Concussion return to sport decisions should always put brain health first. A concussion is a mild traumatic brain injury that can affect thinking, balance, vision, reaction time, mood, and exercise tolerance. It is one of several important topics within sports health, and athletes with ongoing symptoms may also develop related problems such as headaches, neck pain, dizziness, or reduced exercise confidence.

You should never return to play on the same day as a suspected concussion. Early management should focus on removal from sport, medical assessment, symptom monitoring, and a gradual, criteria-based progression back to training and competition.

Common concussion symptoms and signs

• Headache or pressure in the head
• Dizziness or poor balance
• Blurred vision or light sensitivity
• Confusion, feeling slowed down, or poor concentration
• Nausea, fatigue, or feeling “not quite right”

What is concussion?

Concussion is a brain injury caused by force transmitted to the head, neck, or body during sport or exercise. Symptoms may begin straight away, but they can also develop over the next few hours or days. Loss of consciousness is not required, so a player can still have a concussion even if they never black out.

How do you recognise concussion?

Concussion can look different from one athlete to the next. Some players appear dazed or unsteady straight away. Others mainly report headache, fogginess, nausea, blurred vision, or trouble concentrating later that day. In contact and collision sports such as AFL and rugby union, any suspected concussion should trigger immediate removal from play and medical review.

Common visual signs

• Slow to get up after a hit or fall
• Loss of balance or unsteady walking
• Confused, vacant, or disoriented look
• Grabbing the head after contact
• Loss of consciousness or seizure activity

Common symptoms

• Headache
• Dizziness
• Nausea or vomiting
• Visual disturbance
• Sensitivity to light or noise
• Feeling slowed down or mentally cloudy
• Poor concentration or memory
• Fatigue or low energy
• Neck pain or associated cervicogenic headache

What should you do straight after a suspected concussion?

If concussion is suspected, the athlete should stop playing immediately and should not return to sport that day. Early priorities are medical assessment, observation for red flags, and avoiding another head impact. A doctor may use current concussion tools and clinical judgement to guide diagnosis, review, and medical clearance.

Seek urgent medical care if there is worsening headache, repeated vomiting, increasing confusion, seizure, unusual drowsiness, weakness, slurred speech, neck pain after major trauma, or any concern about a more serious brain or cervical spine injury.

Concussion return to sport stages

Concussion return to sport should follow a graded progression. The athlete should move forward only when symptoms remain settled during and after each stage. If symptoms flare up, the load usually needs to be reduced and the progression slowed.

Stage 1 — Relative rest and daily activity

Early recovery usually includes relative rest rather than complete bed rest. Light daily activity, short walks, and a calm routine may help recovery, provided symptoms remain manageable.

Stage 2 — Light aerobic exercise

Once the athlete is tolerating daily activity, light aerobic exercise such as walking or gentle stationary cycling can begin. The aim is to reintroduce movement without symptom escalation.

Stage 3 — Moderate exercise and controlled sport movement

Moderate aerobic work and simple sport-specific drills may be added next. This stage builds exercise tolerance while avoiding contact, collision, or falls.

Stage 4 — Heavier training and non-contact drills

When moderate exercise is well tolerated, the athlete may progress to heavier conditioning, resistance training, and more demanding non-contact sport drills. This is often where a physiotherapist may help with balance, neck function, vestibular symptoms, confidence, and return-to-exercise planning.

Stage 5 — Return to contact training after medical clearance

Contact training should not resume until the athlete has completed the earlier stages successfully and has been medically cleared. This step tests readiness in a more realistic sport setting.

Stage 6 — Return to competition

Full return to competition should come last. The safest plan is a medically guided progression based on symptom resolution, exercise tolerance, and current return-to-sport guidelines.

How long does concussion return to sport take?

For youth athletes and most community sport settings in Australia, current guidance uses a conservative approach. The Australian Sports Commission concussion guidance recommends no same-day return, at least 14 symptom-free days before return to contact training, and a minimum of 21 days before returning to competitive contact sport. Timelines can be longer when symptoms persist or recovery is more complex.

Why do some athletes take longer to recover?

Recovery time varies. Ongoing symptoms may relate to the brain injury itself, but they can also involve the neck, balance system, vision, sleep, mood, headache patterns, or reduced exercise tolerance. Some people need a broader management plan rather than simple rest alone. Related pages that may help include tension headache and headache, neck and jaw pain.

How can physiotherapy help after concussion?

A physiotherapist may help as part of the broader concussion team once serious injury has been excluded and the diagnosis has been made by the appropriate medical practitioner. Management may include graded aerobic exercise, cervical spine assessment, balance retraining, vestibular rehabilitation, movement confidence, and staged return-to-training advice.

This middle phase of concussion return to sport is often where athletes need practical guidance. Instead of guessing when to increase training, a structured plan can help match symptoms, exercise load, and sport demands more safely.

When should you seek professional help?

You should seek professional help if symptoms last more than a few days, worsen with light activity, keep returning during exercise, or interfere with school, work, sleep, or confidence. Athletes with repeated concussion, severe initial symptoms, migraine history, significant neck pain, or persistent dizziness should also be reviewed carefully.

Related information

1. Sports Health: Essential Guide for Athletes’ Safety
2. Headache Causes
3. Tension Headache Relief
4. Headache, Neck & Jaw
5. Neck Headache
6. AFL Injuries
7. Rugby Injuries: Prevention Tips

What to do next

If you or your athlete has had a suspected concussion, the first step is proper medical review and a safe plan for recovery. Do not rush the process, and do not return to contact sport just because the athlete feels better for a day or two.

If you need help with guided exercise progression, neck symptoms, balance, dizziness, or return-to-training planning after medical assessment, a PhysioWorks physiotherapist may be able to assist as part of your concussion recovery team.

References

1. Australian Sports Commission. Concussion in sport. Accessed March 10, 2026.
2. Patricios J, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport—Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695-711. doi:10.1136/bjsports-2023-106898
3. McRae B, Stay S. Assessment and management of sport-related concussion in general practice. Aust J Gen Pract. 2024;53(3). doi:10.31128/AJGP-12-23-7067
4. Patricios J, Davis GA, Makdissi M, et al. Sport Concussion Office Assessment Tool – 6. Br J Sports Med. 2023;57(11):651-667. doi:10.1136/bjsports-2023-106859