Concussion in Children: What Every Sports Parent Needs to Know

Concussion: A Significant Sports Safety Issue

Concussion is one of the most common and most misunderstood sports injuries in children and teenagers. It occurs in virtually all contact and collision sports, and also in non-contact situations including cycling falls, playground accidents, and road traffic incidents. Despite being common, concussion in children is frequently minimised, misidentified, or managed incorrectly, with potentially serious consequences for the child's neurological health and long-term wellbeing.

Understanding what concussion is, how to recognise it, and how to manage it correctly is essential knowledge for any parent whose child is involved in sport or physically active pursuits.

What Is a Concussion?

A concussion is a type of mild traumatic brain injury caused by a bump, blow, or jolt to the head, or by a force to the body that causes the head to move rapidly. Concussion affects brain function, usually temporarily, and produces a range of symptoms. It does not require a loss of consciousness: the vast majority of concussions occur without any loss of consciousness, which is one of the reasons they are so frequently missed.

Concussion is a functional injury rather than a structural one. In most cases, a brain scan would appear normal even in a child with a significant concussion. This contributes to its being underestimated, but it does not mean the injury is trivial. The disruption to brain function during and after concussion is real, measurable, and requires appropriate management.

Why Children Are at Greater Risk

Children and teenagers are at greater risk from concussion than adults, and their recovery takes longer. The developing brain is more vulnerable to the effects of concussive forces, and the consequences of mismanagement are potentially more significant. Children are also more likely to sustain a second concussion before recovering from the first, which dramatically increases the risk of serious and potentially permanent neurological consequences.

This makes correct management of concussion in children not just good practice but genuinely important for their long-term health.

Recognising the Signs of Concussion

Concussion symptoms can appear immediately or may develop hours after the injury. Every parent involved in children's sport should be familiar with the following signs:

Immediate Red Flags (Require Emergency Services)

• Loss of consciousness, even briefly
• Seizure or convulsion
• Repeated vomiting
• Neck pain or tenderness
• Weakness, numbness, or tingling in the limbs
• Severe or worsening headache
• Slurred speech or inability to recognise people or places

Any of these signs requires immediate emergency medical assessment. Do not allow the child to return to activity.

Common Concussion Symptoms

• Headache (the most common symptom)
• Dizziness or balance problems
• Feeling foggy, slow, or confused
• Memory problems (not remembering the incident, events before or after)
• Sensitivity to light or noise
• Nausea without repeated vomiting
• Blurred or double vision
• Feeling slowed down

In children who cannot clearly articulate symptoms, watch for: appearing dazed, moving clumsily, answering questions slowly, showing unusual behaviour, or being unable to recall events.

If You Suspect Concussion: Remove from Play

The single most important message in concussion management is: when in doubt, sit it out. If there is any suspicion that a child has sustained a concussion, they should be immediately removed from the sporting activity and should not return that day, regardless of how they say they feel.

The pressure to return to play, whether from the child, from team dynamics, or from coaches, is very real in the moment of a sporting event. Withstanding that pressure when you suspect concussion is one of the most important protective actions a parent or coach can take. A child who returns to play with a concussion that has not been properly assessed is at risk of a second injury before the first has healed, which can have severe consequences.

Medical Assessment and Diagnosis

Any child suspected of concussion should be assessed by a healthcare professional before returning to sport or school. In many countries, national sporting bodies have specific concussion protocols that require medical clearance before return to play. Familiarise yourself with the requirements of the specific sport your child participates in.

The assessment will typically involve a clinical interview, a physical and neurological examination, and a review of symptoms. Brain scans are not routinely required for uncomplicated concussion but may be recommended if red flag symptoms are present or if the mechanism of injury was severe.

Return to School and Activity

After a concussion, children typically need physical and cognitive rest while symptoms are present. Cognitive rest means limiting activities that require significant concentration: homework, reading, screen time, and gaming can all exacerbate symptoms and slow recovery. This can be challenging to manage practically, particularly in older children with significant academic demands.

Inform the school of the concussion and request appropriate academic accommodations while the child recovers: extended time for assignments, reduced workload, or temporary permission to rest during the school day. Many schools have specific concussion protocols for this period.

Return to sport follows a graduated return-to-play protocol once the child is symptom-free. This protocol typically involves a series of steps of gradually increasing intensity, with at least 24 hours at each step, and a return to the previous step if symptoms recur at any stage. Full return to contact sport requires symptom-free completion of all steps and medical clearance.

Preventing Concussion in Sport

While concussion cannot be entirely eliminated from contact sport, several practices reduce risk:

• Appropriate protective equipment that is correctly fitted: helmets in cycling, skating, and equestrian sports; headguards where permitted in other sports
• Coaches who are trained in recognising and managing concussion and who enforce no-return-to-play policies
• Teaching correct technique in high-risk sports, particularly tackling technique in rugby and American football
• Clear concussion protocols agreed upon at club level, so that all coaches, parents, and young athletes know the expected response

Many sporting bodies now provide mandatory concussion education for coaches, and some have modified rules to reduce high-impact collisions in children's categories. Familiarise yourself with the safeguarding and welfare policies of any club your child participates in.