Existence =/adherence. Exploring barriers to best practice in sports-related concussion return to play (SRC-RTP) in Irish amateur female sport

Objectives: Sports-Related Concussion (SRCs) are of relevant risk and burden for female athletes. The following study aimed to explore potential barriers to return to play (RTP) best practice in coaches of amateur female athletes, and medical professionals who may treat and manage SRCs in amateur female athletes.Design: Qualitative, semi-structured, virtual interviews following a critical analysis framework.Methods: Twenty-five coaches, allied healthcare professionals (AHPs), and general practitioners (GPs) were recruited and interviewed using a convenience snowball sample. Data were transcribed verbatim and thematically analysed.Results: Three themes were identified following reflexive thematic analysis; biopsychosocial norms, stakeholder inaction, and practitioner effectiveness. The findings identify numerous factors which limit the uptake of best practice guidelines as endorsed by Irish national governing bodies (NGBs). Education, training, and implementation of these guidelines are lacking, with sub-standard or non-existent medical support and poor general injury and/or SRC attitudes providing further resistance to these measures.Conclusion: Existence of SRC-RTP protocols does not equal adherence to such. Greater efforts are required to translate knowledge provided by the 6th Concussion Consensus statement. NGBs, league and club administrators, and educators need to better support coaches, practitioners and athletes in the implementation of these protocols in amateur female sport.