Improve brain health in contact sports

In the world of contact sports, where physical strength and speed often take centre stage, brain health is frequently overlooked. This is concerning, especially as more attention is being given to the effects of concussions and other head injuries. Improving brain health is not only essential for athletes but also for coaches, parents and sports organisations. In this article, we discuss practical strategies for improving brain health in contact sports, with a focus on awareness, prevention and recovery.

The Importance of Brain Health in Contact Sports

Contact sports are built around speed, strength and competition. In sports such as rugby, boxing, mixed martial arts and football, physical contact is often unavoidable. Athletes spend a great deal of time improving their fitness and technique, but brain health does not always receive the same attention. This is concerning because the brain controls movement, memory, concentration, emotions and decision making. A brain injury can therefore affect an athlete’s performance as well as their education, work and daily life. Protecting the brain does not mean removing physical contact from sport. It means understanding the risks, reducing unnecessary impacts and responding correctly when an injury occurs.

A concussion is a type of traumatic brain injury caused by a blow to the head or a strong impact to the body. The force can cause the head and brain to move rapidly. An athlete does not need to lose consciousness to have a concussion. Symptoms may include headaches, dizziness, nausea, confusion, balance problems, blurred vision and difficulty concentrating. Changes in memory, mood and sleep may also occur. Symptoms can appear immediately or develop several hours later. Serious warning signs include repeated vomiting, seizures, increasing confusion, weakness, slurred speech and a headache that continues to get worse. These signs require immediate medical attention (Centers for Disease Control and Prevention [CDC], 2025a).

Concussions are not the only concern. Athletes may also experience repeated head impacts without showing clear symptoms. A football player may regularly head the ball, a boxer may receive punches during sparring and a rugby player may be involved in many tackles during a season. These impacts do not always cause an obvious injury, but they still contribute to an athlete’s total exposure. Researchers are continuing to examine the possible long-term effects. Current evidence does not show that every athlete exposed to repeated impacts will develop permanent brain damage. The level of risk may depend on factors such as the number and strength of the impacts, previous injuries, age and the number of years spent participating in the sport. Although some long-term effects remain uncertain, repeated head impacts should not be ignored (Patricios et al., 2023).

Education is one of the most important ways to improve brain health. Athletes must understand the symptoms of a concussion and why they should report them. Some athletes hide symptoms because they do not want to leave a match or disappoint their teammates. Others believe that continuing to play shows toughness. However, an athlete with a concussion may react more slowly, lose balance or make poor decisions. Continuing to play can also expose the brain to another impact before it has recovered.

Coaches, referees and parents should also be able to recognise warning signs. An athlete may appear confused, respond slowly, move unusually or forget what happened.

Coaches and referees are not responsible for diagnosing the injury. Their role is to remove the athlete from play and arrange a professional medical assessment. Training programmes and workshops can help coaches understand how to recognise and respond to possible concussions (CDC, 2025b). This information should be repeated regularly because symptoms can easily be overlooked during an intense match.

Prevention should focus on reducing unnecessary head impacts. Protective equipment can reduce certain injuries, but no helmet or headguard can completely prevent a concussion. The brain can still move inside the skull after an impact. Equipment should fit correctly and meet the safety standards of the sport, but athletes should not assume that it makes dangerous behaviour safe.

Good technique is equally important. Rugby players should learn to position their heads safely during tackles. Football players should practise controlled heading rather than completing large numbers of unnecessary headers. Boxers and MMA athletes can reduce exposure by limiting hard sparring and spending more time on technical and defensive drills. Full-contact training is not needed during every session. Coaches can use controlled or non-contact exercises to improve fitness, movement and decision making.

Younger athletes may require additional protection because their brains and bodies are still developing. They may also have less experience and less control over their movements. Training methods and rules should therefore match the age and ability of the players. Prevention may include rule changes, education, physical preparation and limits on certain types of contact training (Patricios et al., 2023).

When a concussion is suspected, the athlete should be removed from play immediately. They should not return to the same match or training session. The athlete should be assessed by a qualified medical professional and observed because symptoms can become worse after the original impact. Urgent medical assistance is needed when an athlete experiences repeated vomiting, seizures, worsening confusion, weakness, difficulty staying awake or a severe headache (CDC, 2025a). The importance of a match should never influence the decision to remove a player.

Recovery differs between athletes. Some people recover quickly, while others experience symptoms for several weeks. Relative rest is generally advised during the first 24 to 48 hours. This means limiting activities that make symptoms worse without completely avoiding normal daily movement. Light physical and mental activities can then be introduced gradually under the guidance of a healthcare professional (Patricios et al., 2023).

Returning to sport should also happen in stages. The athlete should first return to normal daily activities before moving to light exercise, moderate activity, non-contact training, full practice and competition. Each stage should normally take at least 24 hours. When symptoms return, the athlete should stop the activity and contact their healthcare provider (CDC, 2025c). An athlete may appear physically fit while still experiencing headaches, concentration problems or slower reactions. Medical advice should therefore be followed throughout the recovery process.

A supportive environment is essential. Family members can observe changes in mood, sleep and behaviour. Teammates can speak up when another player appears confused or unsteady. Coaches should keep records of injuries and ensure that medical advice is followed. Sports organisations should also have a clear concussion policy so everyone knows what to do when an injury is suspected.

Improving brain health in contact sports is a shared responsibility. Physical contact will remain part of rugby, boxing, MMA and football, but unnecessary risks can be reduced. Better education, controlled training, safer techniques and proper recovery can protect athletes without removing the competitive nature of sport. Winning a match is temporary, while the effects of an untreated brain injury can last much longer. The long-term health of the athlete should always come first.

References

Centers for Disease Control and Prevention. (2025a, September 15). Signs and symptoms of concussion. https://www.cdc.gov/heads-up/signs-symptoms/index.html

Centers for Disease Control and Prevention. (2025b, September 15). HEADS UP to youth sports coaches: Online concussion training. https://www.cdc.gov/heads-up/training/youth-sports.html

Centers for Disease Control and Prevention. (2025c, September 15). What to do after a concussion. https://www.cdc.gov/heads-up/guidelines/recovery-from-concussion.html

Patricios, J. S., Schneider, K. J., Dvorak, J., Ahmed, O. H., Blauwet, C., Cantu, R. C., Davis, G. A., Echemendia, R. J., Makdissi, M., McNamee, M., Broglio, S. P., Emery, C. A., Feddermann-Demont, N., Fuller, G. W., Giza, C. C., Guskiewicz, K. M., Hainline, B., Iverson, G. L., Kutcher, J. S., … Meeuwisse, W. (2023). Consensus statement on concussion in sport: The 6th International Conference on Concussion in Sport–Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695–711. https://doi.org/10.1136/bjsports-2023-106898