Concussion Is Treatable: Why Pulling Your Child From Sport Isn’t Always the Answer

Sport Is Worth It. Concussion Is Treatable. Both Things Are True.

If your child plays football, soccer, hockey, lacrosse, basketball, or almost any sport, you have probably thought about concussion. If they've already had one, you may have thought about it a lot more.

Should they keep playing? Is another concussion dangerous? Does a normal CT scan mean they're okay? How much rest do they need? When can they go back? The answers online tend to fall into two extremes. One side says sports are too dangerous and the safest choice is to stop. The other says concussion is overblown and athletes should simply get back out there. Neither is particularly helpful to a family sitting across from a clinician with a symptomatic athlete. The more honest answer is this:

Sport has tremendous value. Concussion is a real injury. And concussion is treatable.

All three things can be true.

Sport is about more than winning

We sometimes talk about sport as though the benefits are optional and the risks are absolute.

They're not.

Sport gives young people opportunities for physical activity, social connection, structure, confidence, teamwork, and skill development. Longitudinal research continues to find associations between youth sport participation and favorable physical and psychological outcomes. That doesn't mean sport is risk-free. And it doesn't mean every athlete should continue participating in every circumstance. But it does mean something important:

Removing an athlete from sport is not a neutral decision. It has its own costs. So the goal shouldn't be to eliminate every possible risk. That's impossible. The goal should be to reduce preventable risk, prepare athletes for the demands of their sport, and know what to do when an injury occurs.

A concussion is an injury, not a verdict

One of the most difficult questions I hear from families is: "Did this permanently damage my child's brain?"

A concussion deserves to be taken seriously. But taking it seriously does not mean assuming the worst. Concussion is a form of mild traumatic brain injury, and recovery can vary considerably from person to person. Some athletes recover relatively quickly. Others develop persistent symptoms that require more targeted care. That variability is exactly why concussion shouldn't be treated with a single prescription. And our approach to treatment has changed.

For years, the default message was essentially: Rest until you feel better.

We now know that prolonged strict rest is not the answer for most patients. In a randomized clinical trial of 103 adolescents with sport-related concussion, those assigned to individualized, symptom-limited aerobic exercise recovered in a median of 13 days, compared with 17 days in the stretching group. That doesn't mean every concussion patient should immediately start exercising on their own.

It means something more important: Treatment should be active, individualized, and guided by the patient's clinical presentation. The Amsterdam international consensus on concussion management reflects this shift toward active rehabilitation and targeted interventions rather than prolonged rest as the default.

There isn't one concussion treatment

This is one of the biggest misconceptions I encounter. Two athletes can sustain concussions on the same day and have completely different problems. One may have dizziness and difficulty with balance. Another may develop headaches and light sensitivity. Another may struggle with concentration and mental fatigue. Another may experience significant anxiety, irritability, or sleep disruption. And some patients have several of these problems at once.

That's why simply asking, "How bad is the concussion?" isn't enough.

The injury may be the same word. The treatment shouldn't necessarily be the same plan.

The first week matters

There's another part of concussion care that deserves much more attention: Timing.

A study of 162 adolescent and young adult athletes compared those who began clinical care within seven days of injury with those who began care between eight and 20 days. The later group was significantly more likely to experience a recovery lasting longer than 30 days, with an adjusted odds ratio of approximately 4.7. Importantly, this was an observational study. It does not prove that waiting caused prolonged recovery.

But it does provide an important clinical signal: Early evaluation matters. Think about what happens during that first week.

A patient may be wondering:

Should I exercise?

Should I stay in bed?

Can I go to school?

Why am I dizzy?

Why can't I concentrate?

Why am I exhausted?

Why do I feel anxious?

Without guidance, patients can easily end up doing too much, or almost nothing. Neither extreme is necessarily the right answer. You cannot always control whether an athlete gets injured. You can control what happens next.

Skill may be part of prevention

When we talk about concussion prevention, the conversation often starts with equipment. Equipment matters. But there is another form of protection that athletes carry with them everywhere: their preparation.

Neck strength, physical conditioning, neuromuscular control, anticipation, awareness, and sport-specific technique may all play a role in how an athlete responds to contact. The evidence surrounding neck strength and concussion risk is promising but still developing, and it would be irresponsible to claim that neck training can prevent concussion. The literature remains heterogeneous.

But the broader principle makes sense: Skill is part of injury prevention. Learning how to tackle, to brace, how to position the body, how to recognize contact, and building strength and conditioning before the season starts. These things aren't just about becoming a better athlete. They are about being better prepared for the physical demands of the sport.

What about baseline testing?

This is an area where nuance is especially important. International consensus does not recommend routine, mandatory baseline testing for all young athletes, and a baseline should never itself be used to diagnose a concussion or determine whether someone is ready to return to play. But that doesn't mean baseline information has no value. For some athletes, knowing their individual pre-injury cognitive profile can provide useful context when interpreting post-injury performance. Learn more.

The important distinction is: A baseline is a piece of clinical information, not a crystal ball. And a test score is not a diagnosis. It is one piece of a much larger clinical picture.

What if the CT scan is normal?

This is another place where families can become understandably confused.

A normal CT scan is good news. It can help rule out dangerous structural problems such as acute bleeding or certain fractures. But a normal CT does not mean that a person cannot have a concussion. Routine structural imaging can be normal in someone who is experiencing very real symptoms after a concussion. That's why someone who continues to experience headaches, dizziness, balance problems, visual symptoms, fatigue, sleep disruption, cognitive difficulties, or mood changes after a head injury may still need a clinical concussion evaluation.

The scan can be normal, and the patient can still need treatment.

Preparation before. Treatment after.

If there's one message I hope families take away from this article, it's this: Don't wait until something goes wrong to think about concussion. Before the season:

* Build strength and conditioning.

* Work on sport-specific technique.

* Take neuromuscular preparation seriously.

* Understand your athlete's individual history.

* Consider whether baseline testing is clinically appropriate.

And if an injury happens:

* Take symptoms seriously.

* Don't assume "just rest" is the complete treatment plan.

* Seek appropriate evaluation early.

* Identify what is actually driving the symptoms.

* Start targeted rehabilitation when clinically appropriate.

The goal isn't simply to get an athlete back onto the field.

The goal is to get them back to themselves.

Be prepared. Know what to do.

I don't want parents to leave this article believing that the answer is to pull their children out of sports. I want them to leave understanding that preparation and good concussion care matter.

Sport is valuable.

Concussion is real.

Concussion can be treated.

And when symptoms persist, you don't have to simply wait and hope they disappear.

That's where specialty concussion care matters

At Patel Concussion Institute, we don't approach concussion as a one-size-fits-all injury. We start with the individual. We look at the injury, symptoms, cognitive functioning, psychological factors, sleep, medical history, and other factors that can influence recovery. From there, we work to understand what is driving the patient's symptoms and develop an individualized treatment and rehabilitation plan. The goal isn't simply to tell you when you can return to your sport. It's to understand why you're not feeling like yourself, and determine what can be done about it.

References

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2. Panza MJ, Graupensperger S, Agans JP, Doré I, Vella SA, Evans MB. Adolescent sport participation and symptoms of anxiety and depression: a systematic review and meta-analysis. J Sport Exerc Psychol. 2020;42(3):201-218. doi:10.1123/jsep.2019-0235

3. Leddy JJ, Haider MN, Ellis MJ, et al. Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatr. 2019;173(4):319-325. doi:10.1001/jamapediatrics.2018.4397

4. Leddy JJ, Master CL, Mannix R, et al. Early targeted heart rate aerobic exercise versus placebo stretching for sport-related concussion in adolescents: a randomised controlled trial. Lancet Child Adolesc Health. 2021;5(11):792-799. doi:10.1016/S2352-4642(21)00267-4

5. Patricios JS, 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

6. Kontos AP, Jorgensen-Wagers K, Trbovich AM, et al. Association of time since injury to the first clinic visit with recovery following concussion. JAMA Neurol. 2020;77(4):435-440. doi:10.1001/jamaneurol.2019.4552

7. Silverman S, Vidt ME, Hong JS, Grafton LM. Risk reduction of concussion in athletes: do neck size or neck strength make a difference? Am J Phys Med Rehabil. 2024;103(7):659-664. doi:10.1097/PHM.0000000000002464

8. Eckner JT, Oh YK, Joshi MS, Richardson JK, Ashton-Miller JA. Effect of neck muscle strength and anticipatory cervical muscle activation on the kinematic response of the head to impulsive loads. Am J Sports Med. 2014;42(3):566-576. doi:10.1177/0363546513517869

9. Davis GA, Schneider KJ, Anderson V, et al. Pediatric sport-related concussion: recommendations from the Amsterdam consensus statement 2023. Pediatrics. 2024;153(1):e2023063489. doi:10.1542/peds.2023-063489

About the author:

Shan Patel, PsyD, is a neuropsychologist and concussion specialist who completed his fellowship through the UPMC Sports Medicine Concussion Program. He is the Owner and CEO of the Patel Concussion Institute (PCI), a telehealth-based practice serving patients nationally via PSYPACT, and serves as Clinical Director of the University Orthopedic Care, Concussion Program, and Integrative Behavioral Health Program, overseeing operations across 14 hospital-based clinics in Florida.