A concussion is a brain injury caused by a blow to the head, face, neck or body that makes the brain move inside the skull. A child does not need to lose consciousness to have one. If you suspect a concussion, remove your child from play immediately and do not let them return the same day. Get them assessed by a doctor. Go to the emergency department straight away if they have a worsening headache, repeated vomiting, a seizure, increasing drowsiness, confusion, slurred speech, weakness or numbness, or severe neck pain. Most children recover within about four weeks with brief rest followed by a gradual, step-by-step return to school and sport.
A collision on the football field, a cricket ball to the helmet, a fall in kabaddi or hockey, or a header that goes wrong. Head knocks are part of youth sport, and most are minor. But some cause a concussion, and children’s brains need more careful handling than adults’.
The hardest part for parents is often deciding what to do in the first few minutes and hours. This action plan walks you through it, step by step.
What is a concussion?
A concussion is a mild traumatic brain injury. A sudden jolt makes the brain move rapidly inside the skull, which temporarily disturbs how brain cells work. It usually does not show up on a CT scan or MRI, because it affects how the brain functions rather than its structure.
Key facts for parents:
- Loss of consciousness is not required. Most concussions happen without a child being knocked out.
- It does not need a direct hit to the head. A hard tackle or fall that whips the head can cause one, much like a whiplash injury.
- Symptoms may not appear immediately. They can develop over hours, or up to a day or two later.
- Helmets reduce skull fractures and serious injuries, but they do not prevent all concussions.
Which sports carry the highest concussion risk for children?
Concussions can happen in any sport, but risk is higher in contact and collision sports and those with fast-moving balls or falls:
- Football and rugby
- Hockey
- Cricket (ball strikes to the head or helmet, collisions while fielding)
- Kabaddi and wrestling
- Martial arts and boxing
- Cycling, skating and skateboarding
- Basketball and gymnastics
Concussion symptoms in kids: what to look for
Children often cannot describe how they feel, or downplay symptoms to keep playing. Watch for what you see as well as what they say.
| What you may notice | What your child may report |
| Appears dazed, stunned or confused | Headache or “pressure” in the head |
| Forgets the play or the score | Dizziness or balance problems |
| Moves clumsily or is unsteady | Nausea or vomiting |
| Answers questions slowly | Blurred or double vision |
| Loses consciousness, even briefly | Sensitivity to light or noise |
| Can’t remember events before or after the hit | Feeling foggy, slowed down or “not right” |
| Mood, behaviour or personality changes | Trouble concentrating or remembering |
| Unusually irritable, emotional or tearful | Feeling tired or drowsy |
In younger children, also look for crying that won’t settle, loss of interest in favourite toys, changes in eating or sleeping, and loss of newly learned skills such as toilet training.
Danger signs: when to take your child to the emergency room
Go to the nearest emergency department or call 112 immediately if your child has any of the following after a head injury:
- Headache that gets worse or becomes severe
- Repeated vomiting
- A seizure or fit
- Loss of consciousness, even briefly
- Increasing drowsiness or difficulty waking up
- Confusion, agitation or strange behaviour that is getting worse
- Slurred speech
- Weakness, numbness or tingling in the arms or legs
- One pupil larger than the other
- Severe neck pain or tenderness (do not move the neck if a spinal injury is possible.
- Clear fluid or blood from the nose or ears
- Not recognising people or places
These can be signs of bleeding or swelling in the brain, or a spinal injury, and need urgent assessment.
The parent’s action plan: step by step
Step 1: Remove from play immediately
If you suspect a concussion, the rule is simple: “If in doubt, sit them out.” Your child should not return to the game or training on the same day, even if they say they feel fine.
Step 2: Check for danger signs
Stay with your child and watch them closely for the first few hours. If any danger sign appears, go to hospital straight away.
Step 3: Get a medical assessment
Every suspected concussion should be assessed by a doctor, ideally the same day or within 24 hours. Tell the doctor how the injury happened, what symptoms you saw, and whether your child has had a concussion before.
Step 4: Rest for the first 24 to 48 hours
Early rest means relative rest, not lying in a dark room for days. In the first 24 to 48 hours:
- Allow quiet activities at home
- Limit screen time, especially phones and video games, if they worsen symptoms
- Encourage sleep, regular meals and fluids
- Avoid sport, rough play, cycling and anything that risks another head knock
After this, light activity such as gentle walking is encouraged, as long as it does not clearly worsen symptoms. Research shows that prolonged complete rest can slow recovery, a principle that applies to recovering from most sports injuries.
Step 5: Return to learning gradually
School usually comes back before sport. Many children need a short break and then a gradual return, such as half days, extra breaks, reduced homework and postponed tests. Let the school know about the concussion.
Step 6: Return to sport step by step
Your child should only start a return-to-sport programme once they are back at school without symptoms worsening, and only with a doctor’s clearance before any contact or full-contact training (see the table below). A sports physiotherapist can supervise each stage; learn more about physiotherapy for young athletes.
Step 7: Watch for symptoms that don’t go away
If symptoms last longer than about four weeks, or are affecting school, sleep or mood, go back to the doctor.
Can a child sleep after a concussion?
Yes. Once a doctor has assessed your child and ruled out danger signs, sleep is important for recovery. You do not usually need to wake them every hour. However, if they are very drowsy, hard to wake, or become drowsy soon after the injury before being assessed, take them to the emergency department.
How long does a concussion last in kids?
Most children and teenagers recover within about four weeks. Many feel better sooner. Recovery may take longer if your child:
- Has had previous concussions
- Has a history of migraines, anxiety, depression, ADHD or learning difficulties
- Had severe symptoms early on
- Returned to activity too fast
Return to play after a concussion: the step-by-step protocol
Return to sport follows a graded programme. Each step usually takes at least 24 hours. If symptoms return or worsen, drop back to the previous step.
| Step | Activity | Goal |
| 1 | Daily activities that don’t worsen symptoms | Gradually reintroduce normal life |
| 2 | Light aerobic exercise (walking, stationary cycling) | Increase heart rate |
| 3 | Sport-specific exercise (running drills, no head impact) | Add movement |
| 4 | Non-contact training drills; may start light resistance training | Add exercise, coordination and thinking |
| 5 | Full-contact practice, after medical clearance | Restore confidence; coaches assess skills |
| 6 | Return to competitive play | Full return |
The minimum time to complete this is usually around a week, and often longer in children. Many sporting bodies recommend that young athletes do not return to full contact until they have fully returned to school.
What is second impact syndrome?
Second impact syndrome is a rare but potentially fatal condition. It can occur when a second head injury happens before the brain has recovered from the first, causing rapid brain swelling. Teenagers appear to be most at risk. It is the main reason children must never return to play on the same day as a suspected concussion, and must complete a full recovery before contact sport.
Delayed concussion symptoms: what to watch for in the days after
Symptoms can appear or worsen 24 to 72 hours after the injury. Keep watching for:
- Headaches that don’t improve
- Trouble concentrating at school
- Irritability, sadness or anxiety
- Sleeping much more or less than usual
- Dizziness or balance problems
- Sensitivity to screens, light or noise
What is post-concussion syndrome in children?
When concussion symptoms last longer than about four weeks, doctors may describe this as persisting post-concussion symptoms. Common ongoing problems include headaches, dizziness, fatigue, trouble concentrating and mood changes.
Treatment depends on the main symptoms and may include:
- Guided, gradual aerobic exercise
- Physiotherapy for neck pain and headaches
- Vestibular (balance) rehabilitation for dizziness, which sometimes comes from the neck rather than the inner ear (cervical vertigo)
- Support for sleep, mood and school learning
Can a concussion cause neck pain and headaches?
Yes. The same force that causes a concussion often strains the neck as well. Neck injury can cause cervicogenic headaches, which start in the neck, and can contribute to dizziness.
If your child has ongoing neck pain, stiffness or headaches after a concussion, a physiotherapy assessment of the neck can help.
See persistent neck pain: causes and when to see a specialist.
Does my child need a CT scan or MRI?
Not usually. A concussion does not show up on standard scans. Doctors order a CT scan only if danger signs suggest bleeding, a skull fracture or other serious injury. The diagnosis of concussion is based on how the injury happened and the symptoms.
How to reduce concussion risk in youth sports
- Make sure helmets and protective gear fit properly and meet safety standards, especially in cricket, hockey and cycling
- Teach safe techniques, such as correct tackling and heading in football
- Encourage fair play and enforce rules against dangerous play
- Strengthen neck and shoulder muscles as part of age-appropriate training
- Educate coaches and teammates about concussion signs
- Encourage children to report symptoms in themselves and teammates
How Nivaan Care can help after a concussion
Concussion diagnosis and early management should be led by your child’s doctor, paediatrician or neurologist. Once they have been assessed, Nivaan Care can support recovery from the physical after-effects that often linger, including:
- Neck pain and stiffness after a sports injury
- Headaches that start in the neck
- Physiotherapy-guided, gradual return to exercise
- Strength and conditioning to reduce future injury risk
Neck pain or headaches after a sports injury? Book a consultation with Nivaan.