AIS Concussion and Brain Health Position Statement 2024: Key Takeaways for Clinicians

On 1 February 2024, the Australian Institute of Sport (AIS) released the Concussion and Brain Health Position Statement 2024 (CBHPS24). Developed in collaboration with the Australian Physiotherapy Association and Sports Medicine Australia, and funded by the Australian Government, this document has become the reference framework for concussion management across Australian sport.

Since its release, more than 30 National Sporting Organisations— including the AFL, Rugby Australia, Football Australia, Equestrian Australia, and Athletics Australia — have endorsed and adopted the guidelines. Sport Integrity Australia's CEO publicly stated that the guidelines “should be adopted by all National Sporting Organisations.”

For allied health practitioners, this is the single most important Australian concussion policy document of the past decade. Here are the key changes you need to understand.

The headline change: athletes under 19 and all community-level athletes (regardless of age) must observe a minimum 21-day stand-down from the date of concussion before returning to competitive contact or collision sport. This aligns Australia with the UK and New Zealand guidelines.

Within this window, athletes must be symptom-free at rest for 14 consecutive days before progressing to contact training, and must obtain written medical clearance before returning to competition.

Elite athletes with access to “Advanced Care Settings” — defined as constant medical monitoring by club-employed professionals — may follow a shorter minimum 12-day protocol with an 11-step graded return process.

For a detailed breakdown of the stand-down rules by sport, see our article on the 21-day stand-down in youth sport.

This is perhaps the most significant change for allied health professionals. The 2024 Position Statement explicitly expands the recognised role of physiotherapists in concussion management to include:

The Position Statement describes physiotherapists as “indispensable” in both the immediate response and long-term management of concussion. This language is notable because it goes well beyond previous guidelines, which positioned allied health practitioners primarily in supporting roles.

While the Position Statement names physiotherapists specifically, the clinical skills involved — SCAT6 administration, VOMS screening, BESS testing, and graded return protocols — are relevant across allied health disciplines including osteopathy, chiropractic, and exercise physiology.

Consistent with the Amsterdam Consensus, the Position Statement recommends a graded approach to recovery rather than strict rest:

1. Initial 24–48 hours of relative rest (not total sensory deprivation)
2. Introduction of light exercise (walking, swimming) as tolerated
3. Gradual reintroduction of cognitive stimulation after 48 hours
4. Progressive increase in exercise intensity with symptom monitoring
5. 14 days symptom-free at rest before any contact training
6. Written medical clearance before competitive return

An important clinical nuance: the guidelines acknowledge that temporary, mild symptom exacerbation during exercise is acceptable, provided symptoms resolve quickly after cessation. This represents a shift from the historical approach where any symptom provocation was grounds for regression.

The 2024 Position Statement includes new guidance on populations that were underserved by previous concussion frameworks:

• Female athletes: Recognition that concussion may present differently and that management protocols should account for sex-based differences in symptom profiles and recovery trajectories.
• Para-athletes: Specific guidance for managing concussion in athletes with disabilities, acknowledging unique diagnostic and management considerations.
• Multiple concussions: Best practice for athletes with repeated concussions, including long-term brain health considerations.

The Position Statement also recommends the establishment of a “Concussion Officer” role in schools and community clubs — a designated point person for implementing concussion policy and coordinating return-to-play decisions.