Got a Concussion? Here are the best first steps.
Concussions are common, but they should never be treated casually. Whether someone hits their head, falls hard, takes a hit during sports, or experiences a sudden acceleration-deceleration injury, the first question is often:
“Do I have a concussion?”
A concussion is a brain injury, and it deserves the right care from the very beginning. The encouraging news is that most people recover well when they are evaluated early, monitored appropriately, and guided through an active recovery process.
For healthcare providers, coaches, parents, and patients, understanding what to do in the first hours and days after a concussion can make a major difference.
Step One: Speak Up Right Away
One of the most important first steps after a suspected concussion is simple: tell someone immediately.
This might be a parent, coach, teacher, athletic trainer, school nurse, or healthcare provider. Symptoms of a concussion can vary widely, but common symptoms include:
Headache
Dizziness
Nausea
Blurry vision
Confusion
Feeling foggy
Balance problems
Sensitivity to light or noise
Neck pain
Feeling “off”
No athlete, student, or patient should try to push through these symptoms or hide them. Continuing to play or participate after a suspected concussion can increase risk and may delay recovery.
Early evaluation matters. A person with a suspected concussion should be assessed by a medical professional who understands concussion care and can help guide safe recovery, school or work adjustments, and return-to-activity decisions.
Know the Red Flags
While most concussions do not involve life-threatening complications, certain symptoms require immediate emergency medical care. These are often called red flags.
Seek emergency care or call for help if any of the following occur after a head injury:
Severe or worsening headache
Repeated vomiting
Seizure
Weakness, numbness, or tingling in the arms or legs
Increasing confusion
Unusual behavior
Trouble waking up
Slurred speech
Significant neck pain
Worsening symptoms over time
These symptoms should not be monitored with a “wait and see” approach. They may indicate something more serious than a standard concussion and require urgent medical evaluation.
The First 24–48 Hours: Relative Rest, Not Complete Shutdown
In the first day or two after a concussion, the goal is to reduce unnecessary stress on the brain and body while still supporting normal recovery.
This usually means:
No sports
No rough play
No same-day return to competition
Avoiding activities that significantly worsen symptoms
Drinking water
Eating regular meals
Prioritizing sleep
Having a responsible adult monitor symptoms
It is usually okay to sleep after a concussion as long as symptoms are not worsening and there are no red flags present. In fact, sleep is one of the most important parts of brain recovery.
However, this does not mean the person should be placed in a dark room for days until every symptom disappears.
Why “Cocoon Therapy” Is No Longer Recommended
Years ago, many people with concussions were told to sit in a dark room and avoid nearly all activity until symptoms fully resolved. This was sometimes called cocoon therapy.
We now know this is usually not the best approach.
After a short period of relative rest, concussion recovery should become active and guided. Strict rest until all symptoms are gone can actually slow recovery for some people. Light physical activity, when introduced appropriately, can help support recovery and reduce the risk of prolonged symptoms.
The key is that activity should be matched to the person’s symptoms, tolerance, and clinical findings.
Active Recovery After Concussion
Active concussion recovery may include:
Light walking
Easy stationary biking
School or work adjustments
Sleep support
Gradual return to cognitive activity
Guided return to exercise
Vestibular rehabilitation
Vision-related exercises
Cervical spine treatment
Headache management strategies
Balance training
Autonomic rehabilitation when appropriate
The goal is not to force activity or ignore symptoms. The goal is to carefully identify what the person needs and gradually build tolerance in a safe, structured way.
Concussion Symptoms Can Come From Different Systems
One of the biggest challenges in concussion care is that symptoms can come from multiple body systems.
For example, a headache after concussion may be related to:
The brain injury itself
The neck
The visual system
The vestibular system
Autonomic dysfunction involving heart rate or blood pressure regulation
Sleep disruption
Stress or emotional changes
Two patients may both report “headache,” but the cause and treatment may be completely different.
A neck-related headache may feel like pain in the back of the head, forehead, or temples. A vision-related headache may also show up in the forehead but require a very different treatment approach. An autonomic-related headache may feel like pressure throughout the head and may worsen with standing, walking, or increased physical activity.
This is why guessing is not enough.
A good concussion evaluation should look beyond the diagnosis and identify which systems are contributing to the person’s symptoms.
The Right Care Helps Guide the Right Recovery
If someone has a suspected concussion, the key steps are:
Speak up right away
Stop playing or participating in risky activity
Get evaluated by a qualified medical professional
Watch for red flags
Use relative rest early
Begin a guided, active recovery plan
Address the specific systems driving symptoms
Return to school, work, exercise, and sport in a gradual and safe way
Concussion recovery is not about hiding in a dark room until symptoms disappear. It is about understanding the injury, identifying the right recovery targets, and progressing step by step.
Final Thoughts
A concussion should always be taken seriously, but it should also be treated with confidence and direction.
With the right evaluation, the right education, and the right active recovery plan, most people can recover safely and successfully.
Protecting the brain matters because the brain is what allows us to learn, think, move, communicate, play, work, and be ourselves.
If you are a healthcare provider working with patients after concussion, having a clear clinical framework can make your care more effective, more organized, and more individualized.
Concussion recovery should not be a guessing game. It should be guided, active, and specific to the person in front of you.
Want to feel more confident treating concussion patients? Explore Concussion Spot’s evidence-informed concussion rehabilitation courses and clinical tools designed to help healthcare professionals guide patients from initial evaluation through recovery and return to activity. Learn more about our courses here.