Published: 5th May 2023

Participants in grassroots sports will be better protected from the potentially devastating effects of head injuries and concussion thanks to new official guidelines advising: ‘if in doubt, sit them out’.

• First ever UK-wide concussion guidance published to help people identify, manage and prevent concussion affecting players in grassroots sport
• ‘If in doubt, sit them out’ becomes new call-to-action for all players, coaches, parents, schools and National Governing Bodies and sports administrators
• Guidance, developed by clinicians, academics and sports governing bodies, forms part of Government’s Action Plan on Concussion designed for all grassroots sport

The Government and the Sport and Recreation Alliance today publishes the first UK-wide Concussion Guidelines for Grassroots Sport which will help players, coaches, parents, schools, National Governing Bodies and sports administrators to identify, manage and prevent the issue.

The guidelines, developed by an expert panel of domestic and international clinicians and academics in neurology and sports medicine, sets out steps to improve understanding and awareness of the prevention and treatment of concussion in grassroots sport where trained medical professionals are less likely to be routinely present. It is targeted at people of all ages.

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

Players, parents, coaches, teachers and administrators are now asked to read the guidance and familiarise themselves with the necessary steps to:

• RECOGNISE the signs of concussion;
• REMOVE anyone suspected of being concussed immediately and;
• RETURN safely to daily activity, education/work and, ultimately, sport.

The guidelines include a recommendation to call NHS 111 within 24 hours of a potential concussion, to rest and sleep as much as needed for the first 24 to 48 hours and avoid using devices which involve screen time.

In addition, a graduated return to activity such as work, education and sport is advised to reduce the risks of slow recovery, further brain injury and longer-term problems. Individuals should be assessed by an appropriate healthcare professional if symptoms persist for more than four weeks.

Culture Secretary Lucy Frazer said:

“Sport keeps us healthy and active and is a great way to meet people and get involved in the community.

“Most people take part without doing any serious damage to their body but major injuries to the head can and do happen.

“Research has shown the importance of fast and effective tailored treatment and we are issuing expert guidance to help people spot and treat head injuries.

“Whether used in a local leisure centre during a swimming lesson or on a village green during a cricket match, the guidance will make a real difference to people’s lives.”

The move meets a commitment set out in the Government’s Action Plan on Concussion in 2021 to introduce a national approach to prevent concussion and brain injury in sport, and to do so through a combination of improved research and new technologies.

It follows increasing focus on the long-term negative health effects from brain injury and concussion sustained while playing sport. This is linked to advances in training, coaching, equipment and technology which have led to stronger, faster and better-trained players at all levels.

Development of the guidelines has been led by the Sport and Recreation Alliance, Professor James Calder, chair of the expert drafting group, and Laurence Geller, the Government’s Adviser on Concussion in Sport. The expert drafting group drew upon existing field research, with the aim of producing a consistent and preventative approach across all sports in England, Scotland, Wales and Northern Ireland.

It builds upon the world-leading work conducted in Scotland which was the first nation in the world to produce guidelines covering all types and levels of sport. Its guidance was updated in March 2021.

Lisa Wainwright MBE, CEO, Sport and Recreation Alliance said:

“Concussion is a serious issue and we must always strive to make sport as safe as possible for all those who take part at a grassroots level in clubs, schools and many other settings every week across the UK.

“The Sport and Recreation Alliance is pleased to have supported the development of these guidelines which will ensure there is a consistent, evidence-based approach to concussion in sport across all four home nations.

“When it comes to concussion, the message is clear: if in doubt, sit them out.”

Professor Chris Whitty, Chief Medical Officer for England and Chief Medical Adviser to the UK Government said: 

“These guidelines help players, referees, schools, parents and others balance the substantial health and social benefits and enjoyment from taking part in sport with minimising the rare but serious and potentially lifelong effects of concussion.”

Laurence Geller CBE, UK government independent concussion advisor and Chairman of the ‘Love of the Game’ campaign, said:

“Today’s announcement marks an important step forward for players of grassroots sport.

“The guidelines have been developed by leading minds from across the scientific, sporting and academic fields and will make sure all people from school sports coaches to NHS specialist clinicians are unified in common understanding and practice on concussion.

“It will protect sportspeople at all levels and mean they can participate in the sports they love.”

Professor James Calder, Chair of the UK Concussion Guidelines Expert Drafting Group, said: 

“For the first time we have UK-wide guidance that raises awareness of concussion in grassroots sport at all levels. It provides practical evidence-based advice for those who may have sustained a concussion and gives a step by step plan for their safe return to work, education, exercise and full sport.

“Participation in sport and exercise is crucial for the nation’s mental and physical health and, with appropriate management, the vast majority of those who sustain a concussion during sport should make a full recovery.”

Professor Willie Stewart, Glasgow University, said: 

“The release of these guidelines represents a world-leading landmark in sports concussion management.

“Based on the pragmatic, precautionary approach to immediate concussion management of ‘if in doubt, sit them out’, followed by an emphasis on individualised, self-managed return to normal life and sport, these guidelines set the standard for grassroots concussion management that all sports across the UK will follow.”

Simon Shaw MBE, former England rugby union player and President of the ‘Love of the Game’ campaign, said:

“Concussion in sport can be a serious issue if not managed properly and, as a former sportsperson, I’ve seen first-hand the impact head injuries can have.

“Whether playing football as part of a Sunday league or training for a boxing match, it’s crucial that sportspeople at every level are protected.

“This guidance will help everyone involved in grassroots sport recognise the signs of concussion and remove people from play where necessary. The information is clear: ‘If in doubt, sit them out.’ ”

Participation in sport and physical activity provides significant mental health and wellbeing benefits, including reducing the risk of developing dementia in later life. As well as preventing or lowering the risk of health conditions like stroke, heart disease, cancer and depression, it can also help reduce pressure on the NHS in the longer term.

It is important that adults continue to follow the recommended 150 minutes of physical activity a week, and children 60 minutes a day, as per The Chief Medical Officer’s recommendations.

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