Findings of convergence insufficiency have been identified in children following concussion; however, further research is needed to identify whether these deficits are pre-existing or have their onset following trauma. Recursion and dynamic programming (DP) are very depended terms. If symptoms recur, then the athlete should move back to the previous step. Sports physiotherapists and other sports professionals recognise that the identification of the causes of injury is an important step in injury prevention as this can lead to the development of effective injury prevention programs. This article applies the dynamic, recursive model of sport injury to sport-related concussion and summarizes the process of individualized assessment and management following concussion in athletes of all ages, with a focus on physical rehabilitation. Sport-specific and performance-related skills may be necessary to return to full participation. Clinicians should use a multifaceted assessment that includes symptoms, a neurological screen, and assessment of multiple clinical domains.27,37 The Sport Concussion Assessment Tool Fifth Edition (SCAT5)29 includes an immediate/on-field assessment that incorporates red flags, observable signs, memory assessment (ie, the Maddocks questions), the Glasgow Coma Scale, and a cervical spine assessment. Exercise may facilitate recovery following concussion.40,66,67 Two different paradigms of exercise have demonstrated benefit for symptoms and function: (1) subsymptom aerobic exercise training at 80% of the maximal heart rate that was achieved on the Buffalo Concussion Treadmill Test, 5 days per week67; and (2) exercising at 60% of maximal heart rate (calculated as 220 − age × 60%) for up to 15 minutes, combined with guided imagery and sport-specific coordination exercises.39,40 However, some studies have reported an increase in symptoms with exercise in children and youth, and others have reported no change.77,103 Given the known general positive benefits of exercise, consideration of aerobic exercise training following the initial return to activity after concussion is warranted in the absence of contraindications to exercise.103. Contact and collision sports, such as rugby, American football, and ice hockey, have the highest reported incidence of concussion.93 In youth ice hockey leagues where bodychecking is permitted, there is nearly a 4-fold increase in risk of concussion in the 11- to 12-year age group (Pee Wee).33 Game play has greater concussion risk than practice.1,22,57. Sports injuries are often recurrent in that some people experience more than one sports injury over time. Pediatrics. During sport, athletes are exposed to different events in which no concussion or injury occurs. Once a concussion is suspected, the player should be removed from play and further assessed by a qualified health care professional (FIGURE 2). In part 2, we address concussion assessment and management. It is important for sports professionals to know why certain athletes may be at risk of injury risk factors and how injuries occur (i… Is there a gender difference in concussion incidence and outcomes? Such a rehabilitation strategy, tailored to the individual, can facilitate high-quality, evidence-informed care and injury prevention. The risk factors of concussion may be categorized as intrinsic (internal factors specific to the individual) or extrinsic (external factors related to the environment or sport). ERAIQ. A Dynamic Model of Etiology in Sport Injury: The Recursive Nature of Risk and Causation: Clinical Journal of Sport Medicine 17, 215–219 (2007). J Orthop Sports Phys Ther 2019;49(11):799-810. and behavioral responses of athletes to sport injury. This model considers the implications of repeated exposure, whether such exposure produces adaptation, maladaptation, injury or complete/incomplete recovery from injury. There may be alterations in gait, reduced gait velocity, and increased sway when dividing attention following concussion.38,59 Further research to better understand changes in the ability to divide attention while accounting for growth and development is warranted. A great number of injuries occur in the context of recreational physical activities and competitive athletics. Br J Sports Med. Immediate removal from activity may improve outcomes.4, At the time of injury, screening for more severe injury (eg, intracranial bleeding, cervical spine fracture) is imperative. Ericsson, K. A. Investigation of antihypothalamus and antipituitary antibodies in amateur boxers: is chronic repetitive head trauma-induced pituitary dysfunction associated with autoimmunity? Through a rigorous academic approach, we study the patterns, causes and effects of sport and recreational injury. Thus, consideration of sport-specific skills should be an integral part of a rehabilitation program. 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