Objective To document the incidence of head impacts at the elite level in the sport of cricket, where there currently is very little epidemiological data regarding concussion.

Design Prospective registry of head impacts reported by medical and physiotherapy staff and/or discovered by Chief Medical Officer from clinical record-keeping systems and media reports

Setting Elite-level male and female cricket in Australia for one season (2015–16)

Main results There were 64 head impacts on the registry for season 2015–16, with 20 of these occurring in List A/First Class men’s matches and 6 occurring in List A women’s matches. The match incidence rates were 3.9 head impacts/1000 player days in elite male cricket and 3.1 head impacts/1000 player days in elite female cricket. The vast majority were caused by ball-helmet(head) impact, with a majority in batters (strikers). The next most common players affected were wicketkeepers and close-in fielders. An incidence rate for concussion is not presented as there were a number of ambiguous head impact cases (clinically not diagnosed as concussion on the field but with symptoms or abnormal Cogsport tests after the match)

Conclusions The rate of head impact in cricket is perhaps higher than previously appreciated (as it has been traditionally considered a low-risk sport for concussion), although lower than the football codes. Definition of concussion in this sport is quite subjective and problematic, perhaps as it is the only team sport in which injury substitution is not permitted, which may influence the reporting of symptoms by players during the match.

Competing interests Chief Medical Officer, Cricket Australia.