A Scoping Review of Sport National Concussion Guidelines in Squash.

Abstract

Squash is a commonly played racquet sport in which players are at risk of concussion injuries. This review aims to identify and assess the squash concussion guidelines in top squash countries. Design: Scoping review. Method: This review follows the framework laid out by Arksey and O'Malley and later advanced by Levac et al. This review adheres to the PRISMA-ScR checklist. Eligibility criteria included countries with either a female or male player in the World Squash Federation Top 50 World Rankings in June 2025. This produced a list of twenty-one countries, and seven concussion guidelines were eligible for review. Results: Twenty-one countries matched the inclusion criteria. Canada is the only country identified with a squash-specific concussion guideline. Seven countries had national concussion guidance, and fourteen countries had no national concussion guidance. Conclusions: There is a lack of squash-specific concussion guidelines. The World Squash Federation and national squash organisations should produce squash-specific concussion guidelines that are in line with the Amsterdam Statement and their own respective country's national guidelines. The World Squash Federation should specifically reference concussion in their rules and should strongly consider updating their self-inflicted injury time rules to allow for the suspension of play for up to fifteen minutes if there is a suspected head injury.