Background Sports related concussions are a common injury in field-based contact sports including Gaelic games. Even though accurate data on concussion in Gaelic games is currently limited, it is well documented that concussion is a common injury in Gaelic sports. The purpose of this current research was to discern the psychological impact of concussion on Gaelic games athletes as in many instances, recovery from concussion focuses mainly on physical recovery.Methods A grounded theory methodology was used to explore the experiences of a cohort of adult male and female amateur and elite amateur Gaelic games athletes (n = 22) and their experiences involving psychological recovery post-concussion and eventual return to play. The data for this study were gathered through a series of individual semi-structured interviews.Results Two major themes were identified, (1) lack of psychological recovery management for concussion in Gaelic games athletes and, (2) non-standardised concussion protocols and concussion education within Gaelic games. These themes were further divided into categories and subcategories.Conclusion Recovery from concussion in Gaelic games is broadly a non-standardised process, whereby recovery processes are haphazard and lack enforcement. There are no directives or guidance for recognising the need for psychological recovery, or assistance to recover from concussion in the acute or chronic phases or for those with long term post-concussion syndrome.

IntroductionCoaches, practitioners, and leadership in amateur female sport must navigate many obstacles in the pursuit of athlete availability and optimal performance. The present study aims to evaluate opportunities and challenges to both injury prevention and management in amateur female sport, as experienced by mixed-gender coaches, allied healthcare professionals, and general practitioners.MethodsSemi-structured virtual interviews of coaches, allied healthcare professionals, and general practitioners (N = 25), recruited via convenience snowball sample. Data transcribed verbatim with reflexive thematic analysis through a critical realism framework.ResultsFemale-specific issues, education, and resource capital were challenges to the implementation of injury prevention and management in amateur female sport, thus negatively impacting on performance, prevention, and rehabilitation. Opportunities for improved care for female athletes were developing communication and relationships, outsourcing responsibility, and providing greater education, in response to desires for such, and lastly exposure to elite sport and national governing bodies’ protocols.DiscussionIn amateur female sport, developing communication pathways and relationships, along with upskilling coaches, can help better support female athletes, coaches, and healthcare professionals. Leaders and stakeholders must advocate for and support greater education, resourcing, and an understanding of female-specific issues in amateur female sport. It is intended that these findings will provide evidence and opportunities for discourse between stakeholders in amateur female sport to improve standard of supports for female athletes, coaches, and healthcare professionals. These findings may also help practitioners better exploit opportunities and circumvent challenges to improve the welfare and performance of amateur female athletes.

Background: Injury prevention/reduction strategies are driven by data collected through injury surveillance systems. The aim of this review was to describe injury surveillance systems that are used for ongoing surveillance in either a professional or amateur sporting environment. This was an update to a review done in 2015 to determine the gaps in injury surveillance. Methods: A systematic search process of five databases (MEDLINE, CINAHL, EMBASE, SCOPUS and ProQuest) was used to discover published research that presented methodological data about the injury surveillance systems implemented by clubs and organisations for ongoing surveillance. Inclusion criteria centred on the population under surveillance and the ongoing nature of that activity. Data extracted and summarised included the level of athlete under surveillance, the data collection mechanism and the personnel involved, the injury definitions applied and the date and country of origin to provide a comprehensive picture of the systems. Results: A total of 21 systems were documented as being used in ongoing injury surveillance, with 57% of these exclusively in the professional/elite landscapes and 33% at the amateur level. Surveillance systems cater for one sport per athlete entry so there is a gap in research for multi-sport athletes at the amateur level, especially where there is no early specialisation in a multi-sport participation environment. Conclusions: Research in this area will lead to a better understanding of subsequent injury risk for multi-sport athletes who have a higher athlete exposure than single-sport athletes.

Background/objectives: Ocular tools and technologies may be used in the diagnosis of sport-related concussions (SRCs), but their clinical utility can vary. The following study aimed to review the literature pertaining to the reliability and diagnostic accuracy of such assessments. Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews was adhered to. Reference standard reliability (RSR ≥ 0.75) and diagnostic accuracy (RSDA ≥ 0.80) were implemented to aid interpretation. Results: In total, 5223 articles were screened using the PCC acronym (Population, Concept, Context) with 74 included in the final analysis. Assessments included the King-Devick (KD) (n = 34), vestibular-ocular motor screening (VOMs) and/or near point of convergence (NPC) (n = 25), and various alternative tools and technologies (n = 20). The KD met RSR, but RSDA beyond amateur sport was limited. NPC met RSR but did not have RSDA to identify SRCs. The VOMs had conflicting RSR for total score and did not meet RSR in its individual tests. The VOMs total score did perform well in RSDA for SRCs. No alternative tool or technology met both RSR and RSDA. Conclusion: Ocular tools are useful, rapid screening tools but should remain within a multi-modal assessment for SRCs at this time.

Background: The focus of this qualitative research was to interview current and retired Gaelic games athletes to ascertain how athletes viewed concussion recognition and management. Methods: A grounded theory methodology design was utilised to investigate concussion recognition and management experiences of a cohort of Gaelic games athletes (n = 22). Data for the study were collected using a semi-structured interview format. Results: Two major themes were identified: (1) an inconsistent identification of concussion as an injury and the absence of standardised procedures for removal from play, and (2) the impact of athlete-driven decision making on concussion management. Concussions were experienced by all the participants on multiple occasions while playing Gaelic games. However, concussion recognition and removal rarely occurred, as many athletes chose not to disclose their injuries or self-managed their concussions. Conclusions: The recognition and management of concussions in Gaelic games are currently inadequate, and they may be posing significant risks to athletes’ long-term health. This research highlights the need for more stringent protocols for concussion recognition and removal at pitch side. In addition, Gaelic games require a more objective injury management plan during acute and chronic concussion recovery.

Sports-related concussion (SRC) is an injury whereby impact to the face/head/neck impairs cognitive functioning. Parasport athletes have an increased risk for SRC. The Previous Concussion in Sport Group iterations lack guidance for parasport SRC assessment, management, and return-to-play. This article aims to investigate the research relating to parasport SRCs published since the 2021 Concussion in Para Sport (CIPS) position statement and highlights possible new recommendations. A literature review of parasport concussions was conducted. Articles citing the 2021 publication and/or published since then were reviewed. Relevant data were extracted and discussed in this article. Since 2021, twelve (n = 12) articles emerged investigating parasport SRC. Parasport athletes experience greater concussion symptoms and severity scores compared to able-bodied athletes. Visually impaired athletes account for >50% of parasport SRCs. Wheelchair basketball and rugby have the highest SRC incidence rates across parasports. Current SRC assessment methodologies are not designed with consideration of parasport athletes’ unique experiences. Guidelines lack a return-to-learning protocol, making returning to education/work challenging for such athletes. Understanding these athletes’ SRC experiences is paramount in supporting their recovery. Specific guidelines for SRC assessment, management, return-to-play, and return-to-learn for parasport athletes are necessary to enhance their rehabilitation and avoid the occurrence of long-term symptoms.

Sport-related concussion incidence has increased in many team-based sports, such as rugby, Gaelic (camogie, hurling, football), and hockey. Concussion disrupts athletes’ brain function, causing an “energy crisis” that requires energy and nutrient support to restore function and heal. Performance dietitians and nutritionists play a role in supporting athletes’ post-injury nutritional demands. This study aimed to investigate Irish performance dietitians’ and nutritionists’ knowledge and implementation of nutritional strategies to manage and support athletes’ recovery following concussion. In-depth, semi-structured interviews were conducted with seventeen (n = 17) Irish performance dietitians and nutritionists recruited from the Sport and Exercise Nutrition register and other sporting body networks across Ireland. Participants practised or had practised with amateur and/or professional athletes within the last ten years. All interviews and their transcripts were thematically analysed to extract relevant insights. These data provided valuable insights revealing performance dietitians and nutritionists: (1) their awareness of concussion events and (2) their use of nutritional supports for concussion management. Furthermore, the research highlighted their implementation of ‘novel nutritional protocols’ specifically designed to support and manage athletes’ concussion recovery. There was a clear contrast between participants who had an awareness and knowledge of the importance of nutrition for brain recovery after sport-related concussion(s) and those who did not. Participants presenting with a practical understanding mentioned re-emphasising certain foods and supplements they were already recommending to athletes in the event of a concussion. Performance dietitians and nutritionists were keeping up to date with nutrition research on concussions, but limited evidence has prevented them from implementing protocols in practice. Meanwhile, participants mentioned trialling/recommending nutritional protocols, such as carbohydrate reloading, reducing omega-6 intake, and acutely supplementing creatine, omega-3 fish oils high in Docosahexaenoic acid, and probiotics to support brain healing. Performance dietitians’ and nutritionists’ use of nutrition protocols with athletes following concussion was linked to their knowledge and the limited scientific evidence available. Nutrition implementation, therefore, may be overlooked or implemented with uncertainty, which could negatively affect athletes’ recovery following sports-related concussions.

Sport-related concussions (SRCs) are a mild traumatic brain injury (mTBI) that induces transient symptoms in athletes. These symptoms provide avenues for developing emerging technologies to diagnose SRCs, in particular ocular and vestibular dysfunction. The following study aims to assess the reliability of visual smooth-pursuit technology (EyeGuide Focus) in amateur field-sport athletes. A convenience sample of 30 mixed-gender athletes (mean age = 24.89 ± 6.81 years) completed two testing sessions separated by 2–7 days. Participants were tested at rest, free from distraction, and completed a 10 s smooth pursuit while seated. Participants completed 2–4 practice trials before completing three tests at each session. Appropriate difference, reliability, and repeatability tests were performed in Statistical Packages for the Social Sciences. No significant difference existed between the time points (p > 0.05). The reliability between sessions was poor (ICC = 0.24; 95% CI = 0.03–0.42), and the mean coefficients of variation were 20% and 21% for each session, indicating poor repeatability. However, the implementation of practice trials did prevent the familiarization effects that are evident in the previous literature (p > 0.05). The within-session reliability of EyeGuide Focus has varied from poor (ICC ≤ 0.50) to good (ICC = 0.75–0.90) in the previous literature, indicating the fact that greater research is required before this tool can be implemented in applied settings.

Objective Determine the effectiveness of interventions in changing concussion knowledge and attitudes in athletes, coaches, parents. Design Systematic literature review. Setting Amateur and communiity sports. Participants Human populations ranging from child to adult involved in sport in any capacity. Interventions (or Assessment of Risk Factors) Influence of enhancing concussion knowledge and attitudes in athletes, coaches, parents. Outcome Measures Changes in concussion knowledge and athletes. Main Results Search strategy identified 7534 articles. Following the three stage study screening process, 25 were eligible for inclusion in this review. Sixteen studies examined the effects of an educational intervention on both attitudes and knowledge, five studies examined the effects of an educational intervention on knowledge only and four interventions examined the effects on attitudes only. Conclusions Knowledge transfer frameworks have been shown to be effective for both concussion knowledge and concussion attitudes This abstract has been published in full manuscript format and has the following citation: BMJ Citation https://doi.org/10.1080/02640414.2020.1835223

Background and Objectives: Collision-sport athletes, such as rugby players, are at risk of sport-related concussion (SRC). Women are known to be at higher risk of SRC and may experience more severe and chronic symptomology than men. Knowledge of the factors that affect a player’s disclosure of their concussive symptoms could help to inform strategies to improve compliance with reporting and management of head injuries. The aim of this study was to investigate the factors that may impact women rugby players’ disclosure of a concussion. Methods: Twenty-eight adult (≥18 years of age) elite and semi-elite women rugby players from the UK and Ireland (n = 17) and the United States (n = 11) were interviewed on their playing background and SRC experience in women’s rugby via one-on-one interviews (UK and Ireland) or an online questionnaire (US). Results: SRC data were analysed inductively using a thematic analysis approach to determine the potential reasons for SRC non-disclosure in women’s rugby. Four main themes were identified which may influence a player’s SRC non-disclosure: 1. women rugby players are self-managing SRC; 2. work-related concerns impact on SRC disclosure; 3. players and support staff lack knowledge on SRC management; and 4. poor internal and external communication affect the support players receive when injured. Conclusions: The findings were consistent across players from different countries. This research highlighted several factors that may impact on women rugby players’ disclosure of SRC regardless of country of origin (UK, Ireland, or US) and access to concussion care. Coaches and management teams should be aware of these reasons, which may enhance how they discuss and manage concussion. There is a clear need for further education on concussion for players and support staff and for strategies to create environments where women can openly discuss their concussion concerns.

Concussions from sport and recreational activities can negatively impact academic performance in adolescents. This study aims to use reflexive thematic analysis to understand the knowledge, management, and education of concussion among Irish postprimary educators. A cross-sectional study that involved semistructured interviews with 18 secondary school teachers was conducted. Interviews were recorded and transcribed in preparation for a reflexive thematic analysis process according to research conducted by Braun and Clarke. A total of 664 data items were coded which led to the development of 5 themes (i.e., teacher's background experience, consequences of concussion, concussion in school, educating educators, and existing standards) and 22 subthemes. The implementation of concussion education initiatives for improving student safety, injury management, and recovery through mandatory teacher-continued professional development should be explored. Teachers' knowledge of concussion is influenced by personal experiences, with safer attitudes observed in those who have witnessed or experienced concussions. The role of the Year Head in concussion management should be explored with a focus on communication pathways and dissemination of materials. Protocols for medical emergencies and academic adjustments for concussed students should be made readily available to secondary school teachers. There is an immediate need for structured concussion education and concussion recognition protocols in the Irish secondary school system. Concussion education in the Irish secondary schools system requires coordinating within each individual school to disseminate concussion management policies. Secondary school teachers have a broad knowledge of concussion with a better understanding toward concussion if they have experienced a concussion themselves.

Objective To explore adherence to Consensus return to play (RTP) guidelines and potential barriers to best practice in SRC management in Irish amatuer female sport. Design Qualitative, informal virtual interviews with a convenience snowball sample. Setting Irish amateur female sport. Participants Male & female coaches, & allied healthcare professionals (N = 9) working with Irish amateur female athletes of all ages in rugby union, soccer, camogie and Gaelic Football. Main Results Following thematic analysis, themes of insufficient knowledge and poor culture and attitudes to SRCs were identified within the data. Both coaches and practitioners were generally unaware of Irish national governing body (NGB) RTP Guidelines with poor implementation. GP Clearance was rarely sought for RTP and athlete attitudes to seek treatment for SRCs was poor. Knowledge and use of the SCAT5 was extremely limited and SRC treatment was limited by poor follow up from athletes. Conclusions Concussion Consensus is the greatest tool available to those involved in sport for best practice SRC management and RTP. However, existence does not equal adherence and further research is required within an Irish context to troubleshoot barriers to best practice, particularly around RTP in female athletes. Both club and NGB policies & procedures should form the backbone of such measures, as this may help overcome athlete resistance to treatment. This qualitative analysis is to be extended to a much larger sample in future studies.

PurposeThis study aimed to investigate the carbohydrate beliefs and practices of ultra-endurance runners in Ireland to gain an understanding of their gastrointestinal symptom (GIS) management strategies.MethodologyAn adapted version of a previously developed and validated questionnaire was distributed online to ultra-endurance runners, recognized as those who completed a single bout of exercise lasting 4 or more hours. The questionnaire asked about carbohydrate awareness and sourcing, and dietary practices, particularly in relation to GIS management.ResultsA total of n = 68 individuals completed the adapted questionnaire. Of these, n = 1 was excluded due to their reporting of an ulcerative colitis diagnosis. The remaining participants included 46 men and 21 women. Personal previous experience was the main source directing participants’ nutrition practices (n = 30), while only 3 participants quoted sourcing information from qualified professionals. Forty-two participants experienced GIS, usually equally around training and competition times. Many participants had not previously implemented any specific dietary or non-dietary strategies to alleviate exercise-induced GIS. Supplementing with nitrates (n = 9) and probiotics (n = 4) were the most common dietary practices to alleviate GIS, while other practices (n = 14) and portion control (n = 13) were the most reported non-dietary practices.DiscussionSimilar to previous studies, these findings suggest that GISs are prevalent in the ultra-endurance running community, occurring regardless of whether during training or an event. Similarly, this research highlights the vast range of GISs experienced by this population. However, the absence of both dietary and non-dietary-related practices used for GIS management alludes to a current deficit in the availability of nutrition information specific to this problem. Further research is required to understand the mechanisms behind ultra-endurance-associated GISs and its various management strategies as well as best practices for communicating these to the target audience to reduce individuals’ risks of developing long-term, chronic health complications.

Ocular assessment tools provide insights into neurological functioning when diagnosing sport-related concussions (SRCs). Emerging technologies such as EyeGuide Focus have attempted to improve on pre-existing clinical tools however the reliability of the tool is currently uncertain and it is unclear if physical exertion may affect the validity of the device as seen with similar ocular assessments. The aim of this study was to determine if EyeGuide Focus accuracy is affected by high-intensity, intermittent exercise. Seven amateur female rugby union athletes were recruited (Mean age [± SD] = 23 ± 5 years; stature = 172 ± 4 cm, mass = 87 ± 20 kg). Athletes completed baseline testing on the unit which included two to four familiarisation trials and three official tests on the unit measured in arbitrary units (AUs). Testing was completed in a dark room free from distraction, and participants wore noise-cancelling headphones (BOSE QC45) during assessment. The athlete then performed a brief warmup before beginning the exercise protocol by Whyte et al. (2022, Phys Therapy Sport, 58, 126-133) which involves repeated circuits of acceleration, deceleration, backpedalling, change of direction, jumping, and side shuffling. This protocol has previously displayed significant effects on Vestibular Ocular Motor Screening testing. Athletes repeated circuits until they reported 17-18/20 on the Borg Scale with 30s between each circuit. Athletes then completed three more trials at five- and 10-mins post-exercise cessation. Data were exported to Microsoft Excel and Statistical Packages for the Social Sciences for analysis. Athletes completed an average of 03:15 ± 23 s total work in circuits. Significant differences existed between athlete’s heart rate at rest and post-warmup, post individual circuits, and five mins post-test (P < 0.05) but not 10 mins post-test (P > 0.05). Mean EyeGuide Focus scores were 23443.29 ± 8082.18, 35684.04 ± 13279.40, and 22927.64 ± 6377.61 AUs at baseline, 5 mins post-test, and 10 mins post-test respectively. Scores were significantly different between baseline and 5 mins post-test (P < 0.001), and between 5- and 10-mins post-test (P < 0.001), but not baseline and 10 mins post-test (P > 0.848). Three mins of high-intensity, intermittent exercise was sufficient to induce significant changes in amateur female athletes’ EyeGuide Focus scores, returning to baseline after 10 mins of rest. The findings indicate that physical activity can impact on EyeGuide Focus scores and thus sufficient rest is required when assessing athletes for SRCs. Future research should investigate if sport-related contact or collisions also impact scoring on this device.

BackgroundThe purpose of this qualitative research study was to interview current and retired Gaelic games athletes to understand the current landscape of concussion recovery in Gaelic sports from the athlete perspective.MethodsA grounded theory methodology was employed to explore the experiences of a cohort of Gaelic games athletes (n = 22) regarding recovery from concussion, the levels of concussion awareness in Gaelic sports and their opinions on current concussion identification protocols. The study's data were gathered through semi-structured interviews.ResultsTwo major themes were identified, (1) Male and female athletes experience a range of acute and chronic symptoms post-SRC and (2) Gaelic sports athletes are expected to demonstrate constant allegiance and commitment to the GAA. These themes were further divided into categories and subcategories.ConclusionBased on the experiences of the cohort of Gaelic sports athletes, there exists a wide variation of SRC symptomology in the acute, and chronic (post-concussion syndrome) phases. In many cases, there are reports of long-term side effects associated with the perceived mismanagement or misdiagnosis of SRC in Gaelic sports. Gaelic sports athletes require a more robust SRC management system to support and manage SRC in the acute, chronic and long-term phases.

Sports-related concussions (SRC) may impact athletes at all levels, from recreational to professional. SRC disrupts brain function, initiating various transient, and subjective symptoms(1). Due to the gut-brain axis, gastrointestinal (GI) function is affected and may cause nausea, vomiting, and abdominal pain. Post-concussion GI symptoms may hinder digestion, nutrient absorption, and energy availability to the brain(1), and their prevalence among Irish athletes is unknown. This study aimed to investigate gastrointestinal disturbances experienced by Irish athletes post-concussion.In January 2024, following ethical approval, an online survey was distributed to athletes and their support teams (coaches, nutritionists, physiotherapists, etc.) via social media, email, posters, and word of mouth. Eligible athletes had experienced a concussion/ mTBI. The survey included sections on general and GI-specific symptomology, demographics, injury history, digestive function, and gut health. Questions were retrospective and specific to the Time of Participation (ToP). Quantitative data analysis was performed using Excel.This research presents preliminary data on fifty-three Irish athletes, (43% female) between 18 and 40 years (median = 25). Athletes participated in a variety of sports, including Gaelic football (60%), rugby (53%), soccer (49%), hurling/camogie (30%), running (19%), equestrian (15%), field hockey (9%), athletics (11%), martial arts (11%), either at elite, recreational, or competitive levels. Athletes had sustained 1 to 6 concussions (median = 2), between 10 days (February 2024) to 180 months (2009) before study participation (median = 18 months).Their ToP bowel function ranged from moving once (57%), 2-3 times (23%), 4-6 times (9%) daily, or once every 2-3 days to once a week (12%). Using the Bristol Stool Form (BSF) scale (4) at ToP, 45% were type 3 or 4, and 10% were type 2 (3). Acutely post-concussion participants’ bowel function became more frequent, with 43% moving once daily, 30% 2-3 times, 6% 4-6, and 2% moving 7 times or more daily. 19% had experienced a reduction in bowel movements to once every 2-3 days, 4-6 days, or once a week post-concussion. Their stool forms ranged from hard, lumpy (type 1, 2), sausage-shaped (type 3, 4) to watery (type 5, 6, 7) on BSF (3). All participants identified prevalence of GI symptoms. Rating tiredness (55%), loss of/poor appetite (54%), and nausea/vomiting (47%) as most severe. Increased bloating, flatulence, urgency to open bowels, stomach gurgling, pain/discomfort, constipation, incomplete evacuation, diarrhoea, indigestion, reflux, heartburn, and increased cravings were also reported.Athletes experienced increased bowel movements, irregularities, and constipation, alongside varying symptoms of appetite changes, nausea, vomiting, flatulence, and sensitivities, which resolved as most athletes began to recover.Irish athletes encountered diverse GI disturbances post-concussion. Athletes and their professional support teams need to be mindful that head injuries affect GI function, causing symptoms such as a loss of appetite, vomiting, and changes in bowel habits.

Objective To evaluate the effects of neck strengthening interventions in reducing cervical neck injury and sports related concussion. Design Systematic literature review. Setting Amateur, semi professional and professional sports. Participants Human adult (≥ 18) involved in collision sports. Interventions (or Assessment of Risk Factors) Neck strengthening interventions. Outcome Measures Changes in neck strength; injury data. Main Results Database searches identified 2462 articles. Following title and abstract screening, 12 full papers were retrieved and assessed for inclusion. Three papers were eligible for inclusion in the review. All included papers focused on male participants, two of the papers were focused on rugby and one on American football. One study found that neck strengthening exercises increased isometric neck strength in relation to cervical neck strength. The second study reported no significant improvement in isometric neck strength, however there was a significant reduction in match related injuries. The third included study reported a large positive effect size in isometric composite neck strength favouring the intervention group. Conclusions Neck strengthening exercises are frequently suggested as a possible measure to mitigate the effects of head rotation in concussion/mTBI. Our systematic review of the literature has shown there is a lack of evidence to support this recommendation. Future research should seek to assess the effect of neck strengthening stabilisation of the head and neck on injury reduction. Research specific to female participants is strongly warranted. This abstract has been published in full manuscript format and has the following citation: BMJ Citation https://www.mdpi.com/2411-5142/6/1/8

In 2014, an Irish parliament white paper called for greater addressing of sport-related concussions (SRCs) in Ireland, requesting the adoption of the Concussion in Sport Group’s (CISGs) guidelines and greater consistency in SRC return to play (RTP) management. Ten years later, it is unclear how these requests have been addressed. Recently, the United Kingdom’s government centralised guidelines to one SRC document for all grassroots sports. This study aimed to investigate all publicly available SRC guidance in Irish sports and national governing bodies (NGBs) to determine if centralised guidelines are warranted. Sport Ireland and the Irish Federation of Sports were searched for all recognised NGBs and sports in Ireland. Websites were searched for any information pertaining to SRCs and data were extracted and collated in Microsoft Excel. In total, 15 of 83 sports and/or NGBs included SRC guidance, nine of which provided RTP protocols. Various iterations of the CISGs guidance and tools were implemented. Several sports with a documented SRC risk had no guidelines present. The findings indicate disjointed and outdated guidance across Irish sport. Additionally, there are sports with a documented concussion risk that have no SRC guidance available. This study provides support for centralised guidelines to be adopted in Irish grassroots sports.

The incidence of sport-related concussion (SRC) has increased in many team-based sports (1,2,3) , such as rugby, Gaelic (camogie, hur-ling and football), and hockey in Ireland (3,4) . Following SRC, the brain becomes injured, its function disrupted, and an “ energy crisis ” (5) occurs. In response, the brain requires energy and nutrient support to restore cognitive function, reduce symptoms and support healing (2) . Performance dietitians (PN) and nutritionists (PN) play a critical role in supporting athletes ’ acute injury nutritional demands via fuelling and supplementation. Speci fi c supplementation protocols with nutrients such as omega-3 fatty acids (Docosahexaenoic (DHA), a combination of DHA and Eicosapentaenoic (EPA) acid), magnesium, and N-acetyl cysteine (NAC) may help with SRC recovery. However, their application is unclear and requires further investigation (2) . Therefore, this study aimed to investigate Irish PD and PN knowledge and implementation of nutritional strategies to manage and support their athletes following an acute SRC diagnosis. In-depth, semi-structured, audio-recorded interviews were conducted with 17 PDs and PNs recruited from professional registrations (SENR), sporting bodies (IRFU, GAA, Sports Ireland) and networks. Participants practiced/had practiced with amateur and/or professional athletes within the last ten years. A re fl exive thematic analysis approach was implemented whereby the data were transcribed, coded, and emerging themes were identi fi ed and discussed by all authors. This research developed insight on PD/PN ’ s (1) awareness, knowledge and (2) implementation of nutritional supports in concussion recovery with athletes. There was a clear contrast between participants who had an awareness and knowledge of the importance of nutrition in supporting brain recovery after a concussion and

OBJECTIVES:Sports-Related Concussion (SRCs) are of relevant risk and burden for female athletes. The following study aimed to explore potential barriers to return to play (RTP) best practice in coaches of amateur female athletes, and medical professionals who may treat and manage SRCs in amateur female athletes.DESIGN:Qualitative, semi-structured, virtual interviews following a critical analysis framework.METHODS:Twenty-five coaches, allied healthcare professionals (AHPs), and general practitioners (GPs) were recruited and interviewed using a convenience snowball sample. Data were transcribed verbatim and thematically analysed.RESULTS:Three themes were identified following reflexive thematic analysis; biopsychosocial norms, stakeholder inaction, and practitioner effectiveness. The findings identify numerous factors which limit the uptake of best practice guidelines as endorsed by Irish national governing bodies (NGBs). Education, training, and implementation of these guidelines are lacking, with sub-standard or non-existent medical support and poor general injury and/or SRC attitudes providing further resistance to these measures.CONCLUSION:Existence of SRC-RTP protocols does not equal adherence to such. Greater efforts are required to translate knowledge provided by the 6th Concussion Consensus statement. NGBs, league and club administrators, and educators need to better support coaches, practitioners and athletes in the implementation of these protocols in amateur female sport.