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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 symptoms, 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 work through the steps too quickly and takes rest breaks when they need to. If you 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 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, start at home activities before your child goes back to school.
  • Limit screen time and cell phone use to 15 to 20 minutes at a time.
  • Start doing gentle activities such as walking and light reading.
  • Do homework in 2 sessions for 15 to 20 minutes each and with a 15 minute break between sessions.

Step 2 – Going back to school

  • Go to bed at a regular time and get 8 to 10 hours of sleep each night (including weekends).
  • Start going to school for half days and work up to a full day of classes.
  • Have your child go to less stressful classes to start (such as music class) and avoid those that take more effort until they feel better.
  • Talk to your child’s teacher about making some temporary changes to help them adjust to school such as:
    • 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
  • Take your child to and from school or arrange rides for them so they don’t have to spend as much time walking to and from school, taking the bus, and carrying heavy books and other items.

Step 3 – Near-normal routine

  • Limit your child to a 30 minute nap a day, if needed.
  • Limit homework to 2 sessions for 30 minutes each and with 15 minute breaks 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 rest, your child can start doing regular day-to-day activities, such as reading, texting, and having screen time, as well as 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

  • Light aerobic activities will 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

  • Do 20 to 30 minutes at most of general conditioning exercise such as running, throwing, or kicking a ball, twice a day.
  • Avoid any activities where you 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

  • Do activities with a teammate.
  • 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

Get medical clearance from a healthcare provider experienced with treating concussions before your child starts to do full contact play in their sport.

Step 6 – Full contact training and game play

Start with scrimmages with teammates and work up to regular competitive games.

For 24/7 nurse advice and general health information, call Health Link at 811.

Current as of: January 14, 2020

Author: Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services