A concussion is a brain injury caused by a blow or jolt to the head or body that makes the brain move quickly inside the skull. In football, any player suspected of having a concussion should be removed from play immediately and should not return that day. They need to be evaluated by a qualified healthcare professional, rest at first, then return to school and activity gradually, and only return to contact after completing a step-by-step return-to-play process and receiving medical clearance. Most people recover within a few weeks, but returning too early can prolong symptoms and increase the risk of further injury.
What a concussion is
Concussions are often described as mild traumatic brain injuries. They do not require a direct hit to the head; a hard hit to the body that snaps the head back and forth can also cause one. The sudden movement can stretch and affect brain cells and change how the brain works for a period of time. Most concussions do not involve loss of consciousness, and standard imaging such as CT scans usually appears normal, which is why symptoms and clinical evaluation are so important for diagnosis.
Signs and symptoms
| Type | Examples |
|---|---|
| Physical | Headache, nausea, dizziness, balance problems, sensitivity to light or noise, blurry vision |
| Cognitive | Confusion, memory problems, feeling foggy, slowed reactions, trouble concentrating |
| Emotional | Irritability, sadness, anxiety, feeling more emotional than usual |
| Sleep | Sleeping more or less than usual, trouble falling asleep, drowsiness |
Coaches, teammates and parents may notice signs such as a player appearing dazed, forgetting plays or assignments, moving clumsily, answering questions slowly, showing behavior changes or not remembering events before or after the hit. Symptoms can appear right away or develop over hours or days, so players should be monitored after any significant hit.
Red flags: seek emergency care
Call emergency services or go to the emergency department immediately if a player shows any of the following: loss of consciousness, a headache that gets worse and does not go away, repeated vomiting, seizures, weakness or numbness, decreased coordination, slurred speech, increasing confusion or agitation, unusual drowsiness or difficulty waking, one pupil larger than the other, or neck pain after a hit. These can be signs of a more serious injury, such as bleeding in or around the brain.
What to do if you suspect a concussion
- Remove the player from play. When in doubt, sit them out.
- Check for red flags and call for emergency help if any are present.
- Do not leave the player alone and watch for worsening symptoms.
- Have them evaluated by a qualified healthcare professional experienced in concussion.
- Inform parents or guardians for youth players, and share details of the injury.
- Follow a gradual return plan for school and sport once symptoms improve.
Players should not return to play on the same day as a suspected concussion, even if they feel better. Many laws and league rules require removal from play and written clearance from a licensed healthcare provider before returning.
Recovery and rest
Current guidance generally recommends a short period of relative rest during the first day or two, followed by a gradual increase in light activity as long as symptoms do not significantly worsen. Complete isolation in a dark room is no longer recommended for most people, as gentle activity can support recovery. Limiting screen time early on, getting good sleep and avoiding activities that could cause another head injury are important. Most athletes recover within a few weeks, although some take longer and may benefit from specialized care.
Returning to school
For students, returning to learning often comes before returning to sport. Schools may provide temporary adjustments such as shorter days, extra time on assignments, rest breaks, reduced screen time and postponed tests. These accommodations are typically reduced as symptoms improve. Communication between the student, family, teachers, school nurse and athletic trainer helps make the return smooth.
The return-to-play process
| Step | Activity |
|---|---|
| 1 | Daily activities that do not worsen symptoms |
| 2 | Light aerobic exercise, such as walking or a stationary bike |
| 3 | Sport-specific exercise, such as running drills, with no head impact |
| 4 | Non-contact training drills, including more intense practice |
| 5 | Full-contact practice after medical clearance |
| 6 | Return to competition |
Each step usually takes at least 24 hours. If symptoms return or worsen, the player typically goes back to the previous step. The exact protocol should be directed by a healthcare professional and may vary by organization.
Why young athletes need extra care
Children and teenagers may take longer to recover from concussions than adults, and their developing brains call for a cautious approach. Young players may also be less likely to recognize or report symptoms, especially if they worry about losing their place on the team. A rare but serious risk, sometimes called second impact syndrome, has been described in young athletes who suffer another head injury before recovering from the first, which is one reason same-day return to play is prohibited. Parents and coaches should encourage honest reporting, watch for changes in behavior or school performance, and make sure young athletes complete the full return-to-learn and return-to-play process.
Roles of coaches, parents and teammates
Everyone around a player plays a part. Coaches should complete concussion education, teach safe technique and remove any player who shows signs of a concussion. Parents should know the symptoms, ask about hits after games and practices, and support their child in following medical advice. Teammates can help by speaking up when a teammate seems confused, dazed or unwell. Athletic trainers and team medical staff coordinate evaluation and the return-to-play process when available.
Reducing concussion risk
- Teach tackling and blocking with the head up and out of contact.
- Follow rules against targeting, spearing and helmet-to-helmet hits.
- Limit full-contact practice time, as many leagues and states require.
- Use certified, properly fitted helmets and maintain them.
- Educate players, coaches and parents to recognize symptoms and report them.
- Create a team culture where reporting symptoms is expected and supported.
Concussion laws and policies
In the United States, every state has passed youth sports concussion laws, many inspired by Washington’s Zackery Lystedt Law of 2009. These laws commonly require concussion education, removal from play when a concussion is suspected and clearance from a licensed healthcare provider before returning. The NFL, NCAA and high school associations also have their own concussion protocols. Details differ, so check the policies that apply to your league and state.
Common mistakes
- Letting a player return to the same game after a suspected concussion.
- Assuming it is not a concussion because the player did not lose consciousness.
- Hiding symptoms to keep playing.
- Skipping steps in the return-to-play process.
- Believing helmets prevent all concussions.
Health note: this article is general information, not medical advice. Anyone with a suspected concussion should be evaluated by a qualified healthcare professional, and emergency symptoms require immediate medical care. Follow your league’s concussion protocol and your state’s laws.
Frequently asked questions
How long does a concussion take to heal?
Many people recover within a few weeks, but recovery varies and some symptoms can last longer.
Can you get a concussion without hitting your head?
Yes. A hard hit to the body that jolts the head can cause a concussion.
When can a player return to football after a concussion?
Only after symptoms resolve, a gradual return-to-play process is completed and a qualified healthcare professional gives clearance.
