ACC, in partnership with seven national sporting organisations, has announced the new National Concussion Guidelines for community sport.

The Guidelines – which come into effect for the 2024 winter sport season – are designed to improve the health outcomes and wellbeing for people who play community sport by introducing a standardised approach to managing concussion.

They provide principles and general advice for the sport community and health professionals to recognise and treat concussion in a consistent way.

The key changes are: (1) When a player suffers a concussion, they must have a minimum period of 21 days away from full competition and (2) medical clearance must be obtained prior to return to play.

Dr Stephen Kara says the National Concussion Guidelines are a “game changer” for community sport.

“Historically, there has been no national and consistent standard for recognising and treating concussion at the community sport level,” says ACC’s deputy chief executive of prevention and partnerships Tane Cassidy.

“As a player, parent, caregiver, member of whānau, coach, club official, or referee it is hard to know what advice to follow.

“Similarly for GP’s, it is confusing and hard to know what advice to give and to who.

“This inconsistency increases the risk of people either not reporting their concussion at all or reporting their concussion but returning to sport too soon and risking more serious injury.

“These National Concussion Guidelines aim to change that.”

In June last year, ACC convened an expert panel and held a workshop with the medical directors from the larger and higher risk sports codes.

The expert panel included: Dr Stephen Kara (expertise and specialist interest in concussion), Dr Mark Fulcher (NZ Football medical director), Dr John Mayhew (NZ Rugby League medical director), Dr Ian Murphy (ACC Principal Clinical Advisor), Sharon Kearney (Netball NZ Injury Prevention consultant), Dr Melinda Parnell (Netball NZ medical director) Karen Rasmussen (NZ Rugby Medical manager) and Dr Graeme McCrory (Equestrian Sports NZ medical director and community GP).

ACC collated the latest research around concussion including international consensus statements and applied this in the New Zealand context, with concussion being managed in primary care.

The panel agreed on the return to play changes for a player who has suffered a concussion.

This approach is consistent with community sport in Australia and the UK.

This was based on guidance in the International Consensus Statement on Concussion in Sport, the UK Concussion Guidelines for Grassroots Sports and other relevant research.

Mount Albert Lions centre Dillon Rota receives treatment. In 2023, ACC accepted 489 rugby league related concussions.

The AIS, the Australian Sports Commission’s high performance arm, in a world first has aligned the Youth and Community Sport Guidelines with advice in both New Zealand and United Kingdom.

Keeping young people safe when they participate in sport is paramount and it’s great to see sports organisations engaging with this initiative, says Sport NZ group manager of play, active recreation and sport, Jim Ellis.

“A collective approach to concussion guidelines will have big benefits.

“Ultimately, it will help players, coaches, parents, volunteers and everyone involved community sport to ensure there is consistency in terms of diagnosis, treatment, and the return to sport.

“It’s also important to see our new National Concussion Guidelines aligning with what is happening in community sport across Australia and the UK.”

It believed that the guidelines would lead to greater awareness of concussion and a decrease in risk of longer-term negative effects of concussion.

These guidelines are for community and grassroots sport only, on the assumption that these players do not have medical support.

In elite and high-performance sport environments, athletes have immediate access to medical support and will continue to have that wrap around support and time to develop tailored rehab programmes that can be monitored daily.

Dr Kara, the independent member of the expert panel says the National Concussion Guidelines are an important step to putting player’s welfare first.

Dr Stephen Kara says it’s everyone’s responsibility in community sport to ensure concussions are being managed properly.

“This is a game changer for community sport in this country,” he says.

“We know it can be confusing for coaches, players, family and health practitioners if concussion management advice from each sport is different and this will change that will clear guidelines and process for all sports.”

Kara says managing and preventing concussion is everyone’s responsibility.

“Concussion can happen at home, work or on the sports field and everyone can learn to recognise when a concussion may have occurred,” he says.

“We all have a role to play in creating a culture where concussion is called out and reported to a medical professional. Collectively we can make a big difference.

“These National Concussion Guidelines make it very clear for everyone on the steps to follow to ensure that the player is in a fit state to return to play.”

In 2023, ACC accepted 10,648 claims for sports-related concussion.

These injuries came at a cost of $64 million to help people recover.

This was the highest number of claims and the highest cost over the past five years. From 2019 – 2023 ACC spent $266 million helping people recover from sports-related concussion.

Research from ACC suggests that around 1,100 concussions currently go untreated.

The highest number of sport-related concussions occur in team-based sports such as rugby, football, basketball and from cycling and equestrian activities.  

Cassidy says it’s important that concussion symptoms are managed well.

“Good early management of concussion can improve long term outcomes.

“We are committed to increasing awareness and education around concussion, and these Guidelines give community sport the direction they need.”

Cassidy says that good recovery from concussion before they return to play ensures they get back to their best. This is better for the player and their team’s performance.

“Taking 21 days to get right gives the player the best chance to fully regain their strength, coordination, speed and skills,” he says.

“So, when they’re back, they’re able to hit the ground running and play to their ability.”

The highest volume of sport related concussion are in the 10–19 age category and research shows that this age group people play multiple sports.

Currently, depending on what sport the person plays, when they have a concussion they will get different advice around a safe return to sport, varying from six days to 23 days.

But that is all set to change in a landmark new direction for community sport.

National Concussion Guidelines – FACT BOX

• · The Guidelines present an opportunity to improve the health outcomes and wellbeing for people who play community sport by introducing a standardised approach to managing concussion.
• · The key changes are:

(1) When a player suffers a concussion, they must be symptom-free for 14 days post-injury before a graduated return to play.

(2) They must complete a minimum period of 21 days away from full competition before clearance to return.

(3) Medical clearance must be obtained prior to return to play.

ACC encourages all sports to practice the Four Rs of Concussion Management

• · Recognise (the signs and symptoms of concussion)
• · Remove (the person from play)
• · Refer (to a medical doctor to confirm diagnosis and provide treatment)
• · Recover (before returning to school/work and sport) For more information: Sport Concussion in New Zealand: National Guidelines