If you or someone near you just had a concussion, the most important first step is to stop whatever activity caused it and rest for the first 24 to 48 hours. Most concussions heal on their own within one to two weeks, but how you handle the first few days makes a real difference in recovery time. Here’s what to do, what to avoid, and what to watch for.
Know the Emergency Warning Signs
Most concussions don’t require a trip to the emergency room, but some head injuries cause bleeding or swelling in the brain that needs immediate treatment. Call 911 or go to the nearest emergency department if you notice any of these after a bump, blow, or jolt to the head:
- Seizures or shaking
- Repeated vomiting
- A headache that keeps getting worse and won’t go away
- Slurred speech, weakness, numbness, or loss of coordination
- One pupil larger than the other, or double vision
- Increasing confusion, agitation, or inability to recognize people or places
- Loss of consciousness, extreme drowsiness, or inability to stay awake
If the person is an infant or toddler, also watch for inconsolable crying or refusal to eat or nurse. These signs can appear within minutes or develop over hours, so keep a close eye on things for the first day or two.
The First 48 Hours
The old advice was to lie in a dark room and do nothing for days. That’s no longer the recommendation. Current guidelines call for a brief period of relative rest, not total shutdown. You don’t need to stay in bed, but you should avoid anything physically or mentally demanding for the first couple of days.
Limit screen time during this window. A study published in The Journal of Pediatrics found that people who used screens freely after a concussion took a median of 8 days to recover, compared to 3.5 days for those who avoided screens for the first 48 hours. That’s a meaningful difference for something easy to control. You don’t need to ban all screens permanently, but minimizing phones, computers, and TV for two days gives your brain a better shot at a faster recovery.
Light activities like short walks, gentle stretching, or quiet conversation are fine and even helpful. The goal is to avoid things that spike your heart rate or require intense concentration.
Sleep Normally
You may have heard that you should wake a concussed person every few hours to check on them. This is largely outdated. The CDC’s current guidance is straightforward: let the person sleep as usual. Keep a normal bedtime routine. Don’t prevent them from sleeping, and don’t use sleep medications unless a doctor specifically recommends them.
Sleep is when the brain does its repair work, so interrupting it can actually slow recovery. The exception: if the person showed any of the emergency warning signs listed above before falling asleep, get medical help rather than waiting to see how they are in the morning.
Managing Pain Safely
Headaches are one of the most common concussion symptoms, and you’ll want relief. For the first 48 hours, stick with acetaminophen (Tylenol). Avoid ibuprofen (Advil, Motrin) and aspirin during that initial period because they thin the blood slightly. If the concussion caused any minor bleeding in the brain, a blood thinner could make it worse.
After 48 hours, both acetaminophen and ibuprofen are generally safe to use for concussion headaches. If your headaches are severe or aren’t responding to over-the-counter options, that’s worth bringing up with your doctor.
Eating and Drinking for Recovery
Nausea is common after a concussion, which can make eating feel unappealing. Rather than forcing three full meals, try eating small amounts every two to three hours throughout the day. Don’t skip meals, especially breakfast. Your brain burns a lot of energy during healing, and going without fuel slows the process.
Hydration matters more than usual. Drink fluids throughout the day rather than waiting until you’re thirsty. If plain water doesn’t sit well, add lemon or lime, or get your fluids through smoothies and water-rich fruits and vegetables. Trail mix with nuts, dried fruit, and dark chocolate makes a good recovery snack that’s easy on the stomach and calorie-dense.
Getting Back to School or Work
Most people can return to school or desk work within one to two days of a concussion, though they may need adjustments. Trying to power through a full workload while symptomatic tends to make symptoms worse and drag out recovery.
If you’re a student or a parent of one, practical accommodations make a big difference:
- Reduce assignments to key tasks only, with extra time for completion
- Limit tests to one per day and provide study guides
- Allow rest breaks and visits to the nurse for headache management
- Permit sunglasses indoors or seating away from bright windows if light is bothersome
- Provide a quiet space for studying, testing, or lunch if noise triggers symptoms
- Allow extra time between classes to avoid crowded hallways
For adults returning to work, the same principles apply. Start with shorter days or reduced responsibilities, and increase your workload gradually as symptoms improve. If reading a screen or concentrating on a task makes your headache spike, that’s your brain telling you to take a break.
Returning to Exercise and Sports
Physical activity needs to come back in stages. The widely used return-to-play protocol has six steps, and each step takes a minimum of 24 hours. If symptoms return at any step, you stop, rest, and drop back to the previous level.
- Step 1: Return to normal daily activities like school or work, with no symptoms
- Step 2: Light aerobic activity only. Think 5 to 10 minutes on a stationary bike, walking, or light jogging. No weight lifting.
- Step 3: Moderate activity that involves more head and body movement. Moderate jogging, brief running, lighter-than-usual weight lifting.
- Step 4: Heavy non-contact activity. Sprinting, high-intensity biking, your normal weight lifting routine, sport-specific drills without contact.
- Step 5: Full practice with contact, in a controlled setting
- Step 6: Return to competition
The key rule: you need clearance from a healthcare provider before starting this progression, and you only move forward if you’re symptom-free at your current step. Rushing back too soon is one of the most common mistakes, and it carries real risks. A second concussion before the first one heals can cause severe, sometimes permanent brain injury.
When Recovery Takes Longer Than Expected
Most concussions resolve within two to four weeks. But some people develop what’s called persistent post-concussive symptoms, where problems linger for three months or longer, and occasionally for a year or more. These symptoms typically appear within the first 7 to 10 days after injury and can include headaches, dizziness, fatigue, trouble sleeping, poor concentration and memory, irritability, anxiety, depression, blurry vision, ringing in the ears, and sensitivity to noise and light.
The severity of the original concussion doesn’t always predict who develops persistent symptoms. If you’re still dealing with any of these issues beyond three or four weeks, it’s worth getting a more thorough evaluation. Targeted treatments exist for specific lingering symptoms, including vestibular therapy for dizziness and supervised exercise programs for persistent headaches. Recovery is still very much possible. It just takes a more structured approach.