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Turning people into couch potatoes is not the cure for sports concussion
  1. Catherine Calderwood1,
  2. Andrew Duncan Murray2,
  3. William Stewart3,4
  1. 1 Chief Medical Officer, Scottish Government, Edinburgh, UK
  2. 2 Sports and Exercise, University of Edinburgh, Edinburgh, UK
  3. 3 University of Glasgow, Glasgow, UK
  4. 4 Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow, UK
  1. Correspondence to Dr William Stewart, Department of Neuropathology, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow G51 4TF, UK; William.Stewart{at}glasgow.ac.uk

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Introduction

In little more than a decade, concussion has become one of the biggest issues taxing modern sport. Incidents of apparently concussed athletes in football's World Cup and in recent Six Nations’ rugby matches have generated unparalleled column inches in the press, comment on social media and challenging review articles;1 the clear suggestion is that something is wrong in sport, and young brains are at risk. With the Rugby World Cup under way, yet more scrutiny of further high profile incidents is inevitable. In the USA, heightened anxiety over sports concussion has caused participation levels to fall. Similar reactions are likely to follow in other countries.

Is this reaction justified? What is the risk of losing the proven benefits of participation in sport compared with the risks of sports concussion?

Immediate and late complications of concussion

Concussions are common in contact sports. Data in rugby union suggest approximately one player per match at community level will sustain a head injury requiring medical attention,2 with around one concussion in every 2.5 matches at the elite level.3 Symptoms vary, and may include headache, visual disturbance …

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