Concussion & Head Injury Management Policy

Our Concussion & Head Injury Management Policy is a pioneering and critical component of our commitment to ensuring the safety and well-being of all participants within the martial arts community we serve.

As a leading UK martial arts association, we recognise the inherent risks associated with martial arts training — including the potential for concussions and head injuries. This policy is designed to mitigate those risks by providing a framework for prevention, identification, and management that is style-agnostic and applicable across the wide range of disciplines we represent.

Our primary aim is to foster a safe and supportive environment where practitioners can thrive — learning and progressing in their chosen martial arts discipline without undue risk to their health. This document provides clear, practical guidance rooted in current research and best practice in sports safety and concussion management, with a particular focus on instructors and club management teams.

We are dedicated to educating instructors, students, and families about the importance of recognising the signs and symptoms of concussion, the seriousness of head injuries, and the appropriate steps to take when an injury is suspected. The policy outlines expectations for all affiliated clubs — including the use of protective gear, safe training practices, and mandatory protocols for managing suspected concussions.

Recent events and national discussions have highlighted the need for the martial arts sector to take a more structured, proactive approach to concussion and safeguarding — particularly where children and young people are concerned. While our framework has been developed independently and ahead of external guidance, we continue to refine and strengthen it to ensure we are not only meeting, but setting, the highest standards in safeguarding and injury prevention.

Concussion and head injury management in martial arts is a vast and evolving topic that currently lacks comprehensive funding, research, or regulatory oversight specific to our sector. Accordingly, this policy document provides a structured reference point — but it represents only a summary of BMABA’s broader research and development in this area.

This policy should be used as a best-practice reference guide only. Clubs should base their full safeguarding and injury management policies on the more detailed instruction provided within the CHIMA award.

There is currently very limited peer-reviewed research specific to concussion and head injury risks across the full breadth of martial arts disciplines — particularly at recreational and grassroots levels. In developing this policy, BMABA has drawn from a wide array of external, evidence-based sources, including but not limited to:

While this document reflects leading current guidance, it should be treated as a best-practice framework, not a fixed or final position. The research base is evolving rapidly, and the unique risks present in martial arts settings — especially where children are involved — remain underexplored at a national level.

We will continue to update and expand this policy as the evidence base grows, and we encourage all instructors and clubs to critically evaluate this guidance in light of their specific training environment, student demographics, and contact intensity. There is no one-size-fits-all solution to concussion risk in martial arts, and responsible implementation will always require contextual judgement.

The British Martial Arts & Boxing Association (BMABA) has developed a comprehensive online course specifically for UK martial arts instructors, addressing the critical topic of concussion and head injury management in martial arts environments.

The Concussion & Head Injury Management in Martial Arts (CHIMA) Award is designed to equip instructors and coaching teams with the essential knowledge and practical tools needed to identify, manage, and prevent head injuries. Grounded in the latest research and best practice in sports safety, it covers a broad range of key areas — from the mechanisms of injury and symptom recognition to immediate response, follow-up care, and risk prevention strategies tailored to martial arts.

In addition to building theoretical understanding, the CHIMA course includes extensive applied guidance for reducing risk through training adaptations, protective equipment use, and informed decision-making in contact scenarios. It also addresses the legal and ethical responsibilities instructors hold, particularly when working with children and young people.

Completion of the CHIMA Award supports clubs in developing a culture of safety and accountability, and we strongly encourage all coaches involved in contact training — especially where under-18s are present — to treat CHIMA as a baseline safeguarding competency.

This course is available at no cost to Silver and Gold members, as well as Volunteers and Assistant Instructors.

Head injuries in martial arts can range from minor to life-threatening, and are generally categorised into two main types: external and internal.

Among these, concussions are the most common. The NHS defines a concussion as a temporary injury to the brain caused by a bump, blow, or jolt to the head. Symptoms can include headache, dizziness, confusion, nausea, and — in some cases — temporary loss of consciousness. However, loss of consciousness is not required for a concussion to have occurred.
​

More severe injuries, such as contusions or TBIs, can lead to swelling, bleeding, and potentially permanent neurological damage. These injuries may escalate quickly or appear delayed, making early recognition and cautious management critical.

Head injuries in martial arts may result from:

These risks exist across sparring, competitive fighting, and even routine drills — particularly where supervision, technique, or safety control lapses.

High-risk scenarios include:

It’s important to understand that not all traumatic brain injuries occur in obvious high-contact situations. A poorly executed breakfall or an incidental clash during padwork can be enough to cause a serious and lasting injury. The severity and duration of impact will always influence outcome — but even low-level trauma, if poorly managed, can lead to significant harm.

Further guidance on recognition and response is provided in the following sections.

​

One of the most critical skills you can develop as a martial arts instructor or club leader is the ability to recognise the signs and symptoms of a concussion. This is especially important in martial arts, where head impacts may occur during sparring, grappling, padwork, or falls — often without immediate visible signs.

Understanding the symptoms and immediate assessment actions will enable you to respond quickly and appropriately, helping to protect your students’ short- and long-term health.

Concussion symptoms can appear immediately or may develop over the following minutes, hours, or even days. The NHS and Headway UK outline the following common indicators:

In the context of a martial arts session, you might observe a student struggling to recall simple instructions, performing familiar drills incorrectly, or behaving unusually. You should never assume the absence of visible symptoms means no injury has occurred.

There are generally two sets of symptoms to look for in concussion;

First symptoms of concussion typically appear immediately or within minutes of the injury. Key symptoms to look out for include:

Remember, loss of consciousness only typically occurs in around 10% of instances, so you shouldn’t use this as an exclusive reference to the likelihood of a brain injury.

The injured student may report some of these symptoms, or it may be noticed by you, your teaching team or other students.

It’s crucial anyone with suspected concussions, with any of the prior specified symptoms is removed entirely from the session. They should also be assessed by a medical professional as an immediate point of action.

This applies even if they maintain they are feeling fine – you have a duty of care to enforce this policy.

Delayed symptoms can present at any point in the hours or days following a suspected brain injury.

These can include physical symptoms like;

Cognitive symptoms such as;

Emotional symptoms including;

Most of these symptoms are typical following a brain injury, and will improve by themselves within 2-4 weeks post-injury, however it’s important you don’t rely on this as an instructor. This has to be a treatment choice the student reaches themselves (or a parent, if the student is a minor). Advice should always be that if symptoms worsen at any time, or if they remain for more than 14 days, the student should report to the GP without delay.

We’re quoting directly from the Brain Injury Association Sport Factsheet (we’re a member of BIA) for the red flag symptoms. This is because of the severity of the issue, and just how important it is for instructors and volunteers to recognise this properly;

Concussions are not simply temporary injuries — they can have significant long-term implications for neurological health. While the NHS notes that most people recover fully, the risk of lasting effects increases with the number of concussions sustained, particularly when recovery between injuries is incomplete.

In martial arts, where contact with the head can occur in both striking and grappling disciplines, the risk of repeated head trauma is especially relevant. Instructors must understand and account for this in how they train, supervise, and escalate suspected injuries.

The nature of martial arts training and competition means participants face an inherent risk of head impacts. These may occur through direct strikes, falls, takedowns, or sudden head movements — and can lead to concussion or, with repetition, more serious neurological conditions.

Instructors must be acutely aware of these risks and take proactive steps to minimise them. This includes:

Minimising long-term effects begins with preventing concussions in the first place — and ensuring that any injuries are handled promptly and appropriately.

Key strategies include:

Clubs must take additional precautions with children and young people. This includes:

Further guidance for instructors teaching under-18s is provided later in this policy.

When a head injury occurs in a martial arts setting, the instructor’s initial response can have a significant impact on the safety and recovery of the injured individual. The following steps should be followed in all suspected head injury cases:

1. Stop the Session

2. Assess the Situation

3. Ensure Safety

4. Do Not Rely on Verbal Assurance

As part of your standard first aid responsibilities, you must undertake an initial assessment when a suspected head injury occurs. This does not replace professional medical evaluation — you are not expected to diagnose — but it helps you identify immediate concerns and determine the appropriate response.

Your primary responsibility is the safety and welfare of the student, and your decisions should always prioritise this, regardless of whether legal, insurance, or session-delivery concerns are present.

1. Consciousness Check

2. Symptom Screening

3. Orientation (Memory) Test

Repeat orientation checks periodically while you're monitoring them. Any decline in clarity or confusion warrants escalation.

​

4. Immediate Action: Remove from Session

Concussion and head injury guidance from the NHS and other national authorities consistently emphasises one key principle:
​Always err on the side of caution.

You must ensure a student receives immediate or follow-up medical care if any of the following apply:

Even if symptoms are not apparent, you have a legal and ethical duty of care to ensure the student seeks proper medical advice. This means:

A critical part of concussion management is ensuring that no student returns to martial arts training too soon after a head injury. A premature return can significantly increase the risk of re-injury, Second Impact Syndrome (SIS), and long-term neurological harm.

BMABA mandates a Graduated Return to Play (GRTP or GRtP) protocol for all suspected head injuries — and this must be supervised by a medical professional, not solely left to instructor discretion.

The GRTP is a step-by-step process that gradually reintroduces physical activity in a way that allows the brain to recover fully before increasing intensity. At each stage, the student must be:

Progression to the next step should only occur if the previous step has been completed without the return of any symptoms.

Protective equipment in martial arts serves two key purposes: reducing the risk of injury and supporting student confidence. When properly fitted and used in the correct context, it allows for realistic training while helping mitigate risks — especially during sparring or high-intensity drills. It also helps students focus on learning and applying technique, rather than worrying about injury.

However, in the context of concussion, protective equipment has limitations. For example, a concussion can still occur even when wearing headgear. That’s because concussions are caused by the brain moving inside the skull due to impact — not just from the force at the surface. Helmets may reduce the severity of external injuries (like lacerations or bruising), but they cannot fully absorb or prevent the rotational forces that cause brain trauma.

This makes proper instruction, supervision, and context-sensitive risk management essential. PPE plays an important role, but it is not a substitute for safe coaching practice or robust concussion protocols.

When selecting gear, consider the following:

Padded headgears have been shown to decrease the risk of abrasions and lacerations in contact sport, but its effectiveness in preventing concussion is less clear. Likewise, whilst gumshields clearly perform a crucial role in preventing dental injuries, there remains very little evidence to support mouth guards effectively reducing concussion incidence rates or the severity of concussions.

The developing research on the matter points toward the nature of the head-rolling causing concussion – for example, when receiving a hook to the chin. The headguard or gumshield may take the brunt of the strike, but it is the sudden shift of the neck and head that can lead to concussion. Some in the field believe headguards can help to reduce the severity of an impact or strike by absorbing some of the power on initial contact, but the evidence is clear – it will not prevent a concussion.

This doesn’t mean you shouldn’t consider a headguard useful. It does provide protection from abrasions and contusions, but similarly to a gumshield, you can not assume it to be sufficient in terms of preventing the possibility of concussion or brain injury.

When selecting gear, consider the following:

Padded headgear has been shown to reduce superficial injuries such as cuts and bruises. Similarly, gumshields are proven to significantly lower the risk of dental injuries. However, when it comes to preventing concussion, the evidence is limited and inconclusive.

The mechanics of concussion often involve rotational forces and rapid head acceleration or deceleration — such as during a hook to the jaw. Even if the headguard or gumshield absorbs some of the initial impact, the internal movement of the brain inside the skull can still occur. Some studies suggest headgear may slightly reduce the severity of a blow, but they do not eliminate the risk of concussion.

This doesn’t mean headgear and gumshields aren’t important — they clearly play a vital role in overall injury prevention. But they should not be relied upon as a safeguard against brain injuries. Instructors must ensure that students, parents, and coaches understand this distinction to avoid a false sense of security and to maintain vigilance around concussion risks, even when PPE is in use.

Sparring is a core component of training for many martial arts clubs. It offers students the chance to apply their skills in a dynamic, responsive environment. However, the risks — particularly around head injuries — increase significantly during semi-contact and full-contact sparring.

Effective safety measures are non-negotiable in sparring. They are essential not only for injury prevention, but also for building an environment where students can train confidently and progress without fear.

That means:

These measures do not eliminate risk — nor do we pretend they do — but they can substantially reduce it. We use the term minimal, not nil risk, for good reason.

Promoting safer sparring is not about watering down technical ability. Quite the opposite: a safe and structured environment empowers students to experiment, make mistakes, and develop real-world application under pressure — without the uncontrolled risk of harm that can accompany poorly managed sparring.

It also reinforces a respectful, disciplined atmosphere — where the emphasis remains on learning, not domination or escalation.

Instructors play a central role in this. Your consistency, vigilance, and refusal to compromise on safety directly affect your students' well-being, confidence, and long-term engagement with the sport.

While much of the focus around head injury risk in martial arts falls on striking disciplines, grappling is not exempt. In fact, many concussions and traumatic brain injuries can — and do — occur during throws, takedowns, ground impacts, or improperly executed submissions.

Falls from elevation or with rotational force (such as during hip throws or sacrifice throws) can lead to the head making contact with the floor or snapping backwards with whiplash-like motion. Poorly controlled takedowns or breakfalls can cause head impacts, especially for less experienced students still developing body control and landing awareness.

In addition, chokes and strangles — while a recognised and safe component of many grappling systems — must be closely supervised. Loss of consciousness (even momentarily) can lead to secondary risks, including head injury on impact with the mat or surrounding students. Grappling sparring ("rolling") can also introduce risk if intensity is not well managed, or if students are matched inappropriately by weight or experience level.

Grappling, like striking, must therefore be governed by:

It’s critical that instructors avoid assuming grappling is “safe by default.” While the risks may look different to striking, they are no less real — and concussion protocols must apply equally in these contexts.

Prior to sparring, a thorough warm-up and specific conditioning exercises can prepare the body and mind for the physical demands of sparring. This is of course common knowledge, and is covered in both the Level 1 and Level 2 instructor qualifications however, you should focus specifically on:

These conditioning exercises should form a crucial and recurring part of training, and you should be working to build up these skills in your students long before they first take on any aspect of contact training. In the same way you wouldn’t take a first-time runner and ask them to run a marathon, instead building up experience, skill and muscle performance for long distance running through lots of exercises and shorter runs, the same approach should be taken for martial arts.

As part of our commitment to graduated safety in contact training, BMABA promotes a framework we refer to as Moderated Sparring Access (MSA). This refers to the progressive staging of sparring exposure, requiring students to ‘graduate’ through structured levels based on physical conditioning, technical ability, and maturity.

Each club should define its own MSA framework appropriate to its style, student age range, contact level, and risk profile. In many cases, multiple MSA paths may be needed to reflect the differences between classes (e.g. beginner vs advanced, junior vs adult, or grappling vs striking).

Here’s an example MSA progression:

ENTRY LEVEL – No sparring permitted
​LEVEL 1 – Semi-contact sparring (body only)
​LEVEL 2 – Semi-contact sparring (full body)
​LEVEL 3 – Full contact sparring (body only)
​LEVEL 4 – Full contact sparring (full body)

Each level should have clear entry and progression criteria, including baseline fitness, demonstrated technical control, safe sparring behaviours, and instructor assessment. A full guide to implementing MSA — including progress tracking and safeguards — is available via MyBMABA and our dedicated CHIMA Award.

Instructors must explicitly teach and enforce safe sparring principles, which are critical for reducing risk in any contact setting. This includes:

A complete safe sparring protocol is included in the CHIMA course, along with optional in-class posters and visual cues available through MyBMABA.

Common technical issues can dramatically increase the risk of concussion or head trauma. These often include:

Instructors should:

It is imperative to emphasise the heightened safety risks involved when children participate in sparring activities, particularly where contact to the head is involved. A child’s developing brain is significantly more vulnerable to the adverse effects of head injuries, including concussion and traumatic brain injury. These injuries can have serious, long-lasting impacts on cognitive, physical, emotional, and psychological development.

In light of this — and our statutory and moral duty of care — we strongly recommend that all sparring activities for children and young people under 18 avoid any form of intentional or permissible head contact. This precautionary stance aligns with best practice from safeguarding agencies, paediatric medical guidance, and sport safety authorities across the UK.

We stress that head injury and concussion management should be treated as a safeguarding matter when working with minors. Even moderate levels of impact, if not appropriately managed or monitored, can fall under the scope of child protection concerns. This elevates concussion response beyond just health and safety — it must be recognised as a child welfare issue in its own right.

Where sufficient maturity, technical competence, and physical preparedness is clearly demonstrated, a phased approach to sparring may be considered. This might include carefully moderated semi-contact ‘tag fighting’, focused on technical point-scoring rather than forceful impact. Even in these instances:

Each club should assess its own policy on child sparring based on age, discipline, and class structure. A risk assessment, alongside a clear safeguarding consideration, should inform any decision on whether a child is ready for even light forms of contact training.

These are recommended maximums, not entitlements. BMABA advises clubs to take a progressive, readiness-based approach where students demonstrate maturity, competence, and understanding of risk before moving up levels of contact — regardless of age.

When it comes to children and young people participating in contact martial arts, instructors and clubs must recognise the critical role that parents and guardians play in understanding, managing, and consenting to the risks involved.

Clubs should not rely on passive or blanket disclaimers. Instead, a proactive, transparent, and opt-in approach should be taken with all parents or guardians before permitting any sparring or training that may involve risk of head injury, including accidental contact during drills or grappling.

By involving parents not just as bystanders, but as informed partners in the decision-making process, we strengthen trust, reduce risk, and place child safety at the heart of club culture.

Implementing a safety-first approach in martial arts is essential — not only as a matter of safeguarding, but as a professional standard that underpins trust, retention, and student development.

Concussions are not minor injuries. They are brain injuries, and their effects can be wide-ranging and long-lasting — from cognitive and emotional disruption to physical health complications. In a sport where contact is expected, the risk is present, and instructors have a critical responsibility to manage it.

A culture of safety should not be confused with a lack of intensity or realism. You can still deliver dynamic, high-contact training and grappling — but it must be underpinned by modern, risk-aware protocols. A professional instructor leads from the front, creating an environment where:

This isn’t about being “woke.” It’s about being smart, ethical, and sustainable. Martial arts clubs that tolerate reckless contact or intimidation will lose students — not because martial arts is too hard, but because it’s being taught without care.

A safe club is a strong club. Building a safety-first culture is how we produce resilient, technically capable martial artists who can train for years — not just survive a few weeks.

Head injuries remain one of the most serious risks in martial arts — not just due to the immediate danger, but because of the potential long-term impact. Mitigating this risk requires conscious, consistent effort from instructors, students, and the wider club community.

You should regularly discuss the risks and prevention strategies with both your teaching team and students. This includes not just implementing rules, but also explaining why they matter. Some key mitigations include:

These may seem like small, obvious steps — and likely many are already part of your daily teaching practice. But actively sharing this approach with students, parents, and assistants demonstrates clear, proactive risk management. It shows professionalism and helps normalise a club-wide safety culture.

When your community sees the thought behind your structure, they’re more likely to trust it, respect it, and follow it.

Martial arts places unique demands on the body — from explosive power to sustained control — and with this comes the risk of injury. Among the most serious are concussions and head trauma. One of the most effective long-term mitigation strategies is a structured strength and conditioning programme that supports both resilience and control.

To ensure this advice stays within the scope of martial arts instruction — and not stray into regulated fitness coaching — we’ve developed detailed, role-appropriate guidance for instructors. This includes:

These strategies are fully outlined in our Concussion & Head Injury Management Award.

Participating in third-party events — whether inter-club sparring days, open tournaments, or externally run competitions — introduces a significant increase in risk when it comes to concussion and head injury management. It is critically important that all BMABA-affiliated instructors understand: your duty of care to your students does not end at the door of your dojo. Attending an external event does not release your legal or ethical responsibilities, especially in matters of safeguarding and injury prevention.

Unlike environments where instructors operate under BMABA's training, guidance and expectations, third-party competitions can vary dramatically in terms of medical preparedness, rules of contact, and injury response procedures. Many are run by independent organisations without a consistent or transparent safety framework, and without any oversight or alignment to our concussion management protocols.

Failing to exercise due diligence can place your students in direct harm and leave your club legally exposed. For young people, this risk multiplies — and so too does the obligation to intervene early and assertively when standards are not up to par.

Before agreeing to attend or support a third-party event, you should verify that the following are clearly in place:

Even when those minimum standards are met, your role does not diminish. You, or a designated safeguarding-trained assistant, should remain actively present and vigilant throughout the event. This includes:

In an ideal setup, a BMABA safeguarding-trained parent or team member should attend the event with a specific remit to monitor for injury, allowing the instructor to focus on coaching while maintaining vigilance over student welfare.

It's important to seek guidance from BMABA or a competent authority if you have any concerns or questions surrounding head injuries and concussion.