Current evidence supports a gradual return to sport following a head injury, with a step wise return to play.
Children who return to sport too early are at risk of sustaining complications from their head injury.
The child should have a period of physical and mental rest (“brain rest”). This includes avoiding sporting activities but also activities that require mental concentration including computer use, television, texting and play stations.
Once the child has been symptom free for 48 hours and feels back to normal, they can commence a gradual return to sporting activities as below.
Aim of stage
Stage 1: No activity (For first 48 hours after injury)
Complete physical and mental rest
Stage 2: Light aerobic exercise
Walking, swimming, stationary cycling
Gentle increase in heart rate
Stage 3: Sport-specific exercise
Running drills at football codes, cricket, basketball, netball, hockey
Stages 4: Non-contact training drills
Passing drills at football codes, cricket, basketball, netball, hockey
Adds co-ordination and exercise
Stage 5: Full contact practice
Participate in normal training activities
Restores confidence and allows coaching staff to assess progress
Stage 6: Return to play
Normal game play
Each stage should last 24-48 hours
If the child remains symptom free, they can move on to the next stage
If the child develops any symptoms (headache, dizziness, nausea, or tiredness), they should move back a stage and try to progress again after a further 24-48 hour rest period
If the child has persistent headaches, dizziness, nausea or vomiting, they should be reassessed by their general practitioner or at the Emergency Department.
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