Concussion assessment and management

What is concussion assessment and management?

Concussion is a brain injury caused by a bump, blow or jolt to the head or body that makes the brain move suddenly inside the skull. It affects how the brain works for a while. You do not have to be knocked out to have a concussion, and most people have a completely normal CT or MRI scan.

Assessment means a clinician (or a trained person at the side of the pitch) checks for danger signs, decides whether a concussion is likely, and makes sure nothing more serious — like bleeding inside the skull or a neck injury — has been missed. Management is the plan that follows: a short rest, then a careful, step-by-step return to daily life, study or work, and finally sport.

The single most important rule in UK grassroots-sport guidance is "if in doubt, sit them out". Anyone with a suspected concussion must be removed from play straight away and must not return to sport on the same day. Going back too soon, before the brain has recovered, risks a second injury that can very rarely be catastrophic (this is one reason the rules are strict).

This guide explains what assessment can and cannot do, the warning signs that mean you need emergency help, and how a safe return is staged. It is general information, not a substitute for being assessed by a clinician.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your test

• If you are arranging an assessment after a head knock, write down exactly what happened, whether there was any loss of consciousness, and when symptoms started.
• List all symptoms since the injury — headache, dizziness, feeling foggy, nausea, light or noise sensitivity, sleep and mood changes — and how they are changing.
• Bring details of any previous concussions, how long each took to settle, and any history of migraine, anxiety, depression or learning difficulties, as these affect recovery.
• Bring a list of your medicines, especially any blood-thinners, as these change how a head injury is managed.
• Where possible, bring someone who saw the injury, as the account of a witness is valuable.
• Do not drink alcohol, do not drive, and do not be left alone for the first 24 hours after a significant head knock until a clinician has advised it is safe.

What happens

At the side of the pitch, a trained person checks whether you can be moved safely and looks for danger signs. If a concussion is suspected, you are taken out of play for the rest of the day — this is not optional, and "if in doubt, sit them out" applies even if you feel able to continue.

A clinical assessment reviews how the injury happened and your symptoms, then checks memory, concentration, balance, coordination and eye movements, and examines your neck. The clinician decides whether the picture fits concussion, whether anything more serious needs excluding, and whether you need to go to A&E.

Scans are not used to diagnose concussion. A CT head scan is arranged only when there is concern about bleeding, a skull fracture or another serious injury — for example after loss of consciousness, repeated vomiting, a seizure, or in someone on blood-thinners. A normal scan is reassuring about those dangers but does not mean there is no concussion.

You are then given a clear plan: what to watch for, when to rest, how to start moving again, and when and how to return to study, work and sport.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The biggest dangers are missing a serious head or neck injury early on, and returning to contact sport before the brain has recovered. The safest approach is to assume concussion when in doubt, remove the person from play, watch for red flags, and follow a staged return. Ask your clinician what specific signs should make you seek emergency help, and who to contact if symptoms are not settling.

Published figures to discuss

Concussion recovery varies widely between individuals, so the platform avoids quoting precise percentages. The diagnosis is clinical, not based on a scan, and there is no single test with a fixed accuracy. The figures that are reliable in UK guidance are about timing of return, not about the chance of any particular outcome.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Most people recover from concussion within a couple of weeks, and most children and teenagers within about four weeks, but everyone is different. Recovery is about pacing — doing enough to keep moving forward without setting off symptoms.

• Headache, tiredness and feeling 'foggy' or slowed down for the first days to weeks.
• Dizziness, sensitivity to light or noise, and trouble concentrating that ease gradually.
• Sleep changes — sleeping more than usual or finding it harder to sleep.
• Feeling more emotional, irritable or low than usual while recovering.
• Symptoms that briefly return when you do too much, settling again with rest.

Aftercare

• For the first 24 hours after a significant head knock, stay with someone who can get help if you deteriorate, and do not drink alcohol or drive.
• Rest for 24–48 hours, then build activity back gradually, staying just below the level that brings symptoms on.
• Tell your school, college, workplace and any other sports clubs about the concussion so they can support a graded return.
• Do not return to any sport with a risk of contact until you have completed the staged programme and been advised it is safe.
• Use simple pain relief such as paracetamol for headache only if advised; avoid sedatives and excess alcohol while recovering.
• Build screen time, reading and exercise back in steps, dropping back a level if symptoms flare.
• Keep any planned review appointment, especially if you have had concussions before or symptoms are slow to settle.

• A responsible adult to stay with the injured person for the first 24 hours
• The clinic's contact details, or an urgent-advice number — NHS 111 in England, Scotland or Wales, or your GP out-of-hours or Trust Phone First service in Northern Ireland — saved, and 999 understood for red flags
• A written note of when symptoms started and how they are changing
• School, college or employer informed so studies/work can be eased back
• Sports coach informed so return to play is not rushed
• Driving paused until a clinician advises it is safe
• A follow-up plan if symptoms last beyond four weeks

⚠ Get urgent help if…

• Loss of consciousness, or becoming more drowsy or hard to wake — call 999.
• A severe or rapidly worsening headache — call 999.
• Repeated vomiting — call 999.
• A seizure or convulsion, or limbs twitching or going stiff — call 999.
• Weakness, numbness or tingling in the arms or legs, or problems walking — call 999.
• Double vision, slurred speech, unusual or very agitated behaviour, or increasing confusion — call 999.
• Severe neck pain or tenderness, or any suspicion of a skull fracture (clear fluid or blood from the nose or ears) — call 999 and keep the neck still.
• Anyone on blood-thinning medicine, or with a bleeding disorder, who has a head injury should be assessed urgently even if they seem well.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

There is no single test that confirms concussion. The diagnosis is a clinical judgement based on how the injury happened and the pattern of symptoms and signs. A normal CT or MRI scan is reassuring about bleeding or a fracture, but it does not rule out concussion, and a scan is not needed in most cases.

A good outcome is a full recovery of symptoms and a safe, staged return to study, work and sport. Recovery times vary widely, and being told to take longer than you would like is usually a sign of careful management, not bad news.

Most concussions settle within two to four weeks, but a minority of people have symptoms that last longer and need extra support. Each concussion is managed on its own merits; a history of several concussions, or symptoms that are slow to recover, may prompt a more cautious plan and a discussion about continued participation in contact sport.

Related tests, treatments or support

Assessment after a head injury often includes checking the neck, because neck (whiplash-type) problems can cause similar headaches and dizziness. Where symptoms persist, vestibular (balance) physiotherapy, vision assessment, headache management and psychological support are sometimes combined into a rehabilitation plan.

Follow-up & long-term care

If symptoms are settling normally, you may not need a formal review. If you have had concussions before, are recovering slowly, or symptoms last beyond about four weeks, you should be reviewed by a clinician with experience in concussion. Children and teenagers are generally followed up more closely and returned to activity more cautiously than adults.

• Complete the graduated return-to-sport stages in order, and do not skip steps even if you feel well.
• Tell coaches and teachers about the injury so effort can be increased safely.
• Seek review before the next season or competition if you have had repeated concussions.
• Learn to recognise concussion signs for the future, so the 'if in doubt, sit them out' rule can be applied early.

Repeat, follow-on and what comes next

• There is no scan that confirms concussion, so the assessment may be repeated over days as symptoms change.
• If symptoms persist beyond about four weeks, further assessment and targeted rehabilitation are common.
• A return-to-sport plan may be paused and restepped if symptoms flare when activity is increased.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear written instructions on red flags and exactly when to call 999.
• A named contact for questions and a plan for review if symptoms persist.
• A staged, written return-to-study/work and return-to-sport plan that puts education or work first.
• Liaison with the school, employer or club so effort is increased safely.
• Onward referral to vestibular physiotherapy, vision, headache or psychological support if needed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether the assessment is a one-off appointment or includes follow-up reviews over the recovery period.
• The seniority and experience of the clinician (for example a sport and exercise medicine consultant).
• Whether structured tools, balance or vision testing, or neuropsychological assessment are included.
• Whether a scan is arranged (and scans are not usually needed for concussion).
• Whether a written return-to-sport or return-to-study plan and liaison with a school or club is provided.
• Add-on rehabilitation, such as vestibular physiotherapy or headache management, if symptoms persist.

• The clinician's fee and what the assessment covers.
• Whether follow-up reviews are included or charged separately.
• Whether any tests or scans are included, and what triggers them.
• Whether a written management and return-to-sport plan is provided.
• What happens, and what it costs, if symptoms persist and rehabilitation is needed.
• How to reach the clinic urgently, and that emergencies should go to 999, not the clinic.

On the NHS? Assessment after a head injury is an NHS service: call 999 for red-flag signs. For urgent non-life-threatening advice within 24 hours, use NHS 111 in England, Scotland or Wales; in Northern Ireland, contact your GP out-of-hours service or your HSC Trust's Phone First service. Private sport and exercise medicine clinics may offer follow-up and graduated return-to-sport support, but this does not replace urgent NHS care.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Are any of my symptoms or signs a reason to go to A&E now?
• Do I need a scan, and if so, what exactly is it looking for?
• What is my staged plan for returning to school or work, and then to sport?
• How long should I stay out of contact sport, given my history?
• What specific red-flag signs should make me or my family call 999?
• What should happen if my symptoms last longer than four weeks?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for concussion assessment and management

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: UK Concussion Guidelines for Grassroots Sport (Sport and Recreation Alliance) GOV.UK — Concussion guidance for grassroots sport NHS — Head injury and concussion NICE NG232 — Head injury: assessment and early management Sport England — concussion guidelines for grassroots sport nidirect — urgent and emergency care services (Northern Ireland) nidirect — GP out-of-hours service (Northern Ireland)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.