Suspect and Protect: Common questions about concussion

A concussion is defined as a traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain. Symptoms and signs may present immediately or evolve over minutes to days, and can take up to 72 hours to show. Symptoms commonly resolve within days, but may be prolonged.

Concussions can result in substantially different outcomes, ranging from no detectable effect to temporary functional problems or issues which can be life-threatening.

Knowing the signs can help everyone, while being able to diagnose a concussion and determine its severity as soon as possible - whether on or off the pitch - is essential for team doctors.

Concussions are caused by knocks, bumps or blows to the head, or forces transmitted to the head (e.g. by a blow to the body, neck or shoulder areas).

Symptoms commonly reported by players include:

If any of the following signs are observed, or complaints are reported after an impact to the head or body, the player should be immediately removed from play, evaluated by an appropriate healthcare professional and transported to an appropriate healthcare facility or emergency department.

Yes, symptoms may take up to 72 hours to show following the incident and may change or worsen over days and even weeks.

Always put the player first. Remove them from the pitch immediately and check for the common signs and symptoms. If a doctor is on site, step back and let them take control. A medical assessment should then be done as soon as possible.

While it is helpful for everyone to know the signs, concussion should only be formally diagnosed by a healthcare professional trained in assessing patients with a head injury. These medical professionals will be able to rule out serious brain injury that needs a brain scan or surgery.

Relative rest is important for concussion treatment. It gives the brain a chance to recover from strenuous activity, while allowing some daily activities to continue. Anything which requires concentration, such as studies, reading and even television should be reduced in the first three days, and in general if it worsens symptoms. Driving should be avoided for the first 72 hours. Alcohol should be avoided until completely free of symptoms. Good quality sleep is key, and meditation can also help. Relative rest, and a gradual return to 'thinking' tasks is very important - but complete rest, such as laying down in a darkened room for extended periods, can be unhelpful.

Symptoms may continue for weeks after a diagnosed concussion, including tiredness, clumsy movements, poor concentration, dizziness and nausea, difficulty focusing visually, and irritability. Follow the FIFA Concussion Protocol for Grassroots Football for returning to football, safely.

There are no defined time frames for a brain injury to heal. Each injury should be treated on a case-by-case basis, and all signs and symptoms must be respected. Most symptoms of a concussion resolve within four weeks, but some can take longer. Symptoms lasting longer than one month are considered to be ‘persisting symptoms’ and referral to clinicians with specialised knowledge and skills in concussion management should be considered.

Everyone is unique in their recovery duration, which is why a graduated return to football is important to reduce the risks of a slow recovery, further brain injury and longer-term problems. Children and adolescents may take longer to recover than adults.

Most symptoms of a concussion resolve within four weeks, but some can take longer. If symptoms persist for more than four weeks, players need to be assessed further by an appropriate healthcare professional. Symptoms lasting longer than one month are considered to be ‘persisting symptoms’, and referral to clinicians with specialised knowledge and skills in concussion management should be considered.

Playing on with symptoms of a concussion can make them worse, significantly delay recovery and, should another head injury occur, result in a more severe injury and in rare cases, death (this is known as ‘second-impact syndrome’). That is why it is so important to remove anyone with a suspected concussion from any risky activity immediately.