Concussions and Head Injuries in Children
Returning to school and sport
Go through the following steps to help your child return to school and sport. Your child will be ready to move on to the next step when they can do the activities and handle their symptoms well. If your child has trouble handling their symptoms, they should do the activity in the step for less time or go back to the previous step until they are ready to move to the next step. Your child can begin the Return to Sport steps at the same time they begin the Return to School steps.
Give your child support and encouragement through their recovery and as they work through these steps. Make sure your child doesn’t go too quickly and takes rest breaks when they need to. Learning how to pace activity is an important part of concussion recovery.If your child is not better after 4 weeks or isn’t ready to move on to the next step after 1 to 2 weeks, talk to your healthcare provider and ask for a referral to a pediatrician (a doctor who specializes in children’s health), a concussion specialist, or a neurologist.
Return to school
Getting your child back to school will help them get back to doing regular activities again. It may take your child only a few days or up to 2 weeks to finish the steps of returning to school full time.
Step 1 – Start at-home activities
- After 1 to 2 days of rest, your child can start at-home activities before they go back to school.
- Your child should limit screen time and cellphone use to 15 to 20 minutes at a time to start.
- Your child should start doing gentle activities such as walking and light reading.
- Your child can do homework in 2 sessions for 15 to 20 minutes each. Have them take a 15-minute break between sessions.
Step 2 – Going back to school
- Your child should go to bed at a regular time and get 8 to 10 hours of sleep each night (including weekends).
- Your child can start going to school for half days and work up to a full day of classes.
- Your child should go to less stressful classes to start (such as music class) and avoid those that are harder for them until they feel better.
- You can talk to your child’s teacher about making some temporary changes to help them adjust to school such as:
- having no exams during the first 2 weeks
- sitting in front of the class so there are less distractions
- having a quiet space in school to relax for 20 to 30 minutes
- You should try to take your child to and from school or arrange rides for them so they don’t have to spend as much time walking, taking the bus, and carrying heavy books and other items.
Step 3 – Near-normal routine
- Your child may take only a 30-minute nap a day, if needed.
- Your child can only do 2 homework sessions for 30 minutes each. They should take a 15-minute break between sessions.
- Your child is back to full days of school on most or all days of the week.
- Your child goes to all classes, takes the bus, and is carrying their books.
- Your child takes regular exams, sits in their normal spot in class, and needs fewer rest breaks in a quiet space.
Step 4 – Back to school full-time
- Your child is back to a normal, full workload at school, including taking all exams.
- Your child may also be ready to return to full-contact practice and game play if they are at step 4 of Return to Sport. Talk to your child’s healthcare provider to see if they can have medical clearance to return to full-contact practice and game play.
Return to sport
Your child can begin the Return to Sport steps at the same time they begin the Return to School steps. Your child will be ready to move on to the next Return to Sport step when they are able to do the activities and handle their symptoms well. Spend at least 1 day on each of the Return to Sport steps.
It’s important that your child has gone back to school full-time before you ask their healthcare provider to give them medical clearance for full-contact practice and game play.
If your child is part of a high-level organized sport, talk to a sports medicine doctor before they return to regular sports activities.
Step 1 – Start at-home activities
After 1 to 2 days of relative rest, your child can start doing regular day-to-day activities, such as reading, texting, having screen time, and light walking, as long as their symptoms don’t get worse. They can start doing 5 to 15 minutes of these activities at a time, and slowly start doing them for more time.
Step 2 – Light aerobic exercise
- Your child can do light aerobic activities. These activities depend on the age of your child and may include walking, light jogging, or cycling on a stationary bike.
- Your child should do 10 to 15 minutes at most of light aerobic exercise, twice a day. Check with your child’s healthcare provider if you don’t know which activities are okay for your child to do.
- Your child should not do resistance training or lift weights, any activity with head or body contact, or dives, jumps, high-speed stops, spins, or other fast changes in movement.
Step 3 – Sport-specific training and exercise
- Your child can do 20 to 30 minutes at most of general conditioning exercise - such as running, throwing, or kicking a ball - twice a day.
- Your child should avoid any activities where they could collide (crash into objects or other people) or activities where there is risk of another impact to the head.
Step 4 – Drills with no contact
- Your child can do activities with a teammate.
- Your child should avoid contact drills such as checking, heading the ball, tackling, or live scrimmages.
- Your child can start resistance training and working on basic skills for their sport.
- Once your child feels good doing basic skills, they can start to do harder skills for their sport and work up to participating in gym class or a full team practice.
Step 5 – Medical clearance for full contact
Your child needs to get medical clearance from a healthcare provider with experience treating concussions before they start to do full-contact play in their sport.
Step 6 – Full-contact training and game play
Your child can start with scrimmages with teammates and work up to regular competitive games.
To see this information online and learn more, visit MyHealth.Alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_concussion_schoolsport_ac_child.
Related to Concussions and Head Injuries in Children
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: January 14, 2023
Author: Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
