Concussion management
Specialist assessment for suspected concussion, structured recovery monitoring, and a clear graduated return to sport, work, and learning. Care follows the current Concussion in Sport Group consensus statement and Australian sport-specific protocols.
Concussion is a brain injury, and it deserves brain-injury-grade care. The most common mistake is doing too much too soon. The second is leaving symptoms unaddressed in the hope they settle. Specialist input can help avoid both of those pitfalls.
What concussion is
Concussion is a mild traumatic brain injury caused by direct or transmitted force to the head. The injury is functional, not structural, which is why standard CT and MRI scans are usually normal. Symptoms can be physical (headache, nausea, dizziness, photophobia), cognitive (slowed thinking, memory or attention difficulty), emotional (irritability, low mood), or sleep-related.
Many adult concussions resolve in two to four weeks with appropriate management. A meaningful proportion take longer, and a structured plan from the outset is the best protection against prolonged symptoms.
Specialist assessment
Concussion assessment uses validated tools (such as the SCAT6) alongside a careful history of the mechanism, symptoms, and modifiers. Examination covers neurological status, balance, vestibular and ocular function, and cervical spine. Imaging is requested where red flags are present or where structural injury is suspected.
What is covered
- Mechanism of injury and immediate course
- Symptom inventory and severity
- Cognitive screening
- Balance and vestibular-ocular testing
- Cervical spine assessment (often a contributor to ongoing symptoms)
- Sleep, mood, and energy levels
- Risk factors that may slow recovery
Recovery monitoring
Recovery follows a graduated pattern: 24 to 48 hours of relative rest, then a return to light cognitive and physical activity at a level that does not provoke a meaningful symptom flare. Complete rest beyond 48 hours is no longer recommended, and may delay recovery.
Symptom-limited activity
The principle is simple. Activity at a level that does not significantly worsen symptoms is generally fine. Activity that triggers a clear and lasting symptom flare is too much for now. The threshold rises as recovery progresses.
Sub-symptom-threshold aerobic exercise
Light aerobic exercise, prescribed at an intensity below the symptom threshold, supports recovery. This is one of the few interventions with consistent supportive evidence in concussion care.
Graduated return pathways
Return to learn
Students return to school in stages: shortened day, then full day with breaks, then full curriculum, then assessments. The plan is built with the school where appropriate, with clear written guidance on accommodations.
Return to work
Cognitively demanding work often takes longer than physical work to settle. Phased return, screen breaks, and quiet workspaces are common short-term modifications.
Return to sport
The standard graduated return to sport progression has six stages, from symptom-limited daily activity through to full contact and competition. Each stage requires symptom stability for at least 24 hours before advancing. Contact and competition are not resumed until medical clearance.
Stage 1. Symptom-limited activity
Daily activities that do not provoke symptoms.
Stage 2. Light aerobic exercise
Walking or stationary cycling at low intensity.
Stage 3. Sport-specific exercise
Running drills, no head impact activities.
Stage 4. Non-contact training
Harder training, including coordination and cognitive load.
Stage 5. Full contact practice
After medical clearance, normal training activities.
Stage 6. Return to play
Normal game play.
Sport-specific protocols (rugby, AFL, soccer, combat sports) may require longer minimums. The clinic plan reflects whichever protocol applies to your sport and code.
Prolonged symptoms
Symptoms persisting beyond four weeks (or two weeks in children and adolescents) warrant a structured workup. Common contributors include cervicogenic factors, vestibular and ocular dysfunction, sleep disruption, mood changes, and exercise intolerance. Each is treatable with targeted rehabilitation.
The clinic coordinates with vestibular physiotherapists, neuropsychologists, and other practitioners as the picture requires.
When to seek specialist input
- You or your child has had a concussion and want a clear plan from the outset
- Symptoms are not settling on the expected timeline
- Return to sport, school, or work has stalled
- You have had repeated concussions and want a longer-term assessment
- You are an athlete in a contact or collision sport and want a baseline screening on file (see concussion baseline screening)
Common questions
How long until I can play again?
It is a case-by-case basis, with stage-based recovery and return-to-sport guidelines. The progression is symptom-led, not date-led.
Should I have a CT or MRI?
Imaging is not routinely indicated for uncomplicated concussion. It is reserved for red flag features or persistent symptoms where structural pathology needs to be ruled out.
Is sleep okay after a concussion?
Yes. The advice to keep someone awake after a head injury is outdated. Normal sleep is part of recovery. What matters is monitoring for the red flags above.
Can I drink alcohol while recovering?
Alcohol is best avoided during early recovery. It impairs sleep, balance, and cognition, all of which slow concussion recovery.
Will baseline testing protect me from concussion?
No. Baseline testing makes it easier to interpret post-injury performance, particularly cognitive scores and balance. It does not prevent the injury. See baseline screening for who benefits.
