A concussion is a type of mild head injury. It happens when the head gets bumped, which causes a short-term change in how the brain works.
In young children, the most common cause of concussion is falls – for example, falling from a bed, couch, pram or play equipment.
In older children, most concussions happen in sport – for example, Australian Rules football, rugby, soccer and horse riding. They also happen during leisure activities – for example, falls from bicycles or skateboards.
Signs and symptoms of concussion
Symptoms of concussion might appear straight away, or they might appear several hours later. They can also change over time.
If your child has a concussion, they might:
- lie on the ground without moving
- be slow to get up after a hit to their head
- seem disorientated, confused or unable to respond appropriately to questions
- look blank or vacant
- have trouble with balance, walking, coordination or movement.
Your child might also have one or more of the following symptoms of concussion:
- a facial injury
- head pressure or neck pain
- nausea or vomiting
- drowsiness, fatigue or low energy
- blurred or double vision
- sensitivity to light or noise
- irritability, sadness, nervousness or anxiety
- difficulty concentrating or remembering things
- the feeling of being ‘slow’ or ‘in a fog’.
If you’re concerned about your child’s memory and your child is over 12 years, you could ask some simple questions to test their memory. For example, ‘Where are you?’, ‘Who scored the last goal?’, or ‘What team did you play last week?’ Your child might have a concussion if they have trouble answering.
If you think your child might have a concussion, your child should immediately stop what they’re doing or playing. Don’t leave your child alone or allow them to return to the activity until they’ve seen a doctor, even if symptoms go away. If your child is older, ensure they don’t drink alcohol, use drugs or drive.
Does your child need to see a doctor about concussion?
Yes. Your child needs to see a GP or team doctor (if available), or go to a hospital emergency department as soon as possible.
Call an ambulance on 000 immediately if your child has any of the following symptoms. These symptoms indicate a more serious head injury:
- neck pain or tenderness
- double vision
- weakness, tingling or burning in arms or legs
- severe or worsening headache
- loss of consciousness (blacking out)
- loss of awareness of surroundings
- increasing restlessness, irritability or aggressiveness.
Treatment and management of concussion
Your child should rest for the first 24-48 hours after the injury.
Your child can then gradually get back to regular activities in the following order:
- Return to school and light physical activity.
- Return to play and sport.
For many children, concussion symptoms will go away or significantly improve within a few days to a week. But sometimes symptoms can take up to 4 weeks to go away.
If your child’s symptoms don’t go away within 2 weeks, it’s important to go back to your doctor.
Returning to school after concussion
Children can return to school 24-48 hours after concussion.
The amount of time that your child spends at school will depend on their symptoms and how bad they are. Some children are fine to return to full days at school, but others might be able to handle only a few hours at school to start with.
It’s OK for your child to go home from school if their symptoms get bad. They can try going back again the next day. Or they might like to rest in the sick bay until they feel better and then try going back to class.
It’s a good idea to let school staff know that your child has had a concussion. School staff can tell you whether your child is experiencing any symptoms or can give your child extra support at school. Extra support might include:
- adjustments to timetables or classes
- regular, frequent breaks in a quiet place between classes
- extra time for schoolwork and assignments
- help with schoolwork.
Returning to light physical activity after concussion
Light physical activity is an important part of recovery from concussion for all children. This activity could include walking, swimming, hiking, riding a stationary bike and light jogging.
Make sure your child returns to physical activity slowly and gradually by following these steps:
- After 24-48 hours of rest following the concussion, introduce light physical activity. This could be something like a slow walk around the block or a gentle ride on a stationary bike. If symptoms develop, your child should stop and try again the following day.
- If no symptoms develop after the first time your child tries light physical activity, the next day gently increase the speed and/or distance of the activity.
- If no symptoms develop, keep increasing the speed and/or distance of the activity each day.
Returning to play after concussion
If your child has returned to school full-time and light physical activity isn’t causing symptoms, they can go back to doing activities like skateboarding, scooter or bike riding, rough-and-tumble play, surfing or casual sports with friends.
These kinds of activities do place your child at increased risk of further injury. This is why it’s important to make sure your child is free of symptoms before they go back to them.
Returning to sport after concussion
Your child can return to organised sports like netball, football, cricket or hockey only when they’ve returned to school full time and light physical activity isn’t causing any symptoms.
Your child should take the following steps to return to sport gradually:
- Start by taking part in warm-up exercises and then stop.
- If there are no symptoms, the next practice can include warm-up and training exercises like more intense running.
- If there are no symptoms, the next practice can include non-contact sport drills like passing and catching drills.
- If there are no symptoms, take your child to a doctor for medical clearance to start full contact training and normal game play.
It might be hard for your child to sit out of sport. But they can still be involved with their team even while they’re recovering from concussion. For example, they could help the coaches at training and on game day, or they could help with scoring or timekeeping.
If in doubt, sit it out. If you’re not sure about whether your child is OK to play, it’s best to take a careful approach.
There’s a risk of concussion in many popular sports and activities, and there isn’t much you or your child’s sporting club can do to reduce this risk.
Protective equipment like cycling helmets and mouthguards can prevent other injuries, but there’s little evidence that protective equipment reduces the risk of concussion.
The best way to help prevent concussion is to teach and practise safe playing techniques and encourage fair play and respect among junior players.
How sports clubs and organisations respond to concussion
Sports clubs and organisations should have clear guidelines and protocols about concussion. Professional sports associations – for example, the Australian Football League (AFL) – often set up these guidelines.
It’s the responsibility of your child’s sports club to follow the guidelines.
Coaches, team managers and other club officials have a duty of care to your child and should be aware of and follow the relevant concussion guidelines for their sport.
Concussion guidelines usually outline:
- what to do on the day of the game – for example, recognising the injury, checking symptoms, removing the child from play, and seeking medical advice
- how to return to play after a concussion – for example, following the sport’s or club’s return to play protocol.
It’s a good idea to check with your child’s sports club about the club’s concussion guidelines, find out who the club’s medical and first aid staff are, and check the club’s procedures for both game day and the follow-up period.
Long-term effects of concussion
We still have a lot to learn about the long-term effects of concussion.
The current evidence doesn’t show a link between a single concussion or a small number of life-time concussions and problems in the long term.
If your child has had several concussions in a single sports season or several concussions in their life, it’s a good idea to discuss the risks with a doctor, neuropsychologist, physiotherapist or other allied health professional with concussion expertise.