Sports-related concussion is an important and complex issue, but it is not a new phenomenon. Meehan and Bachur (2009) traced early forms of sports-related concussion to 776 B.C. in the sports of wrestling and fist fighting. The physical risks of contact and collision sports (Luntz, 1980) and challenges of managing injuries (Mitten, 1993), particularly return-to-play or practice decisions, are reoccurring themes across sport, across jurisdictions and across disciplines. However, the recent growth of public awareness regarding sports-related concussion – fuelled by litigation, concussion-related deaths and links to long-term degenerative brain disease – raises questions about the adequacy of the decisions made by rule-makers, including their roles, responsibilities and assessments of risk. It also exposes tensions that arise in balancing the interests of player health and welfare on the one hand, with commercial interests and spectator demands on the other.