Recognising it
Symptoms can develop over the following hours, so a child who seems fine straight after a knock still needs watching that evening. Loss of consciousness happens in only a minority of concussions.
- Dazed, blank or vacant look, slow to answer questions, repeating themselves.
- Headache, pressure in the head, dizziness, nausea or vomiting.
- Sensitivity to light or noise, blurred vision, feeling in a fog.
- Balance problems, clumsiness, unsteadiness getting up.
- Being unusually emotional, irritable or withdrawn after a head impact.
The non-negotiable first step
If in doubt, sit them out
Remove them from play immediately and do not let them return that day, even if symptoms settle. A second impact while still concussed carries a serious risk. Nobody, coach, parent or player, should be making a case for going back on.
Emergency signs
Any of these means an emergency department, immediately. Otherwise, arrange to see a GP within 24 to 48 hours for an assessment and to start a structured return plan.
- Loss of consciousness, seizure or fitting.
- Repeated vomiting, worsening headache, increasing drowsiness or confusion.
- Weakness, numbness, slurred speech, double vision.
- Neck pain or tenderness after the impact, do not move them, call for help.
Return to learn, then return to play
Always follow your national governing body's specific protocol, they differ between sports, and school policies may add their own requirements. The UK grassroots guidance, If In Doubt, Sit Them Out, is the reference point most clubs use.
Stage 1
Relative rest, 24 to 48 hours
Reduced screens and activity, but not a dark room. Light walking is fine.
Stage 2
Return to learn
Back to school, possibly part-time with adjustments, before any sport.
Stage 3
Light aerobic exercise
Walking, stationary bike, no head impact risk.
Stage 4
Sport-specific exercise
Running and drills, still no contact.
Stage 5
Non-contact training
Full training drills, resistance training back in.
Stage 6
Full contact practice
Only after medical clearance, following your sport's protocol.
Stage 7
Return to play
Match play. UK guidance sets a minimum of 21 days from injury for under-19s in most sports.
The order matters: school before sport, and each stage needs 24 hours symptom-free before moving on.
What parents can do
- Tell the school. Concentration, reading and screens are usually affected before running is.
- Keep a simple symptom diary, it makes the graded return much easier to judge.
- Protect sleep and keep hydration and meals regular.
- Do not let the fixture list drive the timeline. There is always another match.
- Get further medical advice if symptoms persist beyond four weeks, that is when specialist input helps.
The perspective to keep
The vast majority of children recover fully from a single concussion that is managed properly. Risk comes from returning too early or from repeated concussions that were never given time. Sport remains overwhelmingly good for young people, the job is to handle the head knocks well when they happen.