NSW Mandatory Concussion Training for Combat Sports: What Clinicians Need to Know

On 3 April 2024, the NSW Government passed the Combat Sports Amendment Act 2024, amending the Combat Sports Act 2013. Among the reforms is a requirement that caught the attention of the broader sports medicine community: mandatory concussion training for all registered combat sports participants.

This is significant not because the training itself is onerous — it's free and takes about 20 minutes — but because it represents the first time an Australian jurisdiction has legislated compulsory concussion education for sports participants. For clinicians working in or around combat sports, understanding these changes is essential. For those working in other sports, it signals where regulation may be heading.

The training requirement applies to every registered individual within NSW combat sports. That includes:

The sports covered by the NSW Combat Sports Authority include boxing, kickboxing, Muay Thai, mixed martial arts (including Pankration), and any other form of martial arts that falls within the definition of “combat sport” under the Act.

The mandatory concussion training is delivered through the NSW Combat Sports Authority and covers the fundamentals: recognising, managing, and responding to concussion risks. The training is structured into modules:

• Modules 1–4: Required for all general participants (combatants, trainers, managers, promoters)
• Module 5: Additional module for Accredited Attending Medical Practitioners and referees

The training is free and takes approximately 20 minutes. If an individual is registered in multiple roles (e.g., both combatant and trainer), the training only needs to be completed once.

The training requirement sits alongside several other concussion-related reforms introduced by the Amendment Act:

• Pre-contest medical declaration: Combatants must declare at their pre-contest medical examination whether they have suffered a concussion in the preceding 30 days.
• Automatic medical suspensions after knockouts: 30, 60, or 90-day stand-downs depending on the frequency and severity of knockout events.
• Immediate stoppage for Category 1 head injury signs: Referees must stop the contest immediately if they observe signs consistent with a serious head injury.
• Interstate contest reporting: Combatants must notify the Authority of any contests held outside NSW within 5 days.

The NSW reforms are part of a broader national shift. In February 2024, the Australian Institute of Sport released its Concussion and Brain Health Position Statement, which introduced a minimum 21-day stand-down for youth and community sport. Over 30 National Sporting Organisations have adopted these guidelines.

For clinicians, the direction is clear: concussion education is transitioning from “nice to have” to “required knowledge.” Whether you're an osteopath treating fighters, a physiotherapist working with community rugby teams, or a chiropractor treating weekend athletes, the regulatory environment is increasingly expecting you to demonstrate competence in concussion recognition and management.

This aligns with AHPRA's annual CPD requirements, which expect practitioners to pursue learning activities relevant to their scope of practice. If you're treating athletes or active populations, concussion management is within that scope.

If you treat athletes in combat sports in NSW, you should already be across the new requirements. But even if your caseload is broader, these reforms are worth noting:

1. Regulatory expectations are rising.State governments are beginning to legislate concussion education. NSW is first, but it's unlikely to be last.
2. Athletes and parents are asking better questions.Increased media coverage and regulatory action mean your patients are more informed — and more likely to expect evidence-based management.
3. Structured assessment competency is becoming the standard. Knowing how to administer the SCAT6, conduct a VOMS screen, and apply the BESS is increasingly expected, not optional.