Exploring sport-related concussion guidelines and medical management approaches

Sport-related concussion (SRC) remains a complex and evolving challenge in both clinical and sporting environments, with ongoing inconsistencies in how the injury is defined, managed, and implemented across different contexts. Despite increasing awareness and the publication of international consensus statements, gaps persist between formal SRC guidance and real-world clinical practice, particularly within high-performance sport. This thesis investigates these gaps through two complementary research studies. The first study employed a PRISMA–guided scoping review to systematically map SRC policies, protocols, and guidelines across sports and international contexts. A total of 115 documents across 22 sports were analysed using template analysis to identify patterns in prevention strategies, sideline assessment, return-to-play (RTP) protocols, follow-up care, and documentation requirements. Findings revealed substantial variation in SRC definitions, audience targeting, and implementation procedures, with many organisations relying on generalised frameworks rather than sport-specific guidance. The second study used qualitative methods to explore practitioner perspectives on SRC management within high-performance sport. Semi-structured interviews were conducted with six healthcare professionals working in elite sporting environments. Reflexive thematic analysis identified key themes related to the invisible and evolving nature of SRC, variability in practitioner confidence and training, and the challenge of applying standardised protocols within dynamic performance settings. Participants emphasised the importance of clinical judgement, relational trust, and contextual flexibility in SRC care. Together, these studies provide a layered understanding of SRC governance and implementation. By examining both the structural landscape of concussion guidance and the lived experiences of practitioners, this thesis highlights the need for SRC policies that are not only evidence-informed but also practically adaptable to the realities of high-performance sport.