A new, practical concussion guide for parents and coaches
This article was initially published in the 4/16/26 edition of our Concussion Update newsletter; please consider subscribing.
The Archives of Physical Medicine and Rehabilitation has published a concussion recognition guide for parents and coaches that includes information on recognizing concussions and practical recovery advice. The authors, Dr. Ruairi Connolly and colleagues, based the guide on the 6th International Consensus Statement on Concussion in Sport (6th Consensus) and the American Congress of Rehabilitation Medicine (ACRM) definition of concussion/mild traumatic brain injury. The authors provide guidance on recognizing concussions, practical recovery advice, and general concussion knowledge to help parents and coaches be more prepared to handle concussions in their youth athletes. Below is a brief summary of the guide.
A sport-related concussion is a mild traumatic brain injury most often from a “direct blow to the head or body,” that transmits impulsive force to the brain, causing it to be “shaken inside the skull.”
A concussion can be identified, according to the ACRM, by one or more of the following clinical signs: if there is any loss of consciousness, trouble with memory or confusion (the child forgets where they are or is unable to remember who their coach is), or neurological symptoms such as headaches, dizziness, nausea, appearing dazed, or sensitivity to light or sound.
For a coach or parent, recognizing a concussion takes vigilance; some signs and symptoms occur immediately after injury, while some symptoms can take hours or up to three days to appear. The athlete may self-report symptoms like headaches, dizziness, trouble seeing, foggy vision, or feeling “slow” physically or mentally. Signs that may be observed immediately after a concussion include the athlete holding their head, stumbling or having trouble with balance, appearing dazed or confused, or being slow to answer questions.
It is good to keep checking in on the athlete as physical, cognitive, emotional, or sleep-related symptoms can develop up to 72 hours after the injury. Physical symptoms can include neck pain, headaches, nausea, vomiting, light and noise sensitivity, and blurred vision. Cognitive symptoms can include trouble concentrating, memory loss, or slowed thinking. Emotional symptoms can include nervousness, irritability, or sadness. Sleep-related symptoms can include sleeping more or less than is usual for the athlete, or even difficulty falling asleep.
The authors recommend the Concussion Recognition Tool 6 (CRT6) for identifying signs and symptoms of suspected concussion withinthe first 72 hours, according to the 6th consensus.
The best way to prevent long-term effects is to act promptly and cautiously. “If in doubt, sit them out,” is the golden rule for concussions. Continuing to play with a concussion can increase the risk of persisting symptoms after concussion, and cause more serious complications. Second-impact syndrome, though very rare, is a potentially life-threatening swelling of the brain that can occur when a second concussion happens before the brain has healed from the first concussion.
The first 24-48 hours after a concussion should involve physical and mental “relative rest.” Relative rest means that the athlete can do light activities of daily living, such as household tasks or going for a walk. They should reduce screentime and avoid challenging homework and intense exercise.
After the first 24-48 hours, the athlete should gradually increase physical activity; the guide recommends that this process be supervised by a health care professional (e.g., primary care physician, pediatrician, sports medicine specialist, or athletic trainer). Concerning return to play, the guide states “Never allows [sic] the athlete to return to play until evaluation by a health care professional experienced in concussion management has been completed.”
To clarify, Concussion Alliance notes that the 6th Consensus recommends medical clearance from a health care professional is required before the athlete progresses to activities that pose a risk of an inadvertent head impact (such as individual drills with a ball with teammates nearby), and after “full resolution of concussion symptoms.”
The guide recommends that, if symptoms last more than four weeks, patients should seek care from a concussion specialist. Concussion Alliance notes that the 6th Consensus recommends earlier rehabilitative care in some cases: the consensus recommends rehabilitative treatment for headaches, dizziness, and neck pain lasting more than 10 days.
Every athlete is different, and every recovery period is different. An athlete may fully recover in 2-4 weeks, but others may take longer. The authors suggest that “The best way to prevent the long-term effects of concussion is education, awareness, and prompt action.”