Head Injury Return to Sports

The American Academy of Pediatrics has published guidelines regarding when athletes can return to sports following a head injury.

American Academy of Pediatrics Return to Sports Recommendations

Grade 1 concussion:

Defined by:

Transient confusion
No loss of consciousness
Mental status changes last for less than 15 minutes

Recommendations:

Return to sports activity same day only if all symptoms resolve within 15 minutes
If a second grade 1 concussion occurs, no sports activity for 1 week

Grade 2 concussion:

Defined by:

Transient confusion
No loss of consciousness
Mental status changes last for 15 minutes or more

Recommendations:

No sports activity for 1 week
If a grade 2 concussion occurs on the same day as a grade 1, no sports activity for 2 weeks

Grade 3 concussion:

Defined by:

Loss of consciousness

Recommendations:

No sports activity for 1 week if loss of consciousness was only seconds
No sports activity for 2 weeks if loss of consciousness was minutes or longer
For a second grade 3 concussion, not sports activity until the person has no symptoms for 1 month
If abnormality is seen on CT scan of the brain or MRI scan or the brain, no sports activity for the rest of the season and the athlete should be discouraged from returning to contact sports.

Continue to Head Injury Skin Wound

Last Updated: Nov 7, 2008 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Head Injury References

Edwards P, Arango M, Balica L, et al. CRASH trial collaborators. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005 Jun 4-10;365(9475):1957-9. [15936423]
Grappling with traumatic brain injury. Lancet. 2007 Dec 8;370(9603):1879. [18068492]
Lee AC, Ou Y, Fong D. Depressed skull fractures: a pattern of abusive head injury in three older children. Child Abuse Negl. 2003 Nov;27(11):1323-9. [14637305]
McKinley J. New challenges in assessing and managing concussion in sports. Am Fam Physician. 2007 Oct 1;76(7):948-9. [17956064]
Ropper AH, Gorson KC. N Engl J Med. 2007 Jan 11;356(2):166-72. Review. No abstract available. Erratum in: N Engl J Med. 2007 Apr 26;356(17):1794. [17215534]
Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1519-25. [16189365]
Tender GC, Awasthi D. Risk stratification in mild head injury patients: the head injury predictive index. J La State Med Soc. 2003 Nov-Dec;155(6):338-42. [14750754]