Concussion is one of the most talked-about medical issues in sport, and it’s encouraging to see it getting so much attention. The better everyone involved in sport understands concussion, the better protected young players will be.
The key message for parents, coaches and players is simple: if in doubt, sit them out.
What is concussion?
Concussion is a brain injury. It temporarily disrupts how the brain works, affecting the way a person thinks, feels and remembers things.
Your brain is a soft organ, cushioned by fluid and protected by your skull. If the head, or another part of the body, takes a hard enough knock, the brain can be jolted and move around inside the skull. A direct blow to the head isn’t needed. A hit to the body that whips the head back and forth, like whiplash, can be enough.
This sets off a chain of chemical and energy changes in the brain that can affect how it works for days or weeks. That’s what causes the physical, mental and emotional symptoms of concussion.
Common myths
- “You have to be knocked out.” You don’t. Most concussions happen without any loss of consciousness. But anyone who is knocked out by a head injury has had a concussion.
- “Symptoms appear straight away.” Often they do, but they can be delayed and develop over the first day or two. Others, such as mood changes, poor sleep or trouble concentrating, may only show up over the following days.
- “It’s just a knock.” All concussions are serious. Most people recover fully with the right management, but playing on can make symptoms worse, slow recovery and, in rare cases, be fatal.
Why children need extra care
Concussion can happen at any age, but children and teenagers:
- may be more vulnerable to concussion
- usually take longer to recover than adults
- are more at risk of rare but dangerous complications, including second impact syndrome. This is when a second blow to the head, before the brain has recovered from the first, causes severe and sometimes fatal swelling of the brain.
A previous concussion also raises the risk of another concussion, which may take longer to recover from. It increases the risk of other sports injuries too.
Where do concussions happen?
Concussions can result from falls, collisions, playground accidents, cycling and road accidents. In sport, they are most common in contact and collision sports such as rugby, football, hockey, boxing and martial arts. They also occur in horse riding, gymnastics, cycling, skiing and snowboarding.
How to spot a concussion
Spotting concussion in a fast-moving game isn’t easy, so everyone has a role to play: players, coaches, officials, spectators and parents.
Signs you might see:
- Lying still on the ground or slow to get up
- Unsteady on their feet, losing balance or falling over
- A dazed, blank or vacant look
- Slow to answer questions
- Confused about what’s happening in the game
- Clutching or holding their head
- A seizure, or lying rigid as if unconscious
- Being more emotional or irritable than usual
- Vomiting
- Losing consciousness, even briefly
Symptoms they might tell you about:
- Headache or a feeling of pressure in the head
- Dizziness or feeling off balance
- Feeling confused, foggy or slowed down
- Not knowing the score, the opponent or what part of the game they’re in
- Blurred or double vision
- Feeling sick or tired
- Sensitivity to light or noise
- Feeling more emotional
- Simply “not feeling right”
If you notice any of these after a knock, or a parent, official or spectator raises a concern, treat it as a suspected concussion.
What to do if you suspect concussion
- Remove them from play immediately. They must not return to that game or training session, even if they say they feel fine.
- Get them assessed within 24 hours. Use an on-site healthcare professional if there is one, or call NHS 111.
- Don’t leave them alone for the first 24 hours. Watch for any worsening over the next 24 to 48 hours.
- Rest for 24 to 48 hours. Gentle everyday activity and short walks are fine. Keep phone and screen time to a minimum, as this helps recovery.
- Tell their school and any other clubs they play for.
When to call 999 or go to A&E
Get urgent medical help if, after a head injury, your child has any of the following:
- Any loss of consciousness
- Increasing drowsiness, or you can’t wake them
- No memory of events before or after the injury
- Increasing confusion or irritability, or unusual behaviour
- Difficulty speaking, understanding, reading or writing
- Weakness, numbness, loss of balance or double vision
- A seizure, twitching or lying rigid
- A severe or worsening headache
- Repeated vomiting
- Severe neck pain (don’t move them if a neck injury is suspected)
- Signs of a possible skull fracture, such as a cut, swelling, bruising or severe pain where they were hit, or clear fluid or blood from the nose or ears
- A history of brain surgery or a bleeding disorder, or if they take blood-thinning medication
Recovery and returning to sport
Most concussion symptoms clear within two to four weeks, but everyone recovers differently, and children and teenagers may take longer. That’s why a graduated return is so important. The current UK guidance sets out six stages:
- Relative rest (24–48 hours). Short spells of easy activity, minimal screen time.
- Back to daily activities. Gentle reading, limited TV and screens, short walks.
- Building tolerance. Short blocks of schoolwork at home, light exercise such as walking or a static bike.
- Back to school and non-contact training. Usually part-time at first. Training only where there is no risk of a head impact.
- Full school and full training. Contact training is allowed only after 14 days with no symptoms at rest.
- Return to competition. Not before day 21 at the earliest, and only if they have been symptom-free at rest for 14 days and through full training.
Some points to remember:
- School comes before sport. Your child should be back to full school before returning to unrestricted sport.
- Mild symptoms are OK in the early stages. Light activity is encouraged as long as it only mildly worsens symptoms, and briefly. If symptoms flare up more than mildly, ease off until the next day.
- Call NHS 111 if symptoms get worse or haven’t improved after 14 days.
- See your GP if symptoms are still there after 28 days. Your child should stay out of sport until then.
Further information
- UK Concussion Guidelines for Non-Elite (Grassroots) Sport
- NHS: Head injury and concussion
- Your sport’s governing body, as many have their own concussion guidance and resources
This article gives general information only and isn’t a substitute for medical advice. If you’re worried about your child after a head injury, call NHS 111 or, in an emergency, 999.
