Concussion is a common injury in community sport, from local football to netball and cycling. It can happen to players of any age and any level. The signs are not always obvious, and a player may want to keep going. Knowing what to look for helps teammates, coaches and parents act quickly.
Australia has clear national guidance on what to do when concussion is suspected. It covers removing a player from the game, resting and returning to sport in stages. The key message is simple and easy to remember. If in doubt, sit them out.
What concussion is
Healthdirect describes concussion as a brain injury caused by a knock or blow to the head or a sudden change in motion. It does not always involve a direct hit to the head. Common causes include sports injuries, falls and car accidents. Contact sports such as Australian rules football, rugby, soccer, boxing and touch football carry a higher risk.
The Australian Institute of Sport says most signs and symptoms resolve on their own if concussion is managed well. It also warns that complications can occur, including prolonged symptoms and a higher chance of further injury. That is why the national approach is cautious. A player who returns too soon is exposed to more harm.
Signs and symptoms to watch for
The AIS notes that symptoms can be very subtle. A player may look normal apart from appearing vacant, dazed or stunned. They might simply say they do not feel right. That alone is a reason to take them off the field.
Healthdirect lists the more obvious symptoms as confusion, memory problems, seizures or jerky movements and balance problems. Subtler symptoms include headache, neck pain, nausea or vomiting and dizziness. Blurred vision, trouble concentrating and sensitivity to noise or light can also occur. Symptoms can show up in many combinations.
When to get urgent help
Healthdirect advises calling triple zero (000) for an ambulance if someone is confused or unconscious after a head injury. It also lists signs that need urgent care. These are worth knowing before you ever need them:
- Neck pain or tenderness
- A seizure or convulsion
- Double vision
- Loss of consciousness or a worsening level of consciousness
- Weakness or tingling in the arms or legs
- Repeated vomiting or a severe headache
- Increasing confusion, agitation or irritability
The AIS says a neck injury should be suspected with any loss of consciousness, neck pain or a fall that could hurt the spine. In that situation the player should not be moved without guidance from trained people. Basic first aid principles apply. Wait for help from someone qualified.
What to do at the ground
The AIS message for any suspected concussion is “If in doubt, sit them out”. Remove the player from the game or training straight away. Do not let them go back on later in the same session. Note the time, how it happened, where the body was hit and what happened next.
The AIS says the diagnosis of concussion should be made by a medical practitioner. Arrange for the player to see a doctor as soon as possible. A player should not return to sport until a medical practitioner has cleared them.
The first few days
The AIS advises immediate physical and mental rest once concussion is diagnosed. The person should stay with a responsible adult and should not drive. They should avoid alcohol and check any medicines with a doctor. The AIS lists aspirin, anti inflammatories, sleeping tablets and sedating pain medicines as ones to avoid.
Healthdirect suggests resting for the first 24 to 48 hours and getting enough sleep. It also suggests limiting screen time and taking time off work or study. Gentle activity such as walking can follow.
Returning to school, work and sport
The AIS says that after resting for 24 to 48 hours, a person can begin light physical activity. Once symptoms have cleared, they can begin a staged return to sport. For school age athletes, returning to school and study should come before returning to sport. Each stage should only move ahead if symptoms do not return.
The national position statement sets minimum timeframes for community and youth sport. The AIS says a player should be free of symptoms at rest for at least 14 days before returning to contact training. It also sets a minimum of 21 days before returning to competitive contact. You can read the details on the AIS concussion guidance for athletes.
Healthdirect says most adults improve within 2 weeks and most people recover fully within 3 weeks. Some people have symptoms that continue for weeks or months. Healthdirect says this happens in up to 5 in 10 cases. See your doctor if symptoms get worse or you are worried, and read more on the healthdirect concussion page.
Helping players and clients stay informed
Coaches and personal trainers are often the first to notice that someone is not quite right. Sharing the national guidance with members before the season starts makes the process familiar. A short note in a newsletter can do the job well, as covered in our post on connecting with personal fitness email subscribers. Keep any message factual and point people to their doctor.
People living with other health conditions may need extra care during recovery. Someone with an autoimmune disease or another ongoing condition should talk with their own doctor about their return to activity. The AIS also suggests athletes with a history of mental illness discuss this with a doctor. Every recovery is different, so personal medical advice matters.
Frequently asked questions
Do you have to be knocked out to have concussion?
No, the AIS lists loss of consciousness as only one of several signs. Many people with concussion never lose consciousness. Feeling dazed, dizzy or not right can be enough. Any suspected concussion should be checked by a doctor.
Can a player go back on if they feel fine after a few minutes?
No, the national advice is to remove the player and keep them off. Symptoms can be subtle or appear later. A medical practitioner should make the diagnosis. The player should not return until a doctor clears them.
How long before returning to contact sport?
For community and youth sport, the AIS sets a minimum of 21 days before competitive contact. Players should also be free of symptoms at rest for at least 14 days before contact training. These are minimums rather than targets. A doctor should guide each step.
Should someone with concussion stay awake?
Healthdirect suggests getting enough sleep as part of recovery. The person should stay with a responsible adult at first. Call triple zero (000) if they become confused or less awake and aware. Danger signs always need urgent care.
This article is general information only and is not medical advice. Please speak with a doctor or qualified health professional about any head injury or concussion.