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. Our policy is designed to mitigate these risks, providing a framework for the prevention, identification, and management of such injuries on a style agnostic basis, allowing the tools and policy guidance to be applicable across all of the disciplines we represent.

Our primary aim is to foster a safe and supportive environment where practitioners can thrive, learning and growing in their chosen martial arts discipline without undue risk to their health. To this end, this policy sets out clear guidelines and procedures that are grounded in the latest research and best practices in sports safety and concussion management predominantly aimed at instructor and club management teams.

We are dedicated to educating our instructors, students, and their families about the importance of recognising the signs and symptoms of concussions, the seriousness of head injuries, and the steps to take should an injury occur. This policy outlines our expectations for all affiliated clubs and members, including the use of protective gear, the implementation of safe training practices, and the protocols for dealing with suspected concussions.

Through adherence to this policy, we aim to not only comply with legal and ethical standards but to surpass them, ensuring that our martial arts community is informed, protected, and empowered. We believe that by working together, we can create a culture of safety and respect that upholds the integrity of martial arts and safeguards the health and future of every practitioner.

Concussion and head injury management in martial arts is a huge topic, and one that lacks any major funding or research. Accordingly, this policy document represents the 'tip of the iceberg' in terms of BMABA's research and development in the subject.

We recommend this policy be used for guidance only, and that a full policy position should only be reached on conclusion of the CHIMA award.

There is little to no established or peer-reviewed information available from martial arts specifically, and certainly not the full breadth of disciplines we represent - especially at recreational level. As an organisation, we've consulted expert guidance and we've pulled in externally validated sources from established guidance and publications from, among many others;

It’s important to note that at this stage, whilst pioneering and the 'first of it's kind' this policy remains a work in progress based on the constantly evolving body of research on concussions and head injuries. We’ll continue to evolve the guidance and always point these findings toward recognised sources, but you should consider this policy a best practice guide and not a definitive position. This is because the research is moving quickly, and the landscape on head injuries in UK martial arts is, as of yet, completely uncharted. As with any content that has serious knock-on impacts to student welfare, we encourage you to scrutinise the evidence, take the guidance as an informative but editorial, and always make club-specific decisions on treatment and prevention. There is no one-size-fits-all approach to head Injuries in martial arts!

The British Martial Arts & Boxing Association (BMABA) has developed a pioneering online course specifically designed for UK martial arts instructors, focusing on the crucial aspects of head injuries and concussion. This comprehensive training program aims to equip martial arts instructors and volunteers with the necessary knowledge and skills to identify, manage, and prevent head injuries in their practice. By delving into the latest research and best practices in sports safety, the course covers a wide range of topics, including the mechanisms of head injuries, symptoms of concussion, immediate and follow-up care, and strategies for concussion prevention. The course is structured to enhance the instructor’s ability to make informed decisions when faced with potential head injuries, emphasising the importance of safety in contact training.

In addition to theoretical knowledge, the BMABA course incorporates practical guidance on creating a safer training environment. It guides instructors on how to implement effective risk management strategies, adapt training methods to minimise the risk of head injuries, and educate students on the importance of protective gear and safe sparring techniques. The course also addresses the legal and ethical responsibilities of martial arts instructors in the UK, ensuring they understand their role in safeguarding students’ health and wellbeing. By completing this course, martial arts instructors will not only improve their competence in managing head injuries but also contribute to the broader effort of making martial arts training safer and more enjoyable for participants of all ages and skill levels.

This course is fully funded for Silver and Gold members, as well as Volunteers and Assistant Instructors.

Head injuries can range from mild to severe and are generally classified into two main categories: external and internal. External injuries, often visible, include cuts, bruises, and fractures to the skull. Internal injuries, which are more concerning, involve the brain and may not always show immediate symptoms. These include concussions, contusions (bruises on the brain), and traumatic brain injuries (TBIs).

In martial arts, head injuries are predominantly caused by direct blows to the head, falls, or rapid acceleration/deceleration movements that cause the brain to move inside the skull. This can happen in various contexts, such as sparring, competition fighting, or even during routine training exercises.

Techniques and practices that increase the risk include high-impact strikes, throws, and takedowns. The likelihood of injury can be exacerbated by inadequate protective gear, improper technique, or insufficient supervision.

Not all Traumatic Brain Injuries (TBIs) will result from full contact fighting. It may seem insignificant, but a poorly managed breakfall or an accidental punch to the face during padwork could be sufficient for a major and devastating brain injury. Of course the most severe the level of impact, and the duration, the more likelihood of serious injuries occurring. We’ll cover this in greater depth later.
​

One of the most crucial skills you can develop as a martial arts leader is the ability to recognise the signs and symptoms of a concussion. This knowledge is vital, as it can occur during any martial arts lesson, whether through sparring, routine training, or competitive fighting. Understanding the immediate assessment techniques will empower you to act swiftly and appropriately, ensuring the safety and well-being of your students.

Concussions can present a wide range of symptoms, which may appear immediately after the injury or develop over hours or days. The NHS outlines several key symptoms to watch for, including but not limited to:

In the context of a martial arts lesson, you might notice a student who seems confused about routine drills or techniques they were previously familiar with, or they might struggle to recall recent events of the session. It’s important to remember concussion isn’t always immediately visible, so you need to be highly alert to potential injuries from impacts or falls, and you shouldn’t be afraid to take pre-emptive steps to minimise on-going injury – such as removing somebody from training.

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 just temporary setbacks; they can have profound long-term effects on an individual’s neurological health. The NHS highlights that while most people recover fully from concussions, the risk increases with the number of injuries sustained. In martial arts, where blows to the head can be frequent, particularly in disciplines involving striking, the risk of repeated head trauma is significant.

Long-term impacts of repeated concussions and head trauma can include:

The nature of martial arts training and competition means that participants are at risk of head impacts that can lead to concussions and, over time, more serious neurological conditions. Strikes to the head, falls, and even the rapid jerking of the head can all cause brain injury. Instructors must be acutely aware of these risks and take proactive measures to minimise them, such as teaching proper technique, enforcing the use of protective gear, and promoting a culture where students feel comfortable reporting symptoms.

Preventing long-term impacts starts with reducing the occurrence of concussions and managing them effectively when they do happen. This includes:

When a head injury occurs during martial arts training, the initial response can significantly influence the outcome for the injured individual. Here’s what you should do:

As part of your general first aid training, as always, you need to undertake an initial assessment. This helps you understand the apparent severity of the injury and will inform your next steps. Remember, you are not a Doctor (unless you’re one of the 1.3% of our members who are!) so you should not be trying to diagnose on the side of the mats. Likewise, whilst legality and insurance may be a concern, your primary ethical and legal responsibility is the welfare of your student so you should be assessing;

All the proper literature on the matter emphasises the importance of erring on the side of caution with head injuries. Immediate medical assistance and evaluation is necessary if the individual:

Even without apparent signs of concussion, you still have a duty to ensure the student seeks competent medical guidance.

Part of our critical guidelines and precautions for safely reintegrating students into martial arts training following a head injury or suspected concussion is a graduated Return to Play (RTP) process which is essential to ensure the well-being of the student, minimising the risk of further injury.

The RTP process is a medically supervised, step-by-step approach to safely resuming physical activity following a concussion. It’s designed to ensure that an individual only progresses to more demanding activities when they can handle current activities without symptoms.

The process should be led by a medically qualified practitioner, but can generally be expected to follow;

Protective equipment in martial arts serves two primary purposes: injury prevention and confidence building. It allows practitioners to train realistically while minimising the risk of injury, thus providing a safer environment for learning techniques and sparring. Moreover, wearing appropriate gear can increase a student’s confidence, enabling them to focus on skill development without the fear of getting hurt.

In terms of concussion, there is an inherent risk of a sense of false-confidence when using protective equipment. For example, a concussion can be sustained even when wearing protective headgear. When there is a knock to the head, the brain moves around inside the skull, and it is this movement and subsequent shearing forces that can cause damage. While helmets can absorb some of the shock of this impact, they are not effective at reducing these rotational forces and therefore cannot completely prevent a concussion from happening. Headgear can, however, protect against cuts and bruises to the scalp and ears, and protect the skull.

As with all areas of training in martial arts, it is about context and good instruction/supervision. PPE (Personal Protective Equipment) has a crucial role to play in injury prevention, however in direct reference to Concussions, it is not a ‘cure all’.

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.

Sparring is a critical component of training for a great majority of our clubs, offering students the opportunity to apply techniques in a dynamic and controlled environment. However, the risk of injury, particularly to the head, increases with semi-contact and full-contact sparring.

The importance of implementing proper safety mitigations during sparring sessions cannot be overstated. Such measures are crucial not only for preventing injuries but also for cultivating an environment where students feel secure and confident in practicing and applying their skills. Effective supervision, coupled with the use of appropriate protective gear and adherence to established safety protocols ensures that participants can engage in sparring with minimal risk. Note please the term minimal, not nil risk.

Moreover, it promotes a respectful and disciplined training atmosphere, where the focus remains on skill development, mutual learning, and the preservation of health. Instructors play a pivotal role in this context, as their vigilance, expertise, and commitment to safety standards directly impact the well-being of their students and the integrity of the martial arts discipline being taught.

Supervising and encouraging safer sparring isn’t watering down the technical ability of students or the essence of your discipline. It is quite the opposite – you are providing a ‘safe space’ in which students can try, fail, try and then succeed with new techniques and strategies ‘in the ring’ – something that doesn’t happen when students feel under physical threat of danger within an uncontrolled sparring bout.

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.

Following on from the above, BMABA employs a methodology we’ve coined as ‘Moderated Sparring Access’ – or ‘MSA’ for shorthand reference. This refers to the policy of moderating access, and requiring students to ‘graduate’ to different phases of sparring based upon physical conditioning and technical ability.

Each club will have a different MSA based on the style, audience, age taught and so on. It’s quite common to have multiple MSA policies to cater for the differing classes offered too, especially if this spans multiple styles.

An example of a moderated access plan may look something along the lines of the below;

> 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)

A full breakdown on each level, and how to determine the progress throughout each stage can be found within MyBMABA and our dedicated course.

Instructors should emphasise the following techniques and principles during sparring sessions. A full set of safe sparring protocols, including 'kill switch' commands, defensive techniques, spatial awareness, proper stance and movement, and control and restraint can be found in our concussion and head injury management course.

Common mistakes that increase the risk of head injuries include overextending, poor timing, and neglecting defence in favour of offence. Instructors should:

It is imperative that we highlight the significant safety concerns surrounding children engaging in sparring activities that involve contact to the head. The developing brains of children are particularly susceptible to the adverse effects of head injuries, which can have long-lasting implications on their cognitive, physical, and emotional well-being. Given the available scientific evidence and the duty of care we hold as instructors and guardians, we strongly recommend that children do not undertake any sparring in martial arts classes that involves head contact. This precautionary approach not only aligns with best practices in sports safety but also ensures that the martial arts environment remains conducive to positive growth, skill acquisition, and the overall health of our young practitioners. Emphasising skill development, technique, and discipline over physical confrontation can provide a comprehensive martial arts education that is both safe and rewarding for children.

Where sufficient maturity, skill and conditioning is present, a phased approach to semi-contact ‘tag fighting’ can be employed but it should still be based on avoidance of head contact, and zero-pointing any form of scoring associated with head contact in favour of ‘chest only’ contact.

Each club should review and adapt this policy based on their specific style, setup and student age range. In light of the scientific evidence suggesting there is no such thing as ‘safe head contact’ and the overwhelming responsibility to safeguard children in our care, we anticipate any form of head contact in sparring or training to cross over into safeguarding and not just health and safety in the near future.

Implementing a safety-first approach in martial arts is crucial for several compelling reasons, particularly in reducing the risk of concussion and head injuries. First and foremost, as you well know concussions are serious brain injuries that can have profound short and long-term effects on health, including cognitive impairment, emotional instability, and physical discomfort. In martial arts, where physical contact is often a key component of training, the risk of such injuries can be significant if proper precautions are not taken.

Begin cultivating the right attitudes in your club with the importance of establishing a culture that prioritises safety above all, explaining how this mindset helps in preventing avoidable injuries. Highlight the role of the instructor in setting expectations for safe practice, including the use of appropriate gear, adherence to rules, and fostering an environment where students feel comfortable reporting symptoms of injury.

This isn’t ‘woke’ – this is sensible. Students will leave in droves if they are constantly injured or intimidated during training, and ultimately, that’s not the best way to build a solid martial artist. It’s perfectly possible to create a safety-first club that still engages in full contact training and grappling, with a robust and modern feel to classes. This is what a professional instructor does, and it’s what we should all be aiming to deliver within our classes.

Discuss the specific risks of head injuries within martial arts training and strategies to reduce these risks directly with your students and teaching team. As an example, this could include;

Simple changes, and in most cases no doubt something you’re doing already on a daily basis. Opening this thought-process up to your students, parents and teaching team helps you share the ‘method behind the action’ and shows a clear prioritisation of safety. Students respect this, and so do fellow instructors.

In the realm of martial arts, the physical demands placed on practitioners can lead to a range of injuries, with head injuries and concussions being among the most serious. To mitigate these risks, a comprehensive strength and conditioning programme tailored to martial artists is essential.

To help guide the strength & conditioning without straying into the uninsured scope of the role of a fitness coach, we've developed comprehensive guidance on strength and conditioning. This covers how to;

This is covered in our comprehensive concussion and head injury management award, which is free for most members.

It's crucial that all clubs realise there is never a release to the duty of care placed upon them in respect of their students when it comes to concussion and head injuries. If you are attending third party events and competitions with non-BMABA affiliated clubs or associations, you should ensure you are confident they have sufficient and thorough concussion management protocols in place.

This should include;

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