There has been growing concern in sporting communities in Australia and internationally about the potential health ramifications for athletes from repeated head trauma (RHT) and sport-related concussion (referred to as concussion here on). Concussion affects athletes at all levels of sport, from the part-time recreational athlete to the full-time professional. If managed appropriately, most episodes of concussion resolve over a short period of time, with or without medical intervention. Complications can occur, however, including prolonged duration of symptoms and increased susceptibility to further injury. There is also concern about potential consequences of RHT for long term brain health. Chronic traumatic encephalopathy (CTE) is a neurodegenerative pathology associated with a history of RHT. There are a growing number of case studies and case series which document CTE neuropathological change (CTE-NC) in retired athletes with a history of RHT. There remain many uncertainties about the strength of the association between RHT, concussion, and CTE-NC. Further research is required to understand the prevalence of CTE-NC in athletic cohorts and the factors that predispose some athletes to the development of CTE-NC following exposure to RHT. Over recent years there has been elevated public awareness of concussion and increased focus on the importance of diagnosing and managing the condition promptly, safely, and appropriately. Sport administrators, healthcare practitioners (HCPs), coaches, parents/guardians/caregivers, and athletes are seeking information regarding the timely recognition and appropriate management of concussion. There is a need for clear, unequivocal, and reliable information to be readily accessible to all members of the community. There is a need for clarity of message and consistency of message in order to optimise safety in contact, collision and combat sports. The Australian Sports Commission (ASC) is the Australian Government agency responsible for supporting and investing in sport at all levels. The ASC`s strategic vision is to ensure sport has a place for everyone and delivers results that make Australia proud. The ASC also plays a critical leadership role in guiding sporting organisations and the sport sector in relation to a range of issues impacting sport. The ASC is not a regulatory authority and has no power to enforce compliance or regulations. The Australian Institute of Sport (AIS) is the high-performance arm of the ASC. As the high-performance arm of the ASC, the AIS functions as a resource for sport organisations, providing expertise and education as required. The AIS seeks to guide, but not instruct sports on a range of policy positions, including concussion. Funded by the Australian Government, this Concussion and Brain Health Position Statement 2024 brings together the most contemporary evidence-based information and presents it in a format that is appropriate for all stakeholders. This position statement is an update to the previous position statement, launched in 2023. The 2024 update is intended to ensure that participant safety and welfare is paramount when dealing with matters of RHT and concussion in sport. This update includes the latest recommendations and addresses evidence specifically relating to the management and treatment of concussion by physiotherapists as healthcare practitioners. This position statement provides an overview of the scientific literature in relation to the potential long-term effects of RHT and concussion in athletes. It recommends that sports operate on a principle of an `abundance of caution`. `If in doubt, sit them out`. Where there is any suspicion of concussion, an athlete should be removed from the field of play and should not be allowed to return, until the successful completion of a graduated return to sport/learn program, and clearance by a healthcare practitioner. This position statement is intended as a general guide relating to current best practices for prevention, recognition, and management of concussion, underpinned by available empirical evidence. It should not be interpreted as a policy for clinical practice or legal standard of care. Recommendations will evolve to reflect evidence and advances in science.
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