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The major focus of this review is to establish concussion in sport as a silent epidemic in our society that is not an accident. Brain injury has a definitive pattern and distinct nonrandom predictable characteristic. The development of successful head protection requires a scientific database approach to the mechanics of headgear. It is the responsibility of the health care clinician to help with the maintenance of protective standards for headgear and support rule changes to decrease the morbidity and mortality of athletes.