A guide for parents and caregivers
If your child plays sport, there is a real chance you will face a concussion at some point. The hardest part is that a concussed child often seems fine. This guide tells you what to look for and what to do.
Download the free guide (PDF)A concussion is one of the most common and most misunderstood injuries in youth sport. The single biggest mistake parents make is assuming their child is fine because the child says so. Concussion does not always show up straight away, and feeling okay is not the same as being recovered.
This guide is written in plain language to give you exactly what you need: how to recognise a concussion, the red flags that mean you should seek emergency care, how to manage the first 48 hours at home, and how to safely return your child to learning and to sport.
A concussion is a brain injury caused by a knock, jolt, or blow to the head, or by a force to the body that causes the brain to move suddenly inside the skull. It will not show up on an X-ray, a CT scan, or an MRI, and there is often no cut, no swelling, and no visible sign that anything has happened. That invisibility is what makes it dangerous.
The brain is not fully developed until a person's mid-twenties. In children, the same force that causes a mild headache in an adult can cause a significantly more disruptive injury in a ten-year-old. Children's brains are more vulnerable, take longer to recover, and are at far greater risk of serious harm if a second concussion occurs before the first one has healed.
Most children recover fully. The key is recognising it early, responding correctly, and not rushing the return to normal activity.
A concussion does not show up on any scan. A normal scan does not mean there is no concussion.
Concussion does not always announce itself, and your child may not lose consciousness. In fact, loss of consciousness happens in fewer than ten percent of cases. The symptoms you are more likely to notice are subtler, and they may not appear until hours after the injury, once the child sits still and the adrenaline wears off.
Headache or pressure in the head, dizziness, nausea or vomiting, blurred or double vision, sensitivity to light or noise, balance problems, or feeling unusually tired.
Difficulty concentrating, feeling foggy or slowed down, memory gaps around the event, confusion, or trouble following a conversation.
Unusual irritability, mood swings, feeling more emotional than normal, anxiety, or sadness that was not there before.
Sleeping far more than usual, or struggling to fall asleep despite being exhausted.
No two concussions look the same. Some children have one or two symptoms, others have many. If your child took a knock to the head and something feels off, trust your instincts and get them assessed.
The first two days after a concussion are the most important, and what you do in this window has a direct effect on how quickly your child recovers. Rest is the medicine, and that means both physical rest and cognitive rest. No sport, no running around, no physical education at school, but also no screens, no reading, no gaming, and no intense social activity. The brain needs quiet to begin healing, and every demand placed on it, even watching television or scrolling a phone, slows that process down.
Your child can sleep normally once the first two to four hours after the injury have passed without any red flags developing. The advice to wake a concussed person every hour through the night is no longer current practice. If your child showed no red flags in the hours after the injury and was assessed as neurologically intact, they can sleep. Before they go to sleep, make sure you can rouse them and that they know where they are and who you are. If you cannot rouse them normally, or anything feels wrong, go to emergency.
Keep the environment calm, dim the lights if there is light sensitivity, reduce noise, and let them rest without pressure to catch up on schoolwork.
Emergency
Most concussions are managed at home with rest and careful monitoring. But some symptoms mean something more serious is happening inside the brain. If your child develops any of the following after a head injury, do not wait.
These signs can indicate a bleed on the brain. They are rare, but they are emergencies.Call an ambulance. Do not drive to the hospital yourself if symptoms are severe.
Recovery from concussion is a process, and when it is managed well the outcomes are good. There are two parallel tracks your child needs to move through: getting back to learning, and getting back to sport. The brain needs to recover its capacity for cognitive work before it is ready for the physical demands of sport, and that sequence must be respected.
Only when your child can manage a full school day without symptoms is the brain ready for the physical demands of sport.
Each stage needs at least 24 hours without symptoms before advancing. If symptoms return, stop, rest, and drop back one stage.
The most common reason children take longer to recover than they should is that someone pushed through symptoms or skipped a stage. Follow the protocol and most children are back to full participation within two to three weeks. Healthcare practitioner clearance is required before a child re-enters contact training or competition.
Any child who takes a significant knock to the head during sport should be assessed by a trained healthcare practitioner, ideally on the same day or within 24 hours. If your child was removed from play for a head injury, that assessment is not optional. A practitioner trained in sports concussion will assess your child's symptoms, cognition, balance, and neurological status, give you a baseline to measure recovery against, and make sure nothing more serious is being missed.
If symptoms are not resolving within 10 days, or are getting worse rather than better, return for a reassessment. A small number of children develop persistent symptoms beyond four weeks, which needs specialist management.
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Yes. Once the first two to four hours have passed with no red flag symptoms, your child can sleep normally. The old advice to wake them every hour is no longer recommended. Just make sure you can rouse them and that they are oriented before they sleep.
Most children recover fully within two to three weeks when the graduated return protocols are followed correctly. A small number take longer. Rushing the return to sport or school is the most common cause of a prolonged recovery.
Only after completing a graduated return to sport protocol, which begins with rest and progresses in stages, each requiring at least 24 hours symptom-free. Return to learning must come first, and healthcare practitioner clearance is required before returning to contact sport.
No. A concussion is a functional brain injury and does not appear on an X-ray, CT scan, or MRI. Scans are sometimes used to rule out more serious injuries such as a bleed, but a normal scan does not mean there is no concussion.
Seek emergency care immediately if your child has one pupil larger than the other, a seizure, loss of consciousness, a worsening headache, repeated vomiting, slurred speech, increasing confusion, or weakness or numbness in the limbs.
Yes. Any child who takes a significant knock to the head during sport should be assessed by a trained practitioner, ideally within 24 hours, especially if they were removed from play. An assessment establishes a baseline and rules out anything more serious.
Dr Neil Cuninghame is a Hillcrest chiropractor and interdisciplinary pain management specialist with over 17 years of clinical experience. He holds an MTech in Chiropractic (DUT) and a Postgraduate Diploma in Interdisciplinary Pain Management (UCT). He works with athletes, busy professionals, and active families across the Upper Highway, combining evidence-based care with a clear focus on getting people moving and confident again.
MTech Chiro (DUT) · PG Dip Int Disc Pain Mgmt (UCT) · AHPCSA A10852 · CASA 0354740
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This page is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for personalised recommendations.
