The management of concussion has evolved significantly over the past decade, and more recently has received significant media attention, particularly as it relates to professional football codes. Many of the concussion guidelines published 30 years ago were predominantly opinion-based, and favoured mandated periods of abstinence from sport, without consideration of individual athlete recovery times. As the science of concussion has developed, significant new data have enabled the formulation of evidence-based guidelines for the management of concussion in sport, culminating in the guidelines published after each International Symposium on Concussion in Sport meeting in Vienna (2001), Prague (2004) and Zurich (2008).1 Current guidelines focus on clinical assessment of recovery to allow graded return to sport. In the absence of a single gold standard direct measure of recovery, combined clinical measures are used (ie, symptoms, balance and cognitive function).

The paper by Price et al 2 examines the extent of practical application of these guidelines into professional football in the UK. They found that there was a …