach embraces an “early, active, and integrated” model of concussion care. One that aligns visual, vestibular, cervical, and cognitive systems from the earliest stages of recovery.

Key Takeaway

Concussion rehabilitation is evolving from “wait and refer” to “treat early, integrate and refer”
Just as sub-threshold aerobic and vestibular interventions transformed concussion outcomes over the past decade, early oculomotor therapy now stands as the next frontier — restoring efficient eye-brain coordination, accelerating recovery, and reducing long-term symptom burden.

So, what are we going to do in Your Brain Health? We will provide more guidance on early foundation oculomotor exercises within our courses. We encourage more orthoptists, ophthalmologists and some behavioral optometrists to join our network, as this is becoming a great ecosystem where clinicians can not only find each other but can share and ask important clinical questions.

Following my colleague David Bartlett’s recent review of the Townsend et al. (2025, BJSM) paper, which quantified real-world heading forces using instrumented mouthguards across Premier League and WSL players, I turned my attention to the next logical question: how do we reduce those loads safely and effectively?

Townsend’s work confirmed that match-like drills (crosses and long balls) produce the highest rotational accelerations, and that female players consistently experience greater rotational forces than males. These findings gave us the most objective dataset yet on what happens when players head the ball. But measurement is only half the story; the real challenge lies in translating that knowledge into modifiable protective strategies.

Why Rotational Load Matters

Rotational acceleration has long been implicated as the more injurious component of head motion. Finite-element brain models show that rotational strain, particularly in cortical sulci, better predicts diffuse axonal injury and potentially chronic traumatic encephalopathy (CTE). Townsend et al. note that cumulative exposure to these rotations may predict pathology more accurately than a history of diagnosed concussions.

For clinicians, this reinforces that sub-concussive load management should focus on quality of movement, neck control, and task design, not only symptom surveillance.

The Role of Neck Strength and Control

Complementary evidence now strengthens this message.

• Fownes-Walpole et al. (2025) combined systematic review and Delphi consensus to outline the essential components of neck-training programs for impact mitigation. Their expert panel emphasised that effective training should target:
• • Multi-planar strength and endurance
  • Dynamic stabilisation and anticipatory control
  • Sport-specific movement patterns rather than isolated static holds
• Garrett et al. (2023, JOSPT) meta-analysed team-sport data and found a moderate negative correlation between neck strength and head-impact magnitude. Stronger necks absorb and redirect more of the incoming force, but only when activation is well-timed and directional.
• Kavyani et al. (2025) reported that athletes with a prior concussion history demonstrate persistent neck-strength deficits, highlighting the importance of post-injury reconditioning before return to contact drills.
• Peek (2022) provided a clear clinical framework for measurement, recommending handheld dynamometry or fixed-rig setups that capture flexion, extension, and lateral strength in neutral head posture. Reliable measurement underpins both screening and training progression.

Together, these studies shift the conversation: neck training is not an optional extra, but a primary prevention and rehabilitation strategy for athletes exposed to repetitive head loads.

Technique and Tactical Preparation

Prevention also extends beyond musculature.

• Peek et al. (2025) urged a “re-think” of head-injury prevention through tactics and technique. Coaching points such as body positioning, timing of jump, and angle of approach can meaningfully alter both impact location and rotational torque.
• Ross et al. (2025, HeaderPrep) demonstrated that targeted heading-readiness programs for youth female players are both feasible and well-accepted, improving confidence and technique while limiting high-force exposures.

For practitioners, these findings support a progression model: prepare before exposure. Blending neuromuscular control, technical education, and measured load increments.

Translating Evidence Into Practice

Quantify and Monitor

Whenever possible, use objective measures such as validated digital tools like instrumented mouthguards or video coding to track exposure patterns over time. Even periodic sampling can highlight positional or drill-specific risk.

Structure Heading Drills

• Begin with low-velocity, “thrown” headers, focusing on timing and neck control.
• Progress to aerial crosses and long-ball scenarios only once mechanics and anticipatory activation are stable.
• Limit overall high-force exposures, particularly across congested training weeks or in younger players.

Integrate Neck Training Year-Round

• Combine isometric holds, dynamic perturbation exercises, and multi-directional resistance (e.g., band or partner drills).
• Train in football-relevant postures: semi-flexed trunk, reactive stance, rather than supine positions.
• Review progress every 4–6 weeks using consistent testing positions.

Educate and Communicate

Ensure players understand why load management matters. Encourage disclosure of dizziness, neck fatigue, or delayed headache after repetitive headers, symptoms that can reflect both musculoskeletal and vestibular strain.

Implications for Female and Youth Athletes

Townsend et al. found higher rotational loads in female players, aligning with other data showing increased concussion incidence in women’s football. Potential contributors include lower baseline neck strength, smaller head-to-ball mass ratios, and different heading mechanics.
Clinicians should therefore:

• Establish sex-specific baselines for neck strength and control.
• Introduce graduated “header readiness” programs for adolescent and female players before exposure to match-like drills.
• Advocate for equitable inclusion in future research. Female cohorts remain markedly under-represented.

The Bigger Picture

Collectively, these studies provide the framework football has long needed:

• Townsend 2025 quantifies how much and how hard players head the ball.
• Fownes-Walpole, Garrett, and Kavyani explain how the neck contributes to mitigating load.
• Peek and Ross show how to coach and measure it in real settings.

For clinicians, this convergence of evidence allows more precise conversations with coaches, strength staff, and governing bodies about “smart exposure” — protecting brain health without losing the skill of heading.

Take-Home Summary

Closing Thought

As Townsend et al. conclude, the aim is not to eliminate heading but to guide it. With a deeper biomechanical understanding, targeted neck-training protocols, and modern monitoring technology, clinicians can lead football toward a future where every header is both skilful and safe.

The recent British Journal of Sports Medicine paper by Townsend et al. (2025) marks a significant step forward in our understanding of heading exposure during football training. For the first time, elite male and female footballers were monitored using instrumented mouthguards (iMGs) to capture the real-world frequency and intensity of headers, moving beyond laboratory estimates and self-report data that have long limited this area of research.

Across 63 professional training sessions, the study recorded nearly 1,500 heading events. The results revealed average peak linear accelerations of 18 g and rotational accelerations of ~1,000 rad/s², with female players consistently experiencing higher rotational accelerations than males. Crucially, match-like scenarios such as crosses and long balls produced the highest forces, while throw-ins, more common in training drills, resulted in lower impacts.

A step forward for football science

This research represents tangible progress. The methodology adheres to the Consensus Head Acceleration Measurement Practices (CHAMP) framework, using a validated iMG technology (Protecht) to produce the most reliable dataset yet on heading in elite football. It provides an evidence base for training-load management and begins to inform guidance on limiting repetitive head impacts, a necessary foundation for future policy and practice.

The use of wearable technology across both men’s and women’s elite tiers should be recognised as a milestone for player welfare. For the first time, we can meaningfully quantify what a “typical” training exposure looks like, rather than relying on conjecture or extrapolation from match data.

But peak force understanding remains limited

While the study provides robust quantification of how often and how hard players head the ball, it stops short of answering the critical question; what do these forces mean for the brain?

The peak linear and rotational accelerations recorded remain well below concussive thresholds, yet our understanding of the cumulative or sub-concussive impact of repetitive exposure remains incomplete. Rotational acceleration, in particular, is thought to exert greater strain on neural tissues, but the clinical consequence of these training-related exposures remains speculative.

This is especially relevant for women’s football, where the study identified significantly higher rotational accelerations but could not determine why. Possible explanations include differences in neck strength, head-neck segment mass, or heading technique, all of which demand closer biomechanical and neuromuscular scrutiny.

The practical takeaway: neck strength and neuromuscular control matter

What this study reinforces, perhaps more than anything, is the need for targeted cervical spine conditioning as part of concussion-prevention and performance programmes.

Strong, well-coordinated neck musculature could reduce head acceleration by stabilising the head–neck complex at the moment of impact. In practical terms, this means progressive strength and proprioceptive training, ideally integrated into existing strength and conditioning or physiotherapy routines.

For female athletes, who may be more susceptible to higher rotational forces, this may carry even greater importance. Tailored neuromuscular interventions that improve timing, co-contraction, and dynamic control could be key to mitigating risk without compromising performance.

Progress made

Townsend et al. should be commended for delivering the most comprehensive quantification of training-related heading to date. Their findings are a clear advance in the ongoing effort to understand, and ultimately manage, the neurological load placed on footballers.

But quantification is not the same as comprehension. Until we better understand how these forces translate into brain strain, metabolism, and long-term neurodegenerative risk, our response must combine data-driven exposure management with proactive neck-control conditioning.

In short: progress has been made, but the science of protection is only just beginning.

Concussion isn’t simply a brain injury – it’s a biomechanical event.

As Professor Mike Loosemore, MBE, aptly puts it: concussion is a “rapid head acceleration injury”. In practical terms, this means the impact is not confined to neural tissue alone. The same acceleration–deceleration forces can strain the cervical spine, disrupt vestibular networks, and impair proprioceptive control. These interconnected systems explain why patients often present with overlapping symptoms—headache, dizziness, balance disturbance, and neck pain—that cannot be attributed to brain injury in isolation.

Why the Cervicovestibular System Matters

The evidence is now clear: concussion is rarely a single-system injury. Whiplash-type cervical involvement and central vestibular disruption often coexist, producing overlapping symptoms such as dizziness, headache, balance impairment, and neck pain.

• Persistent Symptoms: RCTs (Schneider et al., 2014) show that patients receiving combined cervical physiotherapy and vestibular rehab were nearly four times more likely to be medically cleared within 8 weeks compared to rest plus aerobic exercise alone.
• Objective Gains: More recent trials in adults demonstrate that while symptoms may improve similarly with aerobic exercise, the addition of cervicovestibular rehab improves objective function (vestibulo-ocular reflex, cervical ROM, proprioception).
• Prognostic Relevance: Cervicogenic pain and dizziness in the early days after concussion are strong predictors of prolonged recovery. Early, targeted treatment may shorten this trajectory.

Conclusion

Concussion is heterogeneous. For some athletes, symptoms are driven primarily by vestibular dysfunction; for others, cervical whiplash is dominant; and often, both systems are involved. The new study in elite female athletes reinforces the importance of screening both domains systematically.

With the right tools and training, health professionals can identify cervicovestibular dysfunction early, target treatment precisely, and track recovery transparently. At Your Brain Health, we’re committed to equipping clinicians with the skills, confidence, and technology to make that possible.

How We Support Clinicians

At Your Brain Health, our Essential Practical course devotes significant time to hands-on cervicovestibular rehabilitation. We know that physiotherapists and allied health professionals are uniquely positioned to address these impairments—but confidence and skill in assessment and treatment are essential. The reality is that many physiotherapists that have experience in sports and musculoskeletal practice are less confident when it comes to vestibular practice. While many vestibular and neurological physiotherapists have less experience with cervical assessments and treatments. However, it does not take long for us to upskill both groups!

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.

How common is concussion in football?

While the most frequent injuries in football involve the lower limbs, concussions and other head injuries, though less common, remain a significant concern. Head and neck injuries are rank as the 5th most common type of injury, making up about 5% of all football injuries. Specifically, concussions occur at a rate of approximately 0.5 per 1000 match hours, with an even lower incidence during training sessions.

How do head injuries occur?

Head injuries often happen during aerial challenges. Collisions involving head-to-head contact, elbow-to-head, knee-to-head, foot-to-head, and head-to-ground impacts are the primary culprits.

Are some positions more likely to sustain a concussion?

Yes, defenders are most prone to concussions (33%), followed by midfielders (30%), forwards (24%), and goalkeepers (13%). These injuries are most common in the final and initial 30 minutes of a match, particularly in midfield areas where collisions and aerial duels are frequent.

Is there a difference between the male and female game?

Indeed, studies show that head and neck injuries occur more frequently in female players compared to their male counterparts (17% vs. 14%).

What are the impacts of concussion on football players?

Growing concerns have emerged following studies indicating that former professional footballers are 3.5 times more likely to die from neurodegenerative diseases than the general population. Conditions like dementia, Parkinson’s, motor neuron disease, and Chronic Traumatic Encephalopathy (CTE) are linked to repeated head impacts.

One of the lesser-reported impacts of a concussion is that athletes are reported to have a 2.5 times greater risk of sustaining a subsequent musculoskeletal injury following an initial concussion.

What about concussion substitutes?

The International Football Association Board (IFAB) approved the trial of permanent concussion substitutes in 2021. This measure was implemented in the Premier League and Women’s Super League, with FIFA initially trialling it in international competitions such as the FIFA Club World Cup™.

What else are authorities doing to protect players?

Authorities are continuously working to safeguard players. In 2021, new heading guidelines were introduced by The FA, Premier League, EFL, the PFA and the LMA, recommending that a maximum of 10 higher-force headers are carried out in any training week. In May 2024, the FA have begun phasing out deliberate heading in matches for all grassroots youth football from U7 to U11.

How can Your Brain Health help?

Your Brain Health is dedicated to promoting effective concussion management strategies within the football community. Through education, such as the online Level 1 course “Concussion – Are You Ready?”, players, coaches, and officials can learn to protect themselves and others, ensuring the long-term health and safety of everyone involved in the sport.

Together, by staying informed and proactive, we can ensure that football continues to be a source of joy, unity, and safety for all. Enjoy the matches, support your teams, and let’s keep our players safe on the road to glory at Euro 2024!

How common is concussion in cricket?

Concussions in cricket are less frequent than injuries to the hamstring, lumbar spine, and trunk. However, they still occur. Data indicates an annual concussion incidence of 0.9 per 100 players, or 2.3 males and 2.0 females per 1000 days in the elite game.

In England, during the 2023 domestic season, there were 17 reported concussions, each resulting in an average of 10 days lost per concussion.

How do head impacts occur in cricket?

The primary cause of head impacts in cricket is batters being struck by the ball from fast bowlers, accounting for 67% of such incidents. Other causes include close fielders being hit by the ball, collisions with other players or the boundary fence, the head striking the ground, and wicketkeepers being hit by the bat!

Is there a difference in Men’s and Women’s cricket?

Yes, there is a difference. In elite cricket, concussion rates are 0.4 per 1000 player hours for men and 0.5 for women. Interestingly, 53% of head impacts in women’s matches result in concussions, compared to 32% in men’s matches.

What is the impact of concussion in cricket?

Post-concussion, symptoms like balance issues, impaired concentration, and vision problems can affect performance relating to cricket. Repeated head impacts and concussions are linked to chronic traumatic encephalopathy (CTE), though there are no known cases in cricketers so far.

In 2021, Derbyshire wicketkeeper Harvey Hossein retired from cricket following a series of concussions.

What are the concussion protocols in cricket?

In 2019, the International Cricket Council (ICC) mandated concussion protocols, requiring players to pass a series of assessments before continuing play.

What about concussion substitutes?

Since August 2019, the ICC has allowed concussion substitutes in Test matches. If a player is diagnosed with a concussion, they can be replaced by another player who can fully participate.

Marnus Labuschagne became the first concussion substitute in the history of international cricket, replacing Steve Smith during the Lord’s test of the 2019 Ashes series. He went on to score 59 in the fourth innings to help Australia salvage a draw.

What are the helmet regulations?

Modern cricket helmets are designed to offer enhanced protection but cannot eliminate concussion risk entirely. Helmets must comply with the British Standard BS7928:2013, a mandate from the ICC to improve player safety. The introduction of neck guards has also been developed which have now been mandated by both Cricket Australia and the ECB.

What are the guidelines at an amateur club or school?

While elite teams have trained medical staff to manage head impacts, concussions also occur at the community level. In Australia, 28% of cricket-related hospital admissions were as a result head injuries.

Research indicates that players often lack awareness about guidelines, testing, and helmet regulations, highlighting the need for ongoing education. Australian Guidelines now recommend clubs and schools appoint a concussion officer to manage concussions.

How can Your Brain Health help?

Your Brain Health offers education on concussion, including the online Level 1 course “Concussion – Are You Ready?” This 45-minute course is designed for those at elevated risk of concussion or who wish to become designated concussion officers.

Baseline screening

We have removed time and cost limitations by designing fast and cost-effective multimodal screens that focus on key measures monitored and compared at an individual level to inform best care following a concussion.

Education

We have developed a world class programme of three critical courses for anyone involved in concussion management. From parents and teachers through to medical practitioners wanting evidence-based updates. Knowing the most up to date developments saves lives.

Support

We facilitate support by providing opportunities for global networking within our custom designed online community of experts. Knowledge around concussion continues to evolve rapidly from the fields of neurology, vestibular, musculoskeletal and sports rehabilitation. Collaboration and sharing are key to innovation and best practice moving forward.

Technology

We are at leading the way in the selective use of the very best technological advances. From specific software, apps, virtual reality, eye-tracking, balance, movement, heart rate and cognitive testing devices, we know what people need and when. The ScreenIT assessment platform brings many of these tools together in a single multimodal screening workflow.

Biopsychosocial Model:

The paper emphasizes a holistic approach to concussion management.

Beyond physical aspects, consider psychosocial factors (e.g., mental health, social support).

Personalized care is crucial.

Education and Prevention:

From athletes, to coaches, to parents improving education in this area is essential.

The paper underscores the authority of licensed medical professionals in decision-making.

Preventive measures, such as proper technique and equipment, play a vital role.

Assessment Advances:

The assessment process has evolved, including an update on the optimal value of baseline screening measures.

A comprehensive evaluation includes symptom assessment, cognitive testing, balance assessment, vestibular-ocular and mental health screening.

Athletic trainers should be proficient in these areas.

Prognostic Recovery Indicators:

Factors affecting recovery post-concussion are explored.

Initial symptom severity, early care seeking, and other individual characteristics influence outcomes.

Monitoring these indicators can inform key management decisions.

Mental Health Considerations:

Pre- and post-injury mental health are critical.

Screening for mental health conditions is recommended.

Establish referral networks for athletes with mental health needs.

Return to Academics:

Returning to school after a concussion requires careful planning.

Individualized support, academic adjustments, and communication with educators are essential.

Monitor academic progress during recovery.

Physical Activity and Rehabilitation:

Early controlled aerobic exercise benefits recovery.

Targeted rehabilitation interventions address persistent symptoms, including vestibular and cervicovestibular rehab protocols.

Gradual return to physical activity is part of the process.

Return to Sport:

Updated return-to-sport guidelines emphasize a stepwise approach.

Clinically directed aerobic exercise is part of treatment.

Individualized decisions consider the athlete’s well-being.