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When Can I Return to Play after a Concussion?


We’ve all either been there, know someone who has been there, or have heard of a similar situation. The star athlete is involved in a head injury ultimately leading to a concussion. He/she then either stays on the field or just makes their way back out onto the playing field before they have fully recovered. There are a multitude of reasons that athletes do this, ranging from not wanting to let their team/family/coach down, someone important could be in the stands, or maybe their athletic trainer just isn’t adequately trained to know when that athlete should be cleared to play. The list goes on and on but the question still remains, when do I know it's safe to return to play?

“Second impact syndrome, also known as repetitive head injury syndrome, describes a condition in which individual experiences a second head injury before complete recovery from an initial head injury. It is thought that athletes who sustain a concussion and return to their sport early are at particularly high risk. When this occurs the athlete will rapidly develop altered mental status and a loss of consciousness within seconds to minutes of the second hit resulting in a catastrophic neurological injury. The catastrophic injury results from the dysfunctional blood flow to the brain leading to an increase in intracranial pressure. The pressure rapidly develops and eventually results in brain herniation. The herniation may occur resulting in brain stem injury and rapid deterioration and possibly leading to death within 2 to 5 minutes.”(1)

If you read our prior article on what a concussion is you know how there is a neuro-metabolic cascade of events that occurs after a concussion. When this happens sodium, potassium, and calcium are forced into areas that they aren’t suppose to be. When these ions become displaced, your brain has to work overtime to pump them back to where they came from. During that initial 5-7 days is when your brain should be working the hardest to accomplish this task and then usually within 7-10 days you may notice that your symptoms are starting to subside. This is where athletes get in trouble because while you may not feel symptomatic anymore you aren’t out of the woods yet. This process of getting sodium, potassium, and calcium back to where they belong can take up to 4-6 weeks to complete; so when an athlete makes their way back out onto the field before this process is complete and gets hit once again (maybe not even as hard as the original hit) it can lead to a further progression of symptoms, delay their recovery, and possibly even cause detrimental brain trauma. But what happens if you make it to that 4-6 week mark and you are still symptomatic, you now get classified as post-concussion syndrome, stay tuned to learn more on that later.

Now this article isn’t designed to scare you but to inform you on the fact that unlike many of our other organs, we only get one brain, and I won’t say it’ll never happen but as of right now, getting a brain transplant is not a viable option. Take care of the one you have; find a qualified provider that can accuratley assess your brain and help you get back out onto the field as soon as you can. If you or someone you know has recently sustained a head injury, click the contact us button at the top of the page to schedule a complimentary phone call with the Doctor and learn what the best next steps are for you and your unique inujury.


1. May T, Foris LA, Donnally III CJ. Second Impact Syndrome. [Updated 2021 Jul 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:

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