Zero tolerance: the future of head injury in sports.

Concussion is a common type of brain injury caused by impact forces to the head following intentional or unintentional collisions. All sports, whether they are team sports (eg, football, rugby and ice hockey), or individual sports (eg, horse riding, skiing or boxing) have finite risk of a concussion injury, which should be reduced as much as possible if the potential for long-term problems is to be avoided. Concussion must be recognised quickly and treated appropriately; however, the most important aspect of medical management is the timing of the return to play decision. The team physician is commonly under pressure from the team, the coach or the administration to get the athlete back in the game, particularly in high-profile sports. The physician has to take the ultimate responsibility for the decision on when the athlete can safely return to play or not. The main objective for the 4th International Concussion Consensus Conference held in November 2012 in Zurich, Switzerland at the home of Federation International de Football Association (FIFA), was to support the physicians acting in the field by offering an expert consensus based on current and recent scientific evidence to facilitate decision-making.