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Health condition · Clinically reviewed

Concussion, recognise, remove, and recover the right way.

Most concussions settle within two weeks - if they are properly recognised, taken seriously and returned to sport in a structured way.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, the Concussion in Sport Group (CISG) SCAT6 and specialist society standards you can see at the end.

  • 03

    Current for 2026

    Reflects the 2023 Amsterdam consensus, the SCAT6 tool and current UK graduated return-to-play protocols.

Key facts

Concussion at a glance.

The essentials, in plain English - what it is, how long it lasts and why same-day return to play is off the table.

  • What it is

    A mild traumatic brain injury - transient neurological dysfunction after biomechanical force to the head, neck or body transmitted to the brain.

  • Loss of consciousness

    Not required for a diagnosis - most concussions happen without a knockout.

  • Recovery

    Usually 7 to 14 days in adults and up to 4 weeks in children and adolescents when managed correctly.

  • Same-day return

    Never - removal from play on suspicion is mandatory across professional and amateur sport.

  • Persistent symptoms

    Symptoms beyond 4 weeks meet criteria for post-concussion syndrome (roughly 10 to 30% of concussions).

  • Long-term risk

    Repeated concussion is linked to chronic traumatic encephalopathy (CTE), early dementia and mental-health problems.

Why this guide matters

A short recovery, done properly.

Concussion is common and usually short-lived - but the risks of getting it wrong are serious. The three points below shape everything else on this page.

  • If in doubt, sit them out

    A suspected concussion means immediate removal from play and no same-day return - mandatory across professional and amateur sport.

  • Short rest, then gradual return

    Modern evidence favours 24 to 48 hours of relative rest and then a stepped return to activity - prolonged rest slows recovery.

  • Persistent symptoms need help

    Around 10 to 30% of people develop post-concussion syndrome - a specialist team can shorten and improve recovery.

How the diagnosis is made

From pitchside to a clear plan.

The steps a UK clinician or team doctor will normally follow, in order - based on SCAT6 and NICE.

  1. 01

    Recognising

    Recognise and remove

    On suspicion of concussion the player is removed from play immediately - if in doubt, sit them out. No same-day return.

  2. 02

    Recognising

    Primary survey (ABCDE)

    Airway, breathing, circulation, disability and exposure - with cervical spine precautions until the neck is cleared.

  3. 03

    Recognising

    SCAT6 assessment

    The Sport Concussion Assessment Tool 6 covers symptoms, cognition, neurological status and balance in a structured way.

  4. 04

    Confirming

    Rule out structural injury

    Red-flag screen and, where indicated, CT head per NICE and the Canadian CT Head Rule to exclude bleed or fracture.

  5. 05

    Confirming

    Selective MRI

    Reserved for persistent symptoms, focal deficit or research - advanced sequences and diffusion tensor imaging in specialist centres.

  6. 06

    Rehabilitating

    Vestibular and oculomotor screen

    VOMS (Vestibular Ocular Motor Screening) and balance tests such as BESS and tandem gait guide rehabilitation.

  7. 07

    Rehabilitating

    Follow-up and graduated return

    A 24 to 48 hour review, stepwise return to learn and return to play, and neuropsychology or mental-health input if needed.

Typical timeline: recognition on the day, recovery within two to four weeks.

Symptoms

What concussion actually feels like.

Symptoms cluster in four groups - somatic, cognitive, emotional and sleep - and often overlap. And the features that mean it is time for A and E.

  • Headache

    The most common symptom - often pressure-like, worse with cognitive or physical effort.

  • Dizziness and balance

    Unsteadiness, vertigo and motion sensitivity - reflect vestibular and cervical involvement.

  • Nausea or vomiting

    Single episodes are common - repeated vomiting is a red flag needing urgent review.

  • Cognitive slowing

    Feeling foggy, slowed thinking, memory difficulty and short-term disorientation.

  • Amnesia

    Retrograde (before) or anterograde (after) memory loss around the event - amnesia over 30 minutes is significant.

  • Light and sound sensitivity

    Photophobia and phonophobia are typical in the first days and improve with graded exposure.

  • Sleep and mood changes

    Insomnia, hypersomnia, fatigue, irritability, sadness and anxiety often appear together.

  • Red flag - deterioration

    Falling GCS, repeated vomiting, seizure, focal weakness, slurred speech or a worsening headache means A and E now.

Treatment

How concussion is treated in the UK.

Short rest, a graduated return to activity, and targeted rehabilitation for the symptoms that linger.

  • Relative rest, 24 to 48 hours

    Short cognitive and physical rest, then light activity as tolerated - prolonged strict rest is no longer recommended.

  • Graduated return to play (6 stages)

    Symptom-limited activity, light aerobic, sport-specific, non-contact training, full contact after clearance, then return to play - minimum 24 hours per stage.

  • Graduated return to learn

    A stepped return to school or study with reduced screen time, rest breaks and workload adjustments while symptoms settle.

  • Vestibular rehabilitation

    Targeted exercises for dizziness, balance and gaze stability - particularly helpful when vestibular symptoms persist.

  • Headache management

    Simple analgesia short-term, avoid analgesic overuse; amitriptyline and other preventatives for persistent headache.

  • Sleep support

    Sleep hygiene, melatonin and CBT for insomnia (CBT-I) - poor sleep slows every other aspect of recovery.

  • Neuropsychology and cognitive rehab

    For persistent cognitive symptoms and return to work or study - structured assessment and pacing strategies.

  • Specialist concussion clinic

    Multidisciplinary input for persistent post-concussion syndrome - neurology, rehabilitation medicine, physiotherapy and psychology.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and international consensus, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP, A and E team or sports physician knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • Concussion in Sport Group (CISG). Amsterdam Consensus Statement on Concussion in Sport (2023) and SCAT6.

  • NICE. Head injury: assessment and early management (NG232).

  • Canadian CT Head Rule - triage for imaging after minor head injury.

  • RFU, FA and other UK sporting bodies - graduated return-to-play protocols.

  • Headway UK and the Concussion Legacy Foundation UK - patient and family resources.

Red flags

When a head injury needs A and E now.

Most concussions can be managed by the pitchside team and a GP. These are the situations that cannot - and where urgent imaging or hospital care is needed.

  • Deteriorating GCS

    Falling level of consciousness after a head injury means A and E now - a possible bleed or swelling needs urgent imaging.

  • Repeated vomiting

    More than one episode of vomiting after head injury is a NICE criterion for urgent CT head.

  • Seizure

    Any post-traumatic seizure needs emergency assessment and imaging.

  • Focal neurological signs

    Weakness, numbness, slurred speech, double vision or a fixed dilated pupil - call 999.

  • Severe or worsening headache

    A headache that keeps getting worse over hours is not typical for a straightforward concussion.

  • Suspected skull fracture

    Boggy scalp swelling, CSF leak from nose or ear, bruising behind the ear or around the eyes - urgent imaging.

  • Coagulopathy or anticoagulants

    Warfarin, DOACs or a bleeding disorder lower the threshold for CT considerably.

  • Second impact syndrome

    A second concussion before the first has resolved can cause catastrophic brain swelling - this is why the graduated return protocol exists.

  • Mental-health decline

    Low mood, anxiety, PTSD symptoms or thoughts of self-harm after head injury deserve prompt support - not "just push through".

Living with it

A short recovery, done step by step.

Four things that make the biggest difference in the weeks after a concussion - short rest, stepwise return, protected sleep and speaking up early if symptoms drag on.

A quiet reminder

Never a same-day return to play.

A day off is a small price. A second impact before the first has healed can cause catastrophic swelling - the graduated protocol exists to stop that from happening.

  1. 01 Rest

    Short rest, then light activity

    24 to 48 hours of relative rest, then start moving gently - prolonged bed rest slows recovery, not speeds it up.

  2. 02 Steps

    Progress one step at a time

    Only move up a stage in the return protocol if you have been symptom-free for 24 hours - a step back is normal, not a setback.

  3. 03 Sleep

    Protect sleep

    A regular schedule, dim evenings and no alcohol - sleep is when the brain does most of its repair work.

  4. 04 Ask

    Speak up if things aren’t right

    Persistent symptoms beyond 4 weeks deserve a specialist review - do not soldier on alone.

Frequently asked

Everything we get asked about concussion.

Quick answers on symptoms, imaging, recovery time and return to sport.

  • What is a concussion?

    A concussion is a mild traumatic brain injury caused by a biomechanical force to the head, neck or body that is transmitted to the brain. It causes short-lived neurological problems - headache, dizziness, cognitive slowing, mood and sleep changes - and does not have to involve loss of consciousness.

  • Do I have to be knocked out to have a concussion?

    No. Most concussions happen without loss of consciousness. The diagnosis is based on symptoms, cognition, balance and neurological signs after a plausible mechanism - not on whether someone was knocked out.

  • When should I go to A and E after a head injury?

    Straight away if there is deteriorating alertness, repeated vomiting, a seizure, weakness or numbness in the limbs, slurred speech, double vision, severe or worsening headache, a suspected skull fracture, or if the person takes anticoagulants. When in doubt, get seen.

  • How long does a concussion take to recover?

    Most adults recover within 7 to 14 days and most children and adolescents within 4 weeks when managed with short rest followed by graduated return to activity, learning and sport. Symptoms lasting beyond 4 weeks meet criteria for post-concussion syndrome and deserve specialist review.

  • When can I go back to playing sport?

    Never on the same day. Return uses a 6-stage graduated protocol - symptom-limited activity, light aerobic, sport-specific, non-contact training, full contact after medical clearance, then match play - with a minimum of 24 hours between stages and a step back if symptoms return. Children and adolescents usually progress more slowly.

  • What is second impact syndrome?

    It is a rare but catastrophic complication where a second concussion happens before the first has resolved. It can cause rapid, diffuse brain swelling with very high mortality. It is the main reason same-day return to play is banned and graduated return protocols exist.

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