Sports-Related Concussions in Youth: Guidance for Families 

Sports-related concussions are one of the most common injuries seen in young athletes. In 2022, an estimated 2.3 million U.S. children and adolescents ≤17 years had received a diagnosis of a concussion or brain injury at some point in their lives.¹ Concussions can be challenging for families, as they impact school performance, sleep, mood and behavior, and participation in activities. Because symptoms are not always immediately visible, families may feel uncertain about what to expect or how serious the injury may be. For parents, a concussion diagnosis often raises important questions, such as: When can my child return to school? When can they play sports again? How do we know that they’re truly better? 

Understanding how concussions are diagnosed, managed, and monitored is essential to helping young athletes recover safely. Here, our experts at Private Health Management (PHM) summarize what families need to know about sports-related concussions.  

What is a concussion? 

A concussion is a mild traumatic brain injury caused by force transmitted to the brain that may or may not include loss of consciousness.² This force can result from a direct blow to the head or from a hit to the body that causes the head to move rapidly back and forth. In young children, concussions are most often caused by falls, but in adolescents, they are most commonly related to sports and recreational activities.³ Sports associated with higher concussion incidence include football, ice hockey, rugby, soccer, and basketball.⁴ 

Diagnosis and management of pediatric concussions are guided by recommendations from the American Academy of Pediatrics (AAP), the CDC Pediatric Mild Traumatic Brain Injury Guideline, and the International Consensus on Concussion in Sport. These guidelines emphasize symptom-based diagnosis, relative rest, and a structured return to school and sports.^2,5,6 Although these guidelines differ slightly in scope, they are aligned in their core recommendations for safe recovery. 

Importantly, there are no medications that cure concussion. Recovery is guided by symptoms and supported through structured rest and gradual return to activity. 

Concussion symptoms may appear immediately or evolve over hours to days. Not every child will experience all of these symptoms, and loss of consciousness is not required for a diagnosis. Symptoms typically fall into four main categories: 

How concussions are diagnosed 

Diagnosis of a concussion can be challenging for several reasons. Symptoms of concussion can be subtle or overlap with other conditions, results of brain imaging are usually normal, and there is currently no single test that confirms the condition. For this reason, clinicians rely on a careful history and examination rather than a single diagnostic tool. Diagnosis is based on clinical evaluation of symptom history, physical and neurological exams, and cognitive and balance assessments, when appropriate.² Standard imaging (CT or MRI) tests are used only when risk factors suggest more serious injury, not to confirm concussion.⁵ 

Early management: what the guidelines recommend 

Return to sports follows a structured, stepwise progression over several days, advancing only if symptoms do not significantly worsen at each stage.^2,5,6 With proper management, most children recover fully within several weeks, but timelines can vary. Certain factors, including a history of migraine, learning differences, mood conditions, prior concussion, or a higher initial symptom burden may be associated with a longer recovery course. Recognizing these factors allows clinicians to tailor monitoring and follow-up to each child’s needs. The core elements of early concussion management are summarized below. 

1. No same-day return to play 

• An athlete with a suspected concussion should not return to playing on the same day they are injured 

2. Relative brain rest for the first 24–48 hours 

• Short period of reduced physical and cognitive activity 

• This period of reduced activity is often referred to as “brain rest.” 

• Not strict bed rest or complete isolation 

• Avoid activities that significantly worsen symptoms 

3. Gradual reintroduction of activity 

• After the first 1–2 days, light activity can often begin 

• Activities should not cause more than mild, temporary worsening of symptoms 

• Prolonged complete inactivity (“cocooning”) is not recommended 

4. Symptom-guided recovery 

• Medications may be used to help manage specific symptoms such as headache or sleep disruption, but recovery is guided primarily by gradual return to activity and careful symptom monitoring 

• Management focuses on monitoring symptoms and adjusting activity accordingly 

5. Watch for red flag symptoms 

• Families should seek urgent care if a child develops any of the following: 

• Worsening or severe headache 

• Repeated vomiting 

• Increasing confusion or unusual behavior 

• Severe drowsiness or difficulty walking 

• Slurred speech 

• Weakness or numbness 

• Unequal pupils 

• Seizure 

• Any sudden neurological change 

What “brain rest” means in practical terms 

Relative rest or “brain rest,” is a key component of early recovery. While it can feel frustrating to slow down, especially for active children and teens, this temporary reduction in activity gives the brain time to heal and may help prevent prolonged symptoms. It often means temporary adjustments at home and in school while symptoms improve. Research has shown that most children recover better with supported reintegration to school rather than prolonged absence.² Below are practical ways families can support brain rest at home and school: 

• Limiting screen time for both schoolwork and recreation, including phones, video games, and streaming content. 

• Reducing cognitive load including shortening homework sessions, postponing major tests, breaking assignments into smaller tasks, or allowing frequent rest breaks. 

• Avoiding overstimulation including bright lights, loud environments, crowded events, or fast-paced activities that worsen symptoms. 

• Scaling back physical and social demands such as pausing practices, games, parties, or other high-energy activities until symptoms improve. 

• Ensuring consistent sleep routines with regular bedtimes and adequate overnight rest. 

• Working with the school to implement return-to-learn accommodations that may include modified assignments, reduced workload, extended deadlines, or temporary academic adjustments. 

Strategies for preventing concussions 

While no strategy can eliminate the risk of concussion, there are steps that can help reduce the likelihood of injury and support safer participation in sports.^2,5,6 

• Learning and practicing proper technique. Age-appropriate coaching in safe techniques, such as proper tackling in football or safe checking in hockey, helps reduce dangerous head contact. 

• Following and enforcing safety rules. Consistent enforcement by coaches and officials plays an important role in protecting young athletes. 

• Limiting unnecessary contact. Reducing repetitive head impacts during practices, especially full-contact drills, may help lower overall exposure. 

• Building neck strength. Exercises that strengthen the neck may help reduce how much the head moves during impact, which could lower concussion risk in some athletes.⁷ 

• Using properly fitted protective equipment. Helmets and other gear are important for preventing serious head injuries, but families should understand that they do not completely prevent concussions. 

• Speaking up about symptoms. Encouraging athletes to report headaches, dizziness, or other symptoms and ensuring they fully recover before returning to play is one of the most effective ways to prevent repeat injury. 

Recurrent concussions and recovery considerations 

A child’s concussion history plays an important role in recovery planning. While most young athletes recover fully from a single concussion, a history of prior concussions can influence both recovery timelines and future risk.² Research shows that children and adolescents who have sustained one concussion may be at increased risk for another, particularly if they return to play before fully recovering.² 

For athletes with multiple prior concussions, clinicians may take a more cautious approach to return-to-play decisions. This can include allowing additional time for recovery, monitoring symptoms more closely, and carefully weighing the risks and benefits of returning to contact or collision sports. These decisions are individualized and based on the athlete’s medical history, recovery pattern, and overall well-being. Open communication between families, clinicians, and coaches is essential to ensuring safe participation.  

Recently, there has been growing public attention to chronic traumatic encephalopathy (CTE), a brain condition that has been linked to repeated head impacts over many years. Current research suggests that CTE is linked to cumulative exposure over many years, most often studied in adult athletes.⁸ While the relationship between youth sports participation and long-term neurodegenerative disease remains an area of ongoing research, minimizing repeated head injuries and ensuring full recovery before return to play remain important protective strategies. 
 

How PHM supports families through recovery 

Managing a concussion often requires coordination between medical providers, schools, and families. At PHM, our Personal Care Teams help families navigate that process with clarity and confidence. We provide tailored education and individualized guidance, helping families understand what to expect and how recommendations apply to their child’s unique situation. We connect families with leading specialists in pediatric neurology, sports medicine, neuropsychology, or vestibular therapy when additional evaluation or support is needed and help translate evidence-based recommendations into practical next steps at home and at school.  

References  

1. CDCMMWR. QuickStats: Percentage of Children and Adolescents Aged ≤17 Years Who Had Ever Received a Diagnosis of Concussion or Brain Injury, by Sex and Age Group — National Health Interview Survey, United States, 2022. MMWR Morb. Mortal. Wkly. Rep. 72, (2023). 

2. Sport-Related Concussion in Children and Adolescents | Pediatrics | American Academy of Pediatrics. https://publications.aap.org/pediatrics/article/142/6/e20183074/37534/Sport-Related-Concussion-in-Children-and?utm_source=chatgpt.com. 

3. CDC. Data on Sports and Recreation Activities. HEADS UP https://www.cdc.gov/heads-up/data/index.html (2026). 

4. Ingram, V. et al. The Incidence of Sports-Related Concussion in Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Med. – Open 11, 36 (2025). 

5. CDC. Safety Guidelines for Pediatric Mild TBI. Traumatic Brain Injury & Concussion https://www.cdc.gov/traumatic-brain-injury/hcp/clinical-guidance/pediatric-mtbi.html (2025). 

6. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022 | British Journal of Sports Medicine. https://bjsm.bmj.com/content/57/11/695.long. 

7. Collins, C. L. et al. Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports. J. Prim. Prev. 35, 309–319 (2014). 

8. LoBue, C. et al. Traumatic Brain Injury and Risk of Long-Term Brain Changes, Accumulation of Pathological Markers, and Developing Dementia: A Review. J. Alzheimer’s Dis. 70, 629–654 (2019).