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Amsterdam 2022 International Consensus on Concussion in Sport: calling clinicians to action!
  1. Kathryn J Schneider1,2,3,
  2. Jon S Patricios4
  1. 1 Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  2. 2 Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
  3. 3 Alberta Children's Hospital Research institute, University of Calgary, Calgary, Alberta, Canada
  4. 4 Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  1. Correspondence to Dr Kathryn J Schneider, Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, T2N1N4, Canada; kjschnei{at}

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The June 2023 editions of BJSM contain the long-awaited papers emanating from a 5-year process that culminated in the sixth International Conference on Concussion in Sport (Amsterdam, 27–30 October 2022). The COVID-19 pandemic delayed the consensus outcomes by 2 years, but during that time over 100 international experts contributed as coauthors of systematic reviews, screening 78 018 citations and completing 1459 full-text reviews. A total of 600 clinicians and researchers attended the 6th International Conference on Concussion in Sport, 29 expert panellists crystallised the science from the reviews into an updated Consensus Statement, (see page 695) and 5 new sport-related concussion (SRC) assessment ‘tools’ have been produced. (see page 689, 619, 636, 651, 672). We are pleased to share the outputs from the Amsterdam Consensus 2022 which are meant to be adapted for local and national sport contexts around the globe to positively impact the care of athletes with SRC.

Global relevance

International summary, agreement and consensus statements on concussion in sport have evolved over the past 23 years and guided current clinical practice. The last International Consensus Statement on Concussion in Sport was published in 2017,1 along with 12 systematic reviews and the 3 assessment tools. Importantly, true global translation to clinical practice requires these works to be culturally adapted to inform regionally appropriate guidelines for concussion care across the world.2 In fact, there are 14 translations of the SCAT5 available.3

The 6th International Conference on Concussion in Sport was supported by the International Olympic Committee, Fédération Internationale de Football Association, International Ice Hockey Federation, Fédération Equestre Internationale, World Rugby and the Fédération Internationale de l’Automobile. We are grateful for the support of this important scientific process and optimistic that the global networks that these sporting bodies have will further promote better athlete care as they develop and disseminate sport-specific guidelines.

New resources

The outcomes of the Amsterdam Consensus process are intended for athletes of all levels (from grass roots to professional), and across all ages, including children, adolescents and adults. The concept of 11 ‘R’s’ from the 2017 Berlin conference created an easy-to-follow framework that again has been followed in the consensus statement to summarise key messages. The scientific committee used an updated, rigorous methodological process to conduct the systematic reviews and guide the consensus process, which is described in detail in the methodology paper. (see page 712)

While resources and access to care may vary at different levels of sport and geographic locations, similar principles related to the management of athletes to optimise health and safety can be applied across the spectrum. We highlight primary prevention (i.e., preventing SRCs before they occur) as paramount. (see page 749) Recognition of concussion and immediate removal from play continues to be a key message applicable to all settings. The development of an updated Concussion Recognition Tool-6, (see page 689) a Sport Concussion Assessment Tool-6 (SCAT6), (see page 619) and Child SCAT6 (see page 636) have been informed by a systematic review on acute detection of SRC (see page 722) . A new Sport Concussion Office Assessment Tool (SCOAT6) (see page 651) and Child SCOAT6 (see page 672) are designed to guide the subacute (>3 days from injury) assessment of SRC. These assessment tools are all freely available to enable broad access for all stakeholders involved in the care of athletes at risk of or who have sustained an SRC.

Progress but more to do

Appropriate early management of concussion, including the use of exercise (see page 762) , implementation of updated gradual return to learn and return to sport strategies (see page 798) , rehabilitation when symptoms persist (see page 771) and referral to appropriate healthcare professionals using an interdisciplinary team approach (see page 780) are recommended and highlighted by comprehensive systematic reviews in these two concussion-dedicated BJSM editions. In some cases, recommendations may differ across ages, sex, sport or level of play. It is also important to consider differential access to healthcare professionals and the availability of local resources. Another new feature to this Amsterdam consensus is a systematic review dedicated to informing retirement recommendations (see page 822) . The systematic review on potential long-term effects of concussion comprehensively details the science related to this much-publicised topic and includes a narrative section dedicated to chronic traumatic encephalopathy. (see page 810)

For the first time, the Concussion in Para Sport Group and athletes with disabilities were represented on the Amsterdam Scientific Committee and Expert Panel. It is a start that needs to gain momentum and research—facilitating adaptation of recommendations to the specific needs of all athletes across all sports. Additional considerations for the paediatric athlete and ethical considerations are reviewed in more detail in this consensus statement. Recommendations for future research and priorities were voted on by the audience at the International Conference and summarised in the statement. There is also a section on targeted areas for future research, including the need to diversify research from around the globe. We invite you to review these recommendations and contribute to answering critically important research questions that will enable further improvements in concussion prevention, assessment and management.

Take it all in

We encourage you to read not only the consensus statement, but also the accompanying methodology paper, systematic reviews, tools and editorials to have a comprehensive understanding of the outputs of this consensus process. The recommendations from Amsterdam are meant to be adapted to a variety of health contexts. While these recommendations will evolve as new evidence becomes available, our goal remains to define the optimal care of all athletes with suspected or diagnosed SRC.

Playing your part

We would like to extend our thanks to the over 100 researchers and clinicians from around the world who have spent countless hours and days working on this process, as well as the international sport federations for their educational grant and conference organisation support—it truly has been a team effort! We hope that you adapt these recommendations to your environment and use the freely available tools to positively impact concussion care in athletes.

Ethics statements

Patient consent for publication



  • KJS and JSP are joint first authors.

  • Twitter @Kat_Schneider7, @jonpatricios

  • Contributors KJS and JP contributed to the creation of, writing and editing of the editorial.

  • Funding Educational grant from the International Consensus Conference on Concussion in Sport Organising Committee through Publi Creations for partial administrative and operational costs associated with the writing of the systematic reviews.

  • Competing interests KJS has received grant funding from the Canadian Institutes of Health Research (CIHR), NFL Scientific Advisory Board, International Olympic Committee Medical and Scientific Research Fund, World Rugby, Mitacs Accelerate, University of Calgary, with funds paid to her institution and not to her personally. She is an Associate Editor of BJSM (unpaid), Independent consultant to World Rugby and has received travel and accommodation support for meetings where she has presented. She coordinated the writing of the systematic reviews that informed Amsterdam International Consensus on Concussion in Sport, for which she has received an educational grant to assist with the administrative costs associated with the writing of the reviews (with funds paid to her institution). She is a member of the AFL Concussion Scientific Committee (unpaid position), Brain Canada (unpaid positions) and Board member of the Concussion in Sport Group (CISG)(unpaid). She works as a physiotherapy consultant and treats athletes of all levels of sport from grass roots to professional. JSP is an editor for BJSM for which he receives and honorarium. He is a member of World Rugby Concussion Advisory Group (unpaid), Independent Concussion Consultant for World Rugby (fee per consultation), medical consultant to South African Rugby (unpaid), co-chair of the Scientific Committee, 6th International Conference on Concussion in Sport (unpaid), Board member of the Concussion in Sport Group (unpaid) and Scientific Board member, EyeGuide (unpaid).

  • Provenance and peer review Not commissioned; internally peer reviewed.

Linked Articles

  • Consensus statement
    Jon S Patricios Kathryn J Schneider Jiri Dvorak Osman Hassan Ahmed Cheri Blauwet Robert C Cantu Gavin A Davis Ruben J Echemendia Michael Makdissi Michael McNamee Steven Broglio Carolyn A Emery Nina Feddermann-Demont Gordon Ward Fuller Christopher C Giza Kevin M Guskiewicz Brian Hainline Grant L Iverson Jeffrey S Kutcher John J Leddy David Maddocks Geoff Manley Michael McCrea Laura K Purcell Margot Putukian Haruhiko Sato Markku P Tuominen Michael Turner Keith Owen Yeates Stanley A Herring Willem Meeuwisse
  • Editorial
    Ruben J Echemendia Osman Hassan Ahmed Christopher M Bailey Jared M Bruce Joel S Burma Gavin A Davis Gerry Gioia David Howell Gordon Ward Fuller Christina L Master Jacqueline van Ierssel Jamie Pardini Kathryn J Schneider Samuel R Walton Roger Zemek Jon Patricios
  • Editorial
    Ruben J Echemendia Benjamin L Brett Steven Broglio Gavin A Davis Christopher C Giza Kevin M Guskiewicz Kimberly G Harmon Stanley Herring David R Howell Christina L Master Tamara C Valovich McLeod Michael McCrea Dhiren Naidu Jon Patricios Margot Putukian Samuel R Walton Kathryn J Schneider Joel S Burma Jared M Bruce
  • Editorial
    BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
  • Editorial
    BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
  • Editorial
    BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
  • Discussion
    Kathryn J Schneider Jon S Patricios Willem Meeuwisse Geoff M Schneider K Alix Hayden Zahra Premji Osman Hassan Ahmed Cheri Blauwet Steven Broglio Robert C Cantu Gavin A Davis Jiri Dvorak Ruben J Echemendia Carolyn A Emery Grant L Iverson John J Leddy Michael Makdissi Michael McCrea Michael McNamee Margot Putukian Keith Owen Yeates Amanda M Black Joel S Burma Meghan Critchley Paul H Eliason Anu M Räisänen Jason B Tabor Clodagh Toomey Paul E Ronksley J David Cassidy
  • Systematic review
    Paul H Eliason Jean-Michel Galarneau Ash T Kolstad M Patrick Pankow Stephen W West Stuart Bailey Lauren Miutz Amanda Marie Black Steven P Broglio Gavin A Davis Brent E Hagel Jonathan D Smirl Keith A Stokes Michael Takagi Ross Tucker Nick Webborn Roger Zemek Alix Hayden Kathryn J Schneider Carolyn A Emery
  • Systematic review
    Ruben J Echemendia Joel S Burma Jared M Bruce Gavin A Davis Christopher C Giza Kevin M Guskiewicz Dhiren Naidu Amanda Marie Black Steven Broglio Simon Kemp Jon S Patricios Margot Putukian Roger Zemek Juan Carlos Arango-Lasprilla Christopher M Bailey Benjamin L Brett Nyaz Didehbani Gerry Gioia Stanley A Herring David Howell Christina L Master Tamara C Valovich McLeod William P Meehan III Zahra Premji Danielle Salmon Jacqueline van Ierssel Neil Bhathela Michael Makdissi Samuel R Walton James Kissick Jamie Pardini Kathryn J Schneider
  • Systematic review
    John J Leddy Joel S Burma Clodagh M Toomey Alix Hayden Gavin A Davis Franz E Babl Isabelle Gagnon Christopher C Giza Brad G Kurowski Noah D Silverberg Barry Willer Paul E Ronksley Kathryn J Schneider
  • Systematic review
    Margot Putukian Laura Purcell Kathryn J Schneider Amanda Marie Black Joel S Burma Avinash Chandran Adrian Boltz Christina L Master Johna K Register-Mihalik Vicki Anderson Gavin A Davis Pierre Fremont John J Leddy David Maddocks Zahra Premji Paul E Ronksley Stanley Herring Steven Broglio
  • Systematic review
    Kathryn J Schneider Meghan L Critchley Vicki Anderson Gavin A Davis Chantel T Debert Nina Feddermann-Demont Isabelle Gagnon Kevin M Guskiewicz K Alix Hayden Stanley Herring Corson Johnstone Michael Makdissi Christina L Master Rosemarie Scolaro Moser Jon S Patricios Johna K Register-Mihalik Paul E Ronksley Noah D Silverberg Keith Owen Yeates
  • Review
    Keith Owen Yeates Anu M Räisänen Zahra Premji Chantel T Debert Pierre Frémont Sidney Hinds Jonathan D Smirl Karen Barlow Gavin A Davis Ruben J Echemendia Nina Feddermann-Demont Colm Fuller Isabelle Gagnon Christopher C Giza Grant L Iverson Michael Makdissi Kathryn J Schneider
  • Systematic review
    Michael Makdissi Meghan L Critchley Robert C Cantu Jeffrey G Caron Gavin A Davis Ruben J Echemendia Pierre Fremont K Alix Hayden Stanley A Herring Sidney R Hinds Barry Jordan Simon Kemp Michael McNamee David Maddocks Shinji Nagahiro Jon Patricios Margot Putukian Michael Turner Stacy Sick Kathryn J Schneider
  • Systematic review
    Grant L Iverson Rudolph J Castellani J David Cassidy Geoff M Schneider Kathryn J Schneider Ruben J Echemendia Julian E Bailes K Alix Hayden Inga K Koerte Geoffrey T Manley Michael McNamee Jon S Patricios Charles H Tator Robert C Cantu Jiri Dvorak