Paediatric Acute care Guidelines PMH Emergency Department
  • 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. 
Stage Activity Aim of stage
Stage 1: No activity (For first 48 hours after injury) Complete physical and mental rest Recovery
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 Adds movement
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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