Concussions can be serious, even life-threatening if not treated appropriately. Now, groups are calling for national guidelines for responding to concussions in all sports.
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If you hit your head in a game of school rugby, the rules about concussion are clear - right from the start.
Rugby is the first sport in New Zealand to have a mandatory stand-down and a clear path back onto the field - it leads the pack on concussion statistics so it's no surprise that it also leads the way with protocols around head knocks.
But what if you're playing underwater hockey? Or netball?
They've also got rules, but they might not be the same rules - and who knows about these rules? The school? The team? The parents?
Today on The Detail, Sharon Brettkelly looks at where the country stands in dealing with the thousands of teens every year who get concussed.
Over the last five years ACC has recorded more than 100,000 cases of concussion from various sports. Last year nearly half a billion dollars was spent on treating more than 26,000 people with sport-related concussion - the highest number of claims in a single year. Among them were several thousand teenagers.
When it comes to laws governing this area - or even standard protocols governing every sport - New Zealand lags behind other countries.
New Zealand Rugby's head of community rugby, Steve Lancaster, is part of the new push to get national concussion laws for all sports - starting with secondary students.
He says the area around legislation is interesting and we could learn from what's happening in places such as Canada and the US.
"We've got to look after our young people," he says.
"As you know with young people, they don't always make good decisions. There's a culture of bravado amongst New Zealanders - this isn't about any one sport ... attitudes to head injuries, people tend to not want to disclose it, or shrug it off. They're impatient to get back to sport ... or they want to get back to school and learning and they just don't understand the longer-term or medium-term effects that a head injury can have."
Rugby is putting in place a 'Return to Learn' protocol which it's happy to share with other codes.
"There's an opportunity, and a need frankly, in assisting school students in a return to learn."
After all, he points out, they are students first and players second and they need to get back into the classroom before they get back on the field.
NZR has good resources on its website detailing the steps to be taken by using the four Rs - recognise, remove, recovery and return.
Lancaster says there's been a rise in reported incidents - which is good, because it means there's a growing awareness of it and the message is getting through.
NZ Rugby's Dr Danielle Salmon, whose research feeds into the way the game is played, is working on a concussion programme app that could be the template for other sports. Trials are being run in Otago, Hawke's Bay, Wairarapa Bush and North Harbour focusing on using a standard approach to head knocks.
It runs through GPs, and when a concussion happens, automated notifications go out to parents, the school and coaches.
"Everybody gets an email to say this has happened," she says. They also get guidance as to what they should do for the first 24 - 48 hours and what the steps are for a return to work and play.
A lot of schools say they already have a concussion policy, but Salmon says it's "hit and miss".
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