Concussion replacements: how the ICC rules work, and when they changed.

What the Laws allow, and why playing conditions go further

The Laws of Cricket themselves contain no concussion replacement rule. Under the MCC's 2017 Code 4th Edition (2026), in force from 1 October 2026, a nominated player may be replaced only with the opposing captain's consent (Law 1.2.2), and the umpires allow a substitute fielder for an injury or illness that happened during the match, but a substitute may not bowl or act as captain, and may keep wicket only with the umpires' consent (Law 24.1). A concussion replacement is different: the incoming player takes full part in the match, and the match referee, not the opposing captain, approves it. That comes from playing conditions written by the ICC and the national boards on top of the Laws.

The 2019 ICC decision

On 18 July 2019, after its annual conference in London, the ICC announced that it had approved concussion replacements in all formats of men's and women's international cricket and in first-class cricket worldwide, after a two-year trial in domestic cricket. The ICC said the provision would enter its playing conditions from 1 August 2019. Press reports of the decision put the start at the Edgbaston Ashes Test.

The ICC said the team medical representative would continue to make the decision, and that a replacement had to be like-for-like and approved by the match referee. At the same meeting it approved revised Minimum Medical Standards for international cricket.

The first concussion replacement in Test cricket came during the second Ashes Test at Lord's: on 18 August 2019 Marnus Labuschagne replaced Steve Smith, after the match referee approved Australia's application. cricket.com.au reported that Smith's condition had worsened when he was re-tested the morning after being struck by a bouncer.

Before 2019: domestic cricket

Press reports of the 2019 decision said concussion substitutes had been trialled in Australian domestic cricket from the 2016-17 season and adopted by the ECB for its professional domestic competitions in 2018; that is the press's account, not the ICC's. cricket.com.au reported on 21 October 2016 that Cricket Australia had introduced concussion substitutes for men's and women's domestic one-day matches, the BBL, the WBBL and other CA matches, but not the Sheffield Shield, because the ICC had at that time rejected them for first-class cricket. The first in Australian domestic cricket was Nick Larkin, replacing New South Wales opener Daniel Hughes in a One-Day Cup elimination final.

The 2025 changes: nominated replacements

The ICC announced on 27 June 2025 that teams must nominate their concussion replacements before a match, which it said removes the advantage a home side had from a larger pool of players. ESPNcricinfo reported on 14 June 2025 that, in men's internationals, each team gives the match referee a list of five: one wicketkeeper, one batter, one seam bowler, one spin bowler and one all-rounder. If a replacement is also concussed, the referee picks someone outside the five under the like-for-like test. ESPNcricinfo gave the start dates as 17 June 2025 for Tests, 2 July 2025 for ODIs and 10 July 2025 for T20 Internationals; the ICC page we read does not give the dates by format.

The women's game also uses nominated replacements. The ICC Women's ODI Playing Conditions, effective July 2026, allow a concussion replacement (clause 1.2.7) only where:

• a head or neck injury was sustained during play, inside the playing area;
• the team medical representative has formally diagnosed concussion or suspected concussion; and
• a request on the standard form goes to the ICC match referee as soon as possible.

The replacement comes from the nominated list and must be like-for-like. The referee may look outside the list in exceptional circumstances and may set conditions if a replacement would give the team an excessive advantage. The referee's decision is final, the replaced player takes no further part, the replacement inherits any warnings, penalty time and suspensions, and both players count as having played.

The ICC's Classification of Official Cricket, with effect from 1 July 2026, says a concussed player may be replaced by a full-playing substitute without a match losing first-class status.

The seven-day stand-down, and its disputed scope

On 27 June 2025 the ICC announced a minimum stand-down of seven days for a player diagnosed with concussion, on the recommendation of its Medical Advisory Committee. The sources word its reach differently:

• The press account. The PTI report of 27 June 2025 says it applies to any player diagnosed with concussion during a match.
• The ICC's own text. The ICC Concussion Management Guidelines (June 2025, page 15) say the mandatory seven-day stand-down applies to a player diagnosed with concussion during a match in which a replacement is activated.

The earlier February 2024 edition of the guidelines has no stand-down clause, so the rule is new in the June 2025 edition.

What the ICC guidelines say, at policy level

The ICC Concussion Management Guidelines (editions of February 2024 and June 2025) say they follow the 2022 Amsterdam consensus statement on concussion in sport, and cover head injuries in matches and training for men and women. The June 2025 edition states that:

• concussion is not a common injury in cricket, but its possible short- and long-term health risks justify guidelines;
• a player with diagnosed or strongly suspected concussion in a match must be removed from it, and returns to competition only when cleared by a suitably qualified healthcare professional experienced in concussion;
• in one-day and T20 matches this means no return in that game unless an experienced practitioner reverses the diagnosis;
• the player, captain or coach must not overrule a diagnosis;
• symptoms can be delayed by up to 48 hours, and video of an incident must be reviewed where it exists before a final diagnosis;
• replacements are allowed for diagnosed and suspected concussions;
• most diagnosed players are ready to return in about a week, though some take longer;
• children aged 18 and under need a more conservative approach, with recovery typically taking about three weeks under experienced medical oversight.

The document is not internally consistent on one point: it gives the age range of the Child SCAT6 tool as 2 to 12 on page 3 and 5 to 12 on page 15, while its linked instructions are titled for ages 8 to 12.

Replacements beyond concussion

The ICC announced on 27 June 2025 a six-month trial, from October 2025, in domestic first-class cricket: a player seriously injured on the field after the match starts may be replaced by a like-for-like player who takes full part. ESPNcricinfo reported on 16 August 2025 that the BCCI had brought in a serious-injury replacement rule for its domestic multi-day cricket from the 2025-26 season, beginning with the Duleep Trophy, for external injuries such as a fracture or deep cut suffered during the match. Who decides is reported two ways: ESPNcricinfo says the match referee approves it on a medical report, while a law firm's summary says the decision rests mainly with the on-field umpires, who may consult the referee or doctor.

Helmets are a separate question from concussion rules: the ECB says they mainly reduce the risk of fracture rather than concussion. That is covered on helmet rules: the history.