The days of "copping a knock to the head and playing on" are over in Australian sport.
That is the declaration from the medical and sporting fraternity amid evidence that concussions are on the rise in WA.
Australian Centre for Research studies into injuries in sport suggest concussions have risen 60 per cent in the past decade.
Department of Sport and Recreation director-general Ron Alexander this week labelled concussion as "an emerging and serious issue".
To educate all levels of sport about the best ways to manage head injuries, the DSR has teamed with Sports Medicine Australia's WA branch on a new "community concussion in sport" project.
As part of this, WA hosted a concussion symposium yesterday that was told only 20 per cent of children who have concussion are properly diagnosed, and fewer than that go to hospital.
SMA WA health promotion officer Fiona Boys said while elite sporting bodies were doing "great things", it was not always trickling down to the community and club level.
"I definitely think there is still that (relaxed) attitude, but also the culture of getting back out there and not wanting to let down the team or miss a game," she said.
"From coaches, parents, players, this is what needs to be changed - ideally people need to rest and have a graduated return to play otherwise they are risking longer delays in their recovery."
Sport and Recreation Minister Terry Waldron said the days of "copping a knock on the head and playing on" were over.
"The health and wellbeing of players of all ages and at all levels must be the number one priority," he said.
Figures on childhood sporting injuries from Princess Margaret Hospital, compiled by Kidsafe, show that childhood concussions rose from 21 a year in 2008 to 39 last year.
Adult concussions at Royal Perth Hospital totalled 211 last year - up from 144 in 2012, and 25 per cent of those injuries were sports related. SMA WA project officer Deb Bow said the new project would seek to address the misconception that all concussions resulted in loss of consciousness, when in fact the figure was closer to 10-20 per cent.
Ms Bow said it was a huge concern that many concussions went undiagnosed.
"It's a real problem because it means they go straight back on the field next week, and they are more likely to get another concussion," she said.
Sports doctor Michael Makdissi, who has worked at Hawthorn Football Club, said AFL, rugby league and rugby union had among the highest rates of head injury of any sports, with 3-10 concussive injuries per 1000 player hours.
WA Football Commission chief operating officer Nick Sautner said clubs at all levels were provided with resources to manage concussion.
He said the commission had the potential to be a "market leader" in the area, and was investigating the possibility of partnering with WA universities to examine research in sports concussion.
Scotch College student Ruan Greyling discovered the effects of concussion first-hand last weekend during a first-18 game against Aquinas. The 17-year-old was knocked to the ground in the last quarter and was forced off for the remainder of the game.
"I don't really remember anything, but I was in the ruck tap and tapped the ball to myself and caught it again and the guy pinned my arms down and slung me to the ground and I hit my head on the ground," he said.
"The physio checked me out and said I should go to the hospital, so I went and after a few hours the nurse gave me the all clear."
Ruan, who sat his Year 11 exams this week, said he felt groggy after the knock but had been cleared to train this week.
Fellow Year 11 student Harry Sinclair, 16, experienced similar symptoms when he was knocked out during a country game in Moora several years ago.
"I remember blacking out and feeling pretty dizzy and I picked myself off the ground and ran off to the bench," he said.
Scotch College head of junior school physical education and sport Jason Caniglia said staff had been trained to recognise and manage a concussion.
A nurse was always present during school football games and an ambulance was on standby for rugby matches.
People need to rest and have a graduated return. " *Fiona Boys *, Sports Medicine Australia