Kids Health Info

Head injury - return to sport

  • Your child has been diagnosed with a likely concussion.  This factsheet tells you the steps your child should take to recover and return to normal activity.

    Signs and symptons

    The suspected diagnosis of concussion can include one or more of the following concussion complaints:

    • there was loss of consciousness
    • inability to remember the event (amnesia)
    • symptoms of headache or feeling like they are in a fog
    • being irritable
    • slowed reaction times
    • sleep disturbances or drowsiness.

    Treatment and at home care

    The majority of concussions will get better on their own over several days. To recover, the brain and body need to rest. Physical exercise and activities that require concentration (video- or computer-games, text messaging, schoolwork etc) may make symptoms worse and delay recovery. Children and adolescents with concussion need more time to recover than adults.

    Use the steps in the table below to help decide when your child can safely return to playing sport.

    Instructions:

    1. Each step takes at least 24 hours (a total of at least one week).
    2. Your child should only move to the next step if they have no concussion complaints.
    3. If concussion complaints recur, go back to the previous step.
    4. If your child cannot advance to the next step without concussion complaints, you should see the doctor before returning to playing sport. 

    Rehabilitation stage      

    Exercise at each stage   

    Goal

    1. No activity

    Complete physical and mental rest.

    Recovery

    2. Light aerobic exercise

    Walking, swimming or stationary cycling.
    No resistance training.

    Increase heart rate

    3. Sport-specific exercise 

    Running drills in football (soccer or AFL), hockey and other ball games.
    No head impact activities.

    Add movement

    4. Non-contact training drills

    Passing drills in football (soccer or AFL) and other ball games.
    May start progressive resistance training.

    Exercise and coordination

    5. Full-contact practice

    Participate in normal training activities.

    Restore confidence and assess function by coaching staff

    6. Return to play

    Normal game play.  However, before returning to normal game play, your child should have a check-up with their GP.


    Follow up 

    Talk to the doctor if you are unsure whether your child can progress to the next stage or can fully return to play.  Go back to the doctor or hospital immediately if your child has any one of the following:

    • unusual or confused behaviour
    • severe or persistent headache which is not relieved by paracetamol
    • frequent vomiting
    • bleeding or discharge from the ear or nose
    • a fit or convulsion; or spasm of the face, arms or legs
    • difficulty in waking up
    • difficulty in staying awake
    • or if you are worried for any reason.

    Key points to remember

    • The majority of concussions will get better on their own over several days.
    • Follow the 'return to play' steps carefully, ensuring at least 24 hours for each step.
    • Talk to the doctor if you are unsure whether your child can progress to the next stage or can fully return to play. 

    More information 

    Individual information

    In more severe or repeated concussions your treating doctor may ask you to ensure your child avoids all contact sport and other activities with increased risk of head injury before starting the above steps. This period should be for ________ days/weeks (to be completed by treating doctor).

     

    Developed by The Royal Children's Hospital Emergency Department, in consultation with the Departments of Neurosurgery and Neuropsychology. Published: December 2012.  Updated: June 2015.

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Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.