Perceptions of concussion management and testing among healthcare professionals in rugby union: a qualitative analysis

Despite ongoing developments in head injury protocols, rugby union still faces challenges in achieving accurate, rapid and context-appropriate concussion assessment on-field and at pitch-side, with clinicians often required to make complex decisions using tools that remain imperfect. The purpose of this research is to gain insight into the perceptions and experiences of high-level rugby union healthcare professionals (HCPs) on current head injury assessment protocols. Semi-structured interviews were conducted with eight HCPs working in rugby union. Following a six-stage, inductive, reflexive thematic analysis, five key themes emerged. Findings reveal that while standardised protocols offer structure to an assessment, clinical judgement remains central to effective diagnosis. Participants expressed cautious optimism towards emerging technologies, including biomarker testing and motor control assessments. This study offers practitioner-informed insights into the nuanced realities of concussion assessment. Furthermore, this work underscores the need for future tools to be evidence-based and adaptable to the real-world context of elite sport.