After a concussion, the most important things you do are rest in the first day or two, manage pain safely, and gradually return to normal activities over days to weeks. Most concussions resolve within a few weeks, but how you handle the early days matters. Here’s what that looks like in practice.
Know the Danger Signs First
Before anything else, rule out a more serious brain injury. Most concussions don’t require emergency care, but some symptoms signal something worse. Call 911 or go to the emergency department if you notice any of these after a blow to the head:
- Seizures or convulsions
- Repeated vomiting
- One pupil larger than the other
- Slurred speech, weakness, numbness, or loss of coordination
- A headache that keeps getting worse and won’t go away
- Increasing confusion, agitation, or inability to recognize people or places
- Loss of consciousness or inability to stay awake
For infants and toddlers, add inconsolable crying and refusal to eat or nurse to that list. If none of these danger signs are present, you can typically manage recovery at home with guidance from a healthcare provider.
The First 24 to 48 Hours
The initial period after a concussion is about letting the brain settle. A concussion triggers a cascade of chemical and metabolic changes in the brain, and rest gives those processes time to stabilize. That doesn’t mean lying in a dark room doing absolutely nothing for days, which is outdated advice. It means pulling back from anything that makes your symptoms worse.
Limit screen time, reading, and mentally demanding tasks if they increase your headache, dizziness, or fogginess. Short periods of light activity like walking around the house are fine. Avoid driving, alcohol, and any physical activity that raises your heart rate significantly.
One common worry: is it safe to sleep? Yes. The old advice about waking someone every few hours is no longer standard. The CDC’s current guidance is to let the person sleep as usual and keep a normal bedtime routine. Preventing sleep can actually make recovery harder.
Managing Pain Safely
Headaches are the most common concussion symptom, and your choice of pain reliever matters. Acetaminophen (Tylenol) is the safe option. Aspirin and ibuprofen (Advil, Motrin) should be avoided because they thin the blood and may increase the risk of bleeding inside the skull. This is especially important in the first few days when the full extent of the injury may not be clear.
Returning to School or Work
Getting back to mental activity is a gradual process, not a switch you flip. For students, the CDC recommends short-term modifications that are removed as symptoms improve. These might include reduced homework focused only on key assignments, extra time on tests (limited to one per day), permission to wear sunglasses indoors if light is bothersome, rest breaks during the day, and a quiet space for studying or eating lunch if noise triggers symptoms.
Adults returning to work can apply similar principles: shorter days at first, fewer meetings, reduced screen time, and breaks when symptoms flare. The goal is to stay active enough to keep your routine but not so active that symptoms get worse. If a task increases your headache or mental fog, scale back and try again the next day.
The 6-Step Return to Physical Activity
Returning to exercise and sports follows a structured progression. Each step takes a minimum of 24 hours, and you only move forward if you have no new symptoms at the current step. If symptoms return, stop, rest, and drop back to the previous step.
- Step 1: Return to regular daily activities like school or work, with clearance from your healthcare provider to begin the progression.
- Step 2: Light aerobic activity only, such as 5 to 10 minutes on a stationary bike or light walking. No weight lifting.
- Step 3: Moderate activity that increases heart rate with body or head movement. Moderate jogging, brief running, and lighter-than-usual weightlifting.
- Step 4: Heavy non-contact activity like sprinting, high-intensity biking, full weightlifting routine, and sport-specific drills without contact.
- Step 5: Full practice with contact, in a controlled setting.
- Step 6: Return to competition.
At minimum, this progression takes about a week. For many people it takes longer. The key principle is that your symptoms, not a calendar, determine your pace.
What to Eat and Drink During Recovery
Your brain is healing, and what you eat can support that process. The general pattern that helps most is a diet rich in fatty fish like salmon (which provides omega-3 fatty acids that reduce brain inflammation), berries and dark leafy greens (which contain antioxidants that protect brain cells), and plenty of water. Dehydration worsens headaches and fatigue, two symptoms you’re already dealing with. A Mediterranean-style diet is a good template.
Limit caffeine and alcohol during recovery. Alcohol slows healing and can worsen cognitive symptoms. Caffeine in large amounts can disrupt the sleep your brain needs. Some clinicians also recommend supplements like vitamin D for mood and cognition support, magnesium for migraines and sleep quality, and fish oil capsules if you’re not getting enough omega-3s from food. These aren’t replacements for rest and time, but they can complement your recovery.
When Symptoms Last Longer Than Expected
Most concussion symptoms clear within days to a few weeks. But in some people, symptoms persist beyond three months. This is known as persistent post-concussive symptoms (sometimes called post-concussion syndrome), and it typically becomes apparent within the first 7 to 10 days when symptoms that should be improving simply don’t.
Lingering headaches, difficulty concentrating, irritability, sleep problems, and dizziness are the most common complaints. If your symptoms aren’t improving after several weeks, a provider can evaluate what’s driving them and tailor a treatment plan. Some people benefit from vestibular therapy for balance and dizziness, cognitive rehabilitation for memory and focus issues, or targeted treatment for mood changes. Recovery from persistent symptoms is still very possible; it just takes a more individualized approach.
Preventing the Next One
A second concussion before the first one heals is significantly more dangerous than the initial injury. The international consensus on concussion in sport, updated in 2022, emphasizes prevention strategies like rule changes that reduce collisions, neuromuscular training during warm-ups, and mouthguard use in sports like ice hockey. For everyday life, wearing seatbelts, using appropriate helmets for cycling or contact sports, and removing trip hazards at home all reduce your risk. The single most important prevention step after a concussion is completing the full return-to-activity progression before putting yourself back in situations where another head injury is possible.