Your child has come off the field after a knock to the head. Here is what to do, in order.
The first hour
They do not go back on. Not that day, regardless of how they feel five minutes later. Feeling fine is not evidence of anything, because symptoms frequently appear hours later.
Watch for the red flags that mean an emergency department rather than a physiotherapist: worsening headache, repeated vomiting, seizure, weakness or numbness, slurred speech, unusual drowsiness, or any deterioration in how they are behaving. Any of those, go to hospital.
Without those, the plan is rest, supervision, and an assessment.
The first 24 to 48 hours
Relative rest. Not a dark room for a week, which is outdated advice. Reduced physical and cognitive load, meaning less screen time, less homework, no training, and plenty of sleep.
No alcohol. No driving. Someone should be with them overnight for the first night.
Book an assessment. Same day if possible, and we offer same day appointments.
What a proper assessment involves
Concussion affects five domains and asking whether someone feels alright tests none of them.
A proper assessment looks at physical symptoms, cognitive function, sleep, mood and behaviour, and the vestibular and visual systems. It also establishes a baseline, so recovery can be measured rather than guessed.
This is the part that most often gets skipped, and it is why people return to sport too early and get injured again.
The graded return to sport plan
Return happens in stages, and each stage is only cleared once it is completed without symptoms returning.
Broadly: symptom limited activity, then light aerobic exercise, then sport specific exercise without contact, then non contact training drills, then full contact training once medically cleared, then return to play.
Each stage takes a minimum of 24 hours, and a return of symptoms means dropping back a stage. For children and adolescents the timeline is deliberately more conservative than for adults, because young brains take longer to recover.
Return to learn comes before return to play. A student who cannot get through a school day without symptoms is not ready to train.
Why rushing it matters
The risk is not just a slower recovery. Returning while still symptomatic increases the chance of a second concussion, and second concussions sustained before the first has resolved are considerably more serious.
There is no upside to the extra week. There is a real downside to the missing one.
When it is not settling
Most concussions resolve within two to four weeks. Some do not.
If symptoms persist beyond that, particularly dizziness, visual disturbance or balance problems, that becomes specialist vestibular territory. Our colleagues at NeuroPhysio handle persistent post concussion symptoms with accredited vestibular physiotherapists, and we refer directly.
What we do
Same day concussion assessment across our Adelaide clinics, testing all five domains, with a graded return to sport plan and communication with your club and school where you want it. We have worked with elite and community sporting clubs across South Australia for decades, including SANFL clubs and state representative teams.
For the bigger picture, read The Complete Adelaide Guide to Getting Real Relief From Pain and Injury.
If a knock has happened this weekend, call (08) 8357 4988.
