It may seem like a surprising question in the current climate—especially given the growing focus on concussion, serial traumatic brain injury (TBI), and potential long-term effects on children’s brains. In past generations, such concerns received far less attention. Today, however, the conversation carries more weight.

While untreated concussion is a genuine concern and must be taken seriously¹, it is important to recognise that, overall, the benefits of sport and physical activity in large part, outweigh the potential risks. With appropriate awareness, management, and safeguards in place, sport remains one of the most positive influences on child development.

Among the many well-documented benefits of sport participation for children—and indeed for all of us—are²:

• Reduced risk of obesity
• Increased cardiovascular fitness
• Healthy growth of bones, muscles, ligaments, and tendons
• Improved coordination, balance, and motor skills
• Greater ability to physically relax, reducing chronic muscular tension (e.g., headaches or back pain)
• Better quality sleep
• Mental health benefits, including greater confidence and reduced anxiety
• Enhanced social skills and stronger peer connections
• Development of personal skills such as cooperation, discipline, and leadership

Sport not only strengthens the body—it also fosters resilience, belonging, and lifelong habits that promote health and wellbeing. With the right concussion management strategies in place, children and adolescents can continue to enjoy these benefits safely.

The real concern lies with untreated traumatic brain injury (TBI)—most commonly in the form of mild TBI (mTBI). Unlike the dramatic portrayals often seen in movies—such as “seeing stars,” dizziness, blackout, or spasms—many individuals with mTBI show no obvious signs. Like any other injury, if left untreated, complications are likely to occur³.

Because symptoms may be subtle or absent, some sufferers can slip through the cracks, leading to potentially serious and long-lasting effects. Research shows that asymptomatic children and adolescents with a history of concussion experienced measurable performance decline for up to two years following their last concussion⁴. This highlights the urgent need to revisit current return-to-play (RTP) guidelines and incorporate objective assessments—such as biomarkers, cognitive testing, and functional performance measures—into decision-making.

Another challenge is underreporting: many young athletes, particularly in competitive sports like ice hockey, attempt to minimise or hide their symptoms from coaches, parents, and clinicians⁵. This makes the use of standardised patient assessment tools essential, even though existing tools still require further validation.

The Centers for Disease Control and Prevention (CDC) has developed the Heads Up initiative, providing resources for parents, schools, coaches, and clinicians to improve recognition and management of concussion. These include information sheets, posters, infographics, palm cards, apps, embeddable microsites, and free online training modules:
👉 CDC Heads Up

Removing athletes from play immediately following a concussion or suspected TBI is crucial. Athletes are more vulnerable to repeat injury due to slowed reaction times, and repeat concussions prolong symptoms. There is also growing concern that post-concussive symptoms are linked to long-term cognitive decline and other neurological sequelae⁵–⁷. The American Medical Society for Sports Medicine (AMSSM) recommends that athletes should be completely symptom-free before being cleared to return to play⁸.

Interestingly, emerging evidence suggests that early, carefully managed return to light physical activity may reduce the severity and duration of post-concussive symptoms. Importantly, this activity should not involve risk of repeat head injury.

The signs and symptoms of mild traumatic brain injury (mTBI) can vary and may not always be immediately obvious⁹.

• Brief loss of consciousness (seconds to minutes)
• Feeling dazed, confused, or disoriented without loss of consciousness
• Headache
• Nausea or vomiting
• Fatigue or drowsiness
• Difficulty sleeping or sleeping more than usual
• Dizziness or problems with balance

• Blurred vision, ringing in the ears, altered taste, or reduced sense of smell
• Sensitivity to light or noise

• Memory or concentration difficulties
• Mood changes or irritability
• Feelings of depression or anxiety

Infants and young children may not be able to describe their symptoms. Instead, signs of brain injury in children can include:

• Changes in feeding or nursing habits
• Persistent crying and difficulty being consoled
• Increased irritability or unusual fussiness
• Reduced attention span
• Altered sleep patterns
• Low mood or sadness
• Loss of interest in toys or usual activities
• 
  

You should always consult a doctor if you or your child experiences a blow to the head or body that causes concern or leads to changes in behaviour. Seek emergency care immediately if there are clear signs or symptoms of traumatic brain injury following any recent trauma to the head.

It is important to remember that the terms mild, moderate, and severe refer to the effect of the injury on brain function. Even a so-called mild brain injury is a serious medical condition that requires prompt evaluation and an accurate diagnosis⁹.

Sport-related concussion poses a genuine health risk to children and adolescents and requires accurate diagnosis and careful management by trained providers¹⁰. Unfortunately, most standard textbooks offer limited practical guidance for clinicians, meaning education and up-to-date research are vital for supporting accurate diagnosis and management. Until clear evidence-based guidelines are universally adopted, ongoing education of healthcare professionals remains essential.

Despite growing evidence, many sporting codes have been slow to acknowledge and act on the risks associated with concussion. This lack of recognition often flows down to community sport, where children and “weekend warriors” may not receive the care they need after a head knock.

As parents, you are the true gatekeepers of your children’s wellbeing when it comes to concussion. You play a crucial role in:

1. Deciding which sports your children participate in.
2. Ensuring appropriate return-to-play decisions are made after a concussion.

Ultimately, however, it is the responsibility of sporting organisations, clinicians, researchers, and trainers to provide accurate, accessible, and current information to support parents in making these potentially life-changing decisions.

Traumatic brain injury (TBI) poses a particular concern for children, even more so than for professional adult athletes. Unlike many other injuries where young bodies typically recover faster, brain trauma in children often heals more slowly and may have longer-lasting effects¹¹. Beyond current clinical assessments—such as neuropsychological testing, balance and dexterity measures—researchers are advancing blood-based diagnostics that have the potential not only to improve accuracy of diagnosis but, most importantly, to provide prognostic insight into long-term outcomes.

Children are our future. Protecting them must remain our highest priority.

1. McCrory P, Meeuwisse WH, Dvorak J, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838–47.
2. Australian Government Department of Health. Benefits of physical activity. Canberra: DoH; 2019. Available from: https://www.health.gov.au/topics/physical-activity-and-exercise/benefits
3. Ryan LM, Warden DL. Post concussion syndrome. Int Rev Psychiatry. 2003;15(4):310–16.
4. Halstead ME, Walter KD, Moffatt K; Council on Sports Medicine and Fitness. Sport-related concussion in children and adolescents. Pediatrics. 2018;142(6):e20183074.
5. Chrisman SP, Quitiquit C, Rivara FP. Qualitative study of barriers to concussive symptom reporting in high school athletics. J Adolesc Health. 2013;52(3):330–5.
6. Guskiewicz KM, Marshall SW, Bailes J, et al. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery. 2005;57(4):719–26.
7. McKee AC, Cantu RC, Nowinski CJ, et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol. 2009;68(7):709–35.
8. Harmon KG, Drezner JA, Gammons M, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15–26.
9. Mayo Clinic Staff. Traumatic brain injury (TBI). Symptoms and causes. Mayo Clinic. 2021. Available from: https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557
10. Halstead ME, Walter KD, Moffatt K; Council on Sports Medicine and Fitness. Sport-related concussion in children and adolescents. Pediatrics. 2018;142(6):e20183074.
11. Kirkwood MW, Yeates KO, Wilson PE. Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population. Pediatrics. 2006;117(4):1359–71.