What To Do In a Concussion: A Simple, Science-Backed Guide Anyone Can Follow

December 1st 2025

A concussion is a brain injury. Symptoms can appear quickly or over several hours. You do not have to be knocked out to have one.

If you are here because you or someone you care about took a heavy head knock, this guide will help you navigate each stage safely.

Below is a simple menu you can use to jump to the stage you are in.

Jump To Your Situation

I just took a head knock and think I might be concussed

A concussion can cause headache, dizziness, feeling slowed down, fogginess, nausea, confusion or sensitivity to light and sound. Sometimes symptoms appear slowly.

If you have any doubt, treat it seriously.

Signs you might see

• Slow to get up
• Unsteady or off balance
• Blank or dazed look
• Confused or unsure of the score or situation
• Grabbing the head
• More emotional than usual

Symptoms you might feel

• Headache or pressure in the head
• Dizziness
• Feeling slowed down or foggy
• Nausea
• Difficulty concentrating
• Light or noise sensitivity
• Just feeling not right

Recognise and Remove

If you think you have a concussion:

• Stop playing or training immediately
• Tell a coach, teammate, physio or friend
• Do not return to the same game or session
• Do not test yourself by running or doing drills

This protects you from further harm.

Why removal matters: Second Impact Syndrome

If you take another hit before the brain recovers, there is a small but serious risk of rapid swelling in the brain.

This is why World Rugby and national unions follow the principle: recognise and remove.

If concussion is suspected, you must come off and you must not return that day.

Red flags: when to get emergency help now

Get urgent medical care if you experience:

• Worsening or severe headache
• Repeated vomiting
• Increasing confusion or drowsiness
• Hard to wake
• Weakness or numbness
• Difficulty speaking
• Seizure or convulsion
• Double vision
• Clear fluid or blood from nose or ears
• Uneven pupils
• Any loss of consciousness
• Any suspicion of skull fracture

If you are unsure, err on the side of caution.

I know I have a concussion and I am at home wondering what to do now

This is the most common real situation.

You have come home after a match or training session. Your head hurts. You feel foggy or off. What now?

Here is your simple plan.

1. You can sleep

Sleep is safe.

Someone should check on you through the night to make sure symptoms are not getting worse.

If it is hard to wake you or you become more confused, seek emergency care.

2. Use relative rest, not total rest

Modern concussion care does not recommend lying in a dark room all day.

Do:

• Move gently around your home
• Make simple food
• Sit outside for fresh air
• Do small tasks if they feel manageable

Do not:

• Stay in bed all day unless symptoms force you to
• Do anything physically intense
• Find the middle ground, listen to your body

3. Screens are okay in short bursts

Light screen use is fine:

• Sending WhatsApps
• Checking messages
• Light browsing

Avoid:

• Gaming
• Long Netflix sessions
• Fast-paced action visuals

Use screens in short intervals and stop if symptoms increase.

4. Medication: avoid anti-inflammatories

Do not take:

• Ibuprofen (Advil)
• Aspirin
• Naproxen

These can increase bleeding risk.

If you need pain relief, paracetamol (Tylenol/Panado) is usually safer.

It may not speed up recovery but can reduce discomfort.

5. Hydration and nutrition

Eat normally and choose healthy foods:

• Lean proteins
• Whole grains
• Fruits and vegetables
• Healthy fats

Drink water regularly.

Avoid alcohol.

6. No training tonight

Do not:

• Run
• Lift weights
• Cycle hard
• Do rugby drills

Save exercise for later stages.

What is important in the first 24 hours

This is your Day 1 roadmap.

Do

• Get checked by a healthcare professional within 24 hours
• Keep a light routine
• Take short walks if they feel comfortable
• Use screens briefly
• Eat regular meals
• Drink water
• Take paracetamol if needed
• Rest often
• Have someone with you or checking on you

Do not

• Be alone for long periods
• Drink alcohol
• Drive
• Train or return to sport
• Take ibuprofen or aspirin
• Overuse screens

Normal symptoms

Headache, dizziness, fogginess, light sensitivity, nausea, trouble concentrating.

These should slowly improve.

Concerning symptoms

If symptoms worsen or new symptoms appear, seek urgent care:

• Severe headache
• Repeated vomiting
• More confused or very drowsy
• Difficulty speaking
• Weakness or numbness
• Hard to wake
• Seizure

It is day 2 or 3. What am I allowed to do

By now, symptoms should be a little more predictable.

Relative rest continues

Do:

• Light household tasks
• Short walks
• Simple work or study in short sessions

Do not:

• Run
• Lift weights
• Play sport
• Do activities with risk of falling

Light exercise is encouraged

Short, gentle walks or easy cycling are fine if symptoms:

• Do not significantly worsen
• Do not stay worse for more than an hour

If they do, reduce activity and try again later.

Cognitive activity

You can:

• Read
• Study lightly
• Work for short blocks of time

Take breaks as needed.

Getting back to school, study or work

Return to Learn comes before Return to Sport.

You can return when light thinking tasks feel manageable.

Use simple adjustments:

• Shorter days at first
• More breaks
• Reduced screen time
• Extra time for assignments or tasks
• Avoiding PE or high-risk activities

Adults can request similar adjustments at work.

When can I exercise again

Here is the simplified activity progression used across sports.

Move to the next stage only if symptoms do not worsen.

Stage 1: Rest and light daily activity

Short walks, simple home routine.

Stage 2: Light exercise

Easy cycling or gentle movement.

Stage 3: Moderate exercise

Jogging or controlled training that carries no risk of impact.

Stage 4: Sport-specific training without contact

Rugby skills, gym work, non-contact drills.

Stage 5: Full-contact training

Only after you have been symptom-free for 14 days and cleared by a healthcare professional.

Stage 6: Return to matches

No earlier than day 21 in most community sports.

If symptoms return at any stage, drop back one level. 

When can I return to rugby or sport

To return safely:

• You must be symptom-free
• You must complete every stage of the activity progression
• You must not skip steps
• You should be medically cleared before full contact

Most governing bodies require a minimum of 21 days before full return to matches.

My symptoms are not going away. What should I do

If symptoms are:

• Not improving after 2 weeks
• Still present after 4 weeks
• Getting worse
• Affecting school, work or daily life

You should see a healthcare professional with experience in concussion.

Persistent symptoms can be caused by:

• Vestibular issues
• Neck dysfunction
• Headache syndromes
• Mood changes
• Sleep disturbances

These are treatable with specialist care. 

FAQ: Simple answers to common concussion questions

Can I sleep after a concussion

Yes. Sleep is safe. Someone should check on you periodically.

Can I use my phone

Yes, in short bursts. Stop if symptoms increase.

What should I do in a concussion situation or after a heavy head knock

Stop playing, tell someone, and get checked. Do not return the same day.

When can I drink alcohol

Avoid alcohol until you are fully symptom-free.

When can I drive

Do not drive while you still have symptoms or feel slowed down.

Sources:

World Rugby Concussion Guidance (2024) https://www.world.rugby/the-game/player-welfare/medical/concussion

RFU HEADCASE: Concussion Guidelines (2023–2024) https://www.englandrugby.com/run/player-welfare/headcase

6th International Consensus Statement on Concussion in Sport (Amsterdam 2022) Published in British Journal of Sports Medicine https://bjsm.bmj.com/content/57/11/695

Sport Concussion Assessment Tools (SCAT6, CRT6, SCOAT6) https://bjsm.bmj.com/content/57/11

International Concussion & Head Injury Research Foundation / ISEH Concussion Clinic https://iseh.co.uk/clinical-services/clinics/concussion-clinic