Key points

• The majority of concussions will get better on their own over several days.
• Follow the return to school and return to sport steps carefully, ensuring at least 24 hours for each return-to-sport step.
• Physical and cognitive activities can be increased as long as they do not result in more than brief, mild worsening of symptoms of concussion.
• Return to Sport Steps 4–6 should only begin when symptoms are fully resolved,
• Talk to your doctor if you are unsure whether your child is ready for the next stage or if they can fully return to playing sport.
• Seek urgent medical attention if your child’s symptoms get worse or they develop new symptoms of concussion.
• Most children recover well after a mild head injury. If your child is still requiring support to return to everyday activities after two weeks following a mild head injury, they should be reviewed by their GP for a medical assessment. Children with ongoing symptoms can be referred to the RCH Victorian Paediatric Rehabilitation Service (VPRS). GPs can make referrals to your local outpatient VPRS services via its website.
• If you have any questions regarding accessing outpatient VPRS, you can contact the RCH VPRS outpatient coordinator by calling 03 9345 9300 or emailing rehab.services@rch.org.au.

If your child or adolescent has been diagnosed by a doctor with a mild head injury, such as concussion, they will need time to rest and recover (see our fact sheet Head injury – general advice). This fact sheet provides advice for safely returning your child to school and sport if they have had a mild head injury.

For moderate or severe head injuries, follow your doctor’s advice for returning your child to their normal activities.

Signs and symptoms of concussion

While your child is gradually being returned to school or sport, monitor them for these signs and symptoms of concussion:

• vomiting
• headache
• feeling like they are in a fog
• just not ‘feeling right’ or ‘feeling down’
• balance problems or dizziness
• sleep disturbances or drowsiness
• being bothered by light or noise
• confusion, difficulty concentrating or remembering
• slowed reaction times
• easily upset or moody.

Care at home

The recovery time for children with concussion can vary, as can their symptoms. Children and adolescents with concussion can take up to four weeks to recover, but most concussions will get better on their own over several days. For the first 24 to 48 hours, children should have a period of relative (not strict) rest but should continue with their daily activities and return to light physical activity e.g. walking. Children should have sufficient sleep, a healthy diet, and limited screen time e.g. television, computers and smartphones during this initial period.

Physical exercise such as walking or stationary cycling, and other activities such as reading or passive screen time (e.g. watching a movie; not gaming or smart phone use), can be introduced gradually as long as your child only experiences mild worsening of symptoms of concussion for a brief period of time (less than one hour).

Graduated return to school

Your child can continue to increase activities and move onto the next step if they are not showing any symptoms of concussion, or the symptoms are mild and brief in nature (less than one hour). Leave 24 hours between advancing to each step. If the activity results in more than mild, brief worsening of symptoms, go back to the previous step. If your child cannot advance to the next step without substantially increasing symptoms of concussion, take them to see a doctor.

Graduated return to sport

Children and adolescents should not return to sport until they have successfully returned to school. If your child has had a concussion, they should not return to sport for 21 days. However, if they still show signs of concussion at 21 days, it is important they wait until all their symptoms have resolved.

Allow at least 24 hours for each step, and a minimum of one week after the injury before your child returns to normal game play. Only move onto the next step if your child is not showing any symptoms of concussion or the symptoms are mild and brief (less than one hour in duration). Steps 4-6 should only begin when symptoms are resolved. If concussion symptoms are experienced in steps 4-6 return to step 3 until symptoms are resolved including with and after exertion.

Talk to your doctor if you are unsure about your child’s progress at any step.

Following repeated concussions, your doctor may recommend your child avoid contact sports and any activities with increased risk of head injury for a period of time. This is because after a head injury, your child’s reaction times and thinking may be slower, and this can put them further at risk.

At-risk sports and activities include:

• football which involves tackling. 
• soccer and hockey
  
• basketball and netball
  
• horse riding
  
• riding motorbikes or BMX bikes
  
• skiing, snowboarding and surfing
  
• riding a bike, scooter, skateboard or skates
  
• playing on a trampoline
  
• climbing trees or other high structures.

Make sure your child always wears a helmet when riding a bike, scooter or skateboard.

When to see a doctor

Seek urgent medical attention at your local hospital emergency department if during your child’s recovery they have any of the following:

• unusual or confused behaviour, or irritability
  
• severe or persistent headache that 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
  
• they are making you worried for any reason.

If your child’s symptoms worsen or your child is experiencing new symptoms of concussion, seek urgent medical attention.

Was that bump a head injury?

For more information

• Kids Health Info fact sheet: Head injury – general advice
• Murdoch Children’s Research Institute: HeadCheck App
• The Murdoch Children’s Research Institute: MCRI Concussion Clinic
  

Developed by The Royal Children's Hospital Emergency, Neurosurgery and Neuropsychology departments. We acknowledge the input of RCH consumers and carers.

Reviewed December 2024.  

Please always seek the most recent advice from a registered and practising clinician.