Prevent Brain Injuries: Safety in Contact Sports

Contact sports such as rugby, boxing and MMA are popular and offer many benefits, including physical fitness, teamwork and discipline. However, these sports also involve risks, particularly when it comes to brain injuries. Understanding how these risks can be reduced is essential for protecting athletes. This article examines the main causes and risks of brain injuries in contact sports and provides practical advice for improving safety.

Preventing Brain Injuries: Safety in Contact Sports

What Is a Brain Injury?

A brain injury occurs when the normal functioning or structure of the brain is disrupted. In sport, this may happen after a direct blow to the head, a fall or a collision that causes the brain to move rapidly inside the skull. Brain injuries range from mild to severe and their effects may be temporary or long lasting.

A concussion is the most common type of traumatic brain injury in contact sports. Possible symptoms include headaches, dizziness, confusion, nausea, memory problems and difficulty concentrating. An athlete does not need to lose consciousness to have a concussion. Symptoms can also develop several hours after the original impact rather than appearing immediately (Centers for Disease Control and Prevention [CDC], 2025a).

A cerebral contusion is a bruise to the brain tissue. It can involve bleeding and swelling and is usually more serious than a concussion. Repeated head impacts are another concern. These impacts do not always produce clear symptoms but may still contribute to an athlete’s total exposure over several seasons.

Chronic traumatic encephalopathy, commonly known as CTE, is a brain disease associated with a history of repeated head impacts. However, not every athlete who experiences concussions or repeated impacts develops CTE. The condition can currently only be confirmed through examination of brain tissue after death. Researchers are still studying the relationship between participation in contact sports and long-term neurological problems (Patricios et al., 2023).

The Effects of Brain Injuries

The effects of a brain injury differ between athletes. Some recover within a relatively short period while others experience symptoms for several weeks or longer. Cognitive problems may include difficulties with concentration, memory, reaction speed and decision making. These problems can affect sporting performance as well as school, work and daily activities.

Emotional and behavioural changes may also occur. An athlete may become unusually irritable, anxious, emotional or withdrawn. Physical symptoms can include headaches, fatigue, dizziness, balance problems, blurred vision and sensitivity to light or noise. Changes in sleep are also common (CDC, 2025a).

Certain symptoms require urgent medical attention. These include repeated vomiting, seizures, weakness, slurred speech, increasing confusion, difficulty waking up and a headache that continues to get worse. One pupil may also appear larger than the other. Coaches, parents and teammates should never ignore these warning signs.

Protective Equipment

Correctly fitted protective equipment can help reduce certain injuries. Helmets may reduce the risk of skull fractures, cuts and some types of direct trauma. Mouthguards can help protect the teeth and mouth. Shoulder and chest protection can reduce the force placed on other parts of the body during collisions.

However, no helmet or headguard can completely prevent a concussion. The brain may still move inside the skull after a strong impact. Athletes should therefore not use protective equipment as a reason to play recklessly. Equipment should fit properly, meet the safety standards of the sport and be checked regularly for damage (Patricios et al., 2023).

Training and Awareness

Education is one of the most important parts of injury prevention. Athletes should understand the symptoms of a concussion and know why these symptoms must be reported. Some athletes remain silent because they are afraid of losing their place in the team. Others believe that continuing to play shows toughness. This behaviour can place their health at greater risk.

Coaches, parents and officials also need regular concussion training. They should be able to recognise changes in movement, behaviour and performance. An athlete who looks confused, responds slowly or struggles with balance should be removed from play. Coaches are not expected to diagnose a concussion. Their responsibility is to recognise a possible injury and arrange a professional medical assessment (CDC, 2025b).

Safe technique can further reduce unnecessary head impacts. Rugby players should learn how to position their heads correctly during a tackle. Boxing and MMA athletes can limit hard sparring and spend more time on controlled technical and defensive drills. Full-contact practice does not need to take place during every training session.

Rule changes can also improve safety. World Rugby has used lower tackle-height initiatives to reduce dangerous upright tackles and head-to-head contact. Evidence from its trials indicates that lowering tackle height can reduce head contact and suspected concussions. From July 2026, a lower legal tackle height applies in community rugby under World Rugby’s updated framework (World Rugby, 2026).

Medical Checks and Injury Response

Regular medical checks may help identify existing problems and give athletes an opportunity to discuss previous injuries. However, a routine examination cannot predict or prevent every concussion. Medical assessment is especially important after a suspected head injury or when symptoms continue.

When an athlete may have suffered a concussion, they should stop playing immediately. They should not return to the same match or training session. The athlete should be evaluated by a healthcare professional and monitored because symptoms can change after the original impact.

Returning to sport should happen gradually. The CDC recommends a staged process that begins with normal daily activities and then moves through light exercise, moderate activity, heavy non-contact training, full practice and competition. Each stage normally takes at least 24 hours. If symptoms return, the athlete should stop the activity and contact their healthcare provider (CDC, 2025c).

Creating a Safer Sports Culture

A safe sports culture begins with coaches and sports organisations. Coaches should place health above competition and support athletes who report symptoms. Players should never be punished or criticised for leaving a match after a possible head injury.

Parents can support younger athletes by watching for changes in mood, sleep and behaviour. Teammates also have an important role. They may notice confusion or balance problems that the injured athlete does not recognise. Clear communication makes it easier to identify problems early.

Professional organisations have introduced systems to improve concussion management. The NFL uses a concussion protocol for the identification, assessment and management of suspected injuries. World Rugby uses a Head Injury Assessment process in eligible elite competitions. These systems cannot remove every risk but they demonstrate the importance of structured medical evaluation and a controlled return to competition (National Football League, 2024; World Rugby, n.d.).

The Role of Technology

Technology may support injury prevention and research. Instrumented mouthguards and sensors can measure the movement and acceleration of the head during an impact. This information may help researchers understand when and how athletes experience high levels of head-impact exposure.

These devices have limits. A high sensor reading does not automatically mean that an athlete has a concussion. A low reading also cannot rule one out. Concussion remains a clinical diagnosis that must be made by a qualified healthcare professional. Technology should support medical judgement rather than replace it.

Conclusion

Brain injuries are a serious risk in contact sports but many unnecessary impacts can be reduced. Protective equipment, safe techniques, sensible training schedules and clear rules all contribute to a safer environment. Education is equally important because athletes, coaches and parents must recognise symptoms and respond correctly.

When a concussion is suspected, the athlete should be removed from play and assessed by a healthcare professional. A gradual return to sport should only begin with medical approval. Contact sports can continue to offer fitness, teamwork and discipline but an athlete’s long-term health must always come before the result of a match.

References

Centers for Disease Control and Prevention. (2025a, September 15). Signs and symptoms of concussion. CDC HEADS UP. 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. CDC HEADS UP. https://www.cdc.gov/heads-up/training/youth-sports.html

Centers for Disease Control and Prevention. (2025c). Responding to a sports-related concussion. CDC HEADS UP. https://www.cdc.gov/heads-up/response/index.html

Centers for Disease Control and Prevention. (2025d). Returning to sports. CDC HEADS UP. https://www.cdc.gov/heads-up/guidelines/returning-to-sports.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