The impact of the concussion crisis on safeguarding in sport

For ~30 years, sociologists have explored the distinct ways in which athletes experience injury (Young, 2019). This work has explained the apparent high incidence of injury in relation to subcultural factors such as the dominance of masculinity (McGannon et al., 2013) and the specific organizational dynamics of sport (Nixon, 1992). Walk (1997, p. 24) perceptively noted that the implication of these analyses was that “medicine is practiced differently, more competently, and/or more ethically in non-sports contexts,” a hypothesis that has largely been borne out by subsequent empirical analyses (Malcolm, 2017). Indicatively, a study of English professional football concluded that “many clubs fail to meet the requirements of health and safety legislation” (Murphy and Waddington, 2011, p. 239). A high incidence of injury allied to limited or substandard healthcare runs contrary to the guiding principles of safeguarding in sport.

In the last decade, rising public health concerns about brain injuries in sport—both concussion and chronic traumatic encephalopathy (CTE)—have reinvigorated this field. Specifically, as coroners decreed that the neurodegenerative illnesses of former athletes were a form “industrial disease,” questions were asked about the sport's subcultural practices and a range of harm reduction measures were initiated. The previous routine dismissal of concussions as short-lived and relatively trivial events has been replaced by claims that there is now a concussion epidemic or crisis (Malcolm, 2020). Public support for sports injury safeguarding measures is perhaps stronger now than at any time in recent history.

This opinion piece explores the impact of this concussion crisis on injury prevention and safeguarding in sport. It outlines the significant changes that have been made in recent years and the problematic or potentially limiting aspects of these changes. The discussion identifies three far-reaching changes required to promote further safeguarding and de-institutionalize physical harm to sport participants.