Concussion in sport is a considerable concern of sport organisations. The football public remembers when Chelsea's goalkeeper Peter Cech suffered a severe head injury from the collision with the knee of a counterpart. Less dramatic, but as important concussion issues were discussed at the 3rd International Conference at the Home of FIFA in Zurich.

FIFA, the International Olympic Committee, the International Ice Hockey Federation, and the International Rugby Board organised this third conference that began with Vienna (2001) and Prague (2004). Once more, international leaders and experts in the field from Europe, Australia, the US and Canada came to present the latest findings on this difficult injury to sports physicians from all over the world. After FIFA President Joseph S. Blatter opened the conference, stressing the importance of learning more on this important matter, the discussion focused on different topics.

In general, the two big issues in concussion are first of all recognising that the injury has occurred and, secondly, when to allow a player back to play. These are among the most important decisions a physician has to make. The experts debated the tools used to monitor concussion and how these tools should be applied in deciding when to move a player back into play, regardless of whether the player is elite or non-elite. The risk of an extremely rare, but potentially fatal collapse of the brain's circulation forces team physicians to be very careful about returning a player to the same match, or any competition before full recovery. Public health care providers and sports organisations search for options and strategies (such as coaching, rules enforcement, protective equipment, training interventions) for preventing head injuries in the hope that such programmes can be effective at protecting athletes from concussion.

The youth athlete is particularly susceptible to brain injury and a special session of the conference was devoted to the unique case of injury to athletes less than 15 years of age. Because the developing brain can take longer to recover from an injury, the physician needs to be especially vigilant about releasing a previously concussed young athlete back to sport. The invited speakers as well as the audience strongly supported a conservative approach requiring resolution of symptoms followed by a symptom-free period before allowing a return to play.

The British Journal of Sports Medicine will publish a special issue detailing the content of all the presentations of this consensus meeting in order to advance the level of understanding of this injury that continues to challenge physicians worldwide. However, as important as educating the medical staff taking care for players is just how should the medical community educate the public about the nature of this injury.

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