Sports Concussions

Quick answer

Sports and recreation are a leading cause of head injuries in children and teens. The CDC estimates that about 283,000 children under 18 are treated in U.S. emergency departments each year for a sports- or recreation-related traumatic brain injury.[1] Every state and the District of Columbia has a youth sports concussion law,[2] and international guidance now favors a short period of relative rest followed by a gradual, step-by-step return to sport.[3]

How common sports head injuries are

A CDC study of emergency department visits from 2010 to 2016 estimated an average of 283,518 visits per year for sports- and recreation-related TBIs among children under 18.[1] About 194,340 of those visits each year were for boys and about 89,178 for girls.[1] These figures count only emergency department visits, so injuries treated elsewhere or never treated are not included.

Sports with the most injuries

The CDC study found these activities accounted for the most emergency department visits for TBI among children each year:[1]

Football

53,657 visits per year

Basketball

29,675 visits per year

Playground

27,350 visits per year

Bicycling

25,955 visits per year

Soccer

23,847 visits per year

Football was linked to 26.8% of these visits among boys. Among girls, soccer (13.1%), playground activities (12.6%) and basketball (11.9%) were the most common causes.[1]

Recognizing a sports concussion

The CDC defines a concussion as a type of TBI caused by a bump, blow or jolt to the head, or by a hit to the body that makes the head and brain move rapidly back and forth.[4] In young athletes, the CDC lists signs others may notice, such as appearing dazed or confused, answering questions slowly, being clumsier than usual, slowed reaction time, and mood or behavior changes.[5]

The 2023 international consensus statement from the Concussion in Sport Group says a player should be removed from play if a concussion is suspected, to avoid further injury, and re-evaluated over the following hours and days.[3] The conference also produced standardized assessment tools, including the SCAT6 and, for children ages 8 to 12, the Child SCAT6.[3]

Learn more: Concussion · Post-concussion syndrome

Why repeat injuries matter

The CDC states that exposure to repeated head impacts increases the chance of concussions and other TBIs, and that the risk of more serious, longer-lasting symptoms is greater when a child has multiple concussions, especially without enough healing time between them.[4] NINDS notes that a second concussion soon after the first can, in some cases, lead to permanent damage or death.[6] NINDS also reports that repeated TBIs may cause chronic traumatic encephalopathy (CTE).[6]

State concussion laws

Washington passed the first youth sports concussion law, the Zackery Lystedt Law, in 2009.[2] After Mississippi’s law was signed in January 2014, every state and the District of Columbia had a sports concussion law.[2] According to the National Federation of State High School Associations, the Lystedt model includes three core requirements:[2]

  1. Concussion education for coaches, athletes and parents
  2. Immediate removal from play for an athlete suspected of having a concussion, with no return the same day
  3. Written clearance from a licensed healthcare provider trained in concussion before returning

The NFHS notes that state laws vary significantly. For example, 13 state statutes extend coverage beyond school sports to youth sports programs, and 25 follow the Lystedt model in requiring concussion education for coaches. Not every state law addresses return-to-learn procedures.[2] See your state’s concussion law.

Return to sport

Guidance on rest has changed. The 2023 consensus statement found that strict rest until symptoms are gone is not beneficial, and it recommends relative rest (normal daily activities and less screen time) for up to about the first two days.[3] Light activity such as walking can begin during that period as long as it does not more than mildly worsen symptoms.[3]

Return to sport then follows a stepwise progression. The American Academy of Physical Medicine and Rehabilitation summarizes the six stages as:[7]

  1. Symptom-limited daily activities
  2. Light aerobic exercise
  3. Sport-specific exercise
  4. Non-contact drills
  5. Full-contact drills
  6. Return to sport

The consensus statement says each step typically takes at least 24 hours, and that athletes move into stages with a risk of head impact only after a healthcare professional authorizes it and concussion-related symptoms and findings have fully resolved.[3] The BMJ’s summary notes that full sports participation usually occurs within one month of injury.[9]

Return to school

The NFHS summary of the 2023 consensus statement notes that long absences from school are now considered harmful to recovery, and recommends returning to school as soon as it can be tolerated, even before full learning resumes.[8] Adjustments such as breaks, postponed tests, half days, or sunglasses for light sensitivity can help students cope with the school environment.[8] The CDC states that most children with a concussion feel better within 2 to 4 weeks.[4]

This page provides general information from the sources listed below. It is not medical advice and is not a substitute for evaluation by a qualified healthcare provider. In an emergency, call 911.

Youth sports concussion laws set rules for removal from play and written clearance before return.[2] When an injury was caused by someone else’s failure to use reasonable care, general negligence principles apply.[10] Depending on the facts, the options described in personal injury claims may apply. When a concussion leads to lasting impairment, see Social Security disability.

Sources

  1. Sarmiento K, et al. “Emergency Department Visits for Sports- and Recreation-Related Traumatic Brain Injuries Among Children — United States, 2010–2016.” CDC, Morbidity and Mortality Weekly Report, March 15, 2019. https://www.cdc.gov/mmwr/volumes/68/wr/mm6810a2.htm
  2. National Federation of State High School Associations. “Legal Perspectives, Recommendations on State Concussion Laws.” https://nfhs.org/stories/legal-perspectives-recommendations-on-state-concussion-laws
  3. Patricios JS, et al. “Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022.” British Journal of Sports Medicine, 2023. https://bjsm.bmj.com/content/57/11/695
  4. Centers for Disease Control and Prevention, HEADS UP. “Concussion Basics.” https://www.cdc.gov/heads-up/about/index.html
  5. Centers for Disease Control and Prevention, HEADS UP. “Signs and Symptoms of Concussion.” https://www.cdc.gov/heads-up/signs-symptoms/index.html
  6. National Institute of Neurological Disorders and Stroke. “Traumatic Brain Injury (TBI).” https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi
  7. American Academy of Physical Medicine and Rehabilitation, PM&R KnowledgeNow. “Sports Concussion.” https://now.aapmr.org/sports-concussion/
  8. National Federation of State High School Associations. “International Consensus on Sports Concussion: Summary for Schools.” https://nfhs.org/stories/international-consensus-on-sports-concussion-summary-for-schools
  9. BMJ Newsroom. “International expert panel revises management of concussion in sport for athletes at all levels.” https://www.bmj.com/company/newsroom/international-expert-panel-revises-management-of-concussion-in-sport-for-athletes-at-all-levels/
  10. Legal Information Institute, Wex. “Negligence.” https://www.law.cornell.edu/wex/negligence

Sources last checked: October 11, 2026

©Head Injury Resource Center. All rights reserved.