Concussion Treatment: What Parents Need to Know About Youth Sports Head Injuries

The hit looked routine. Your son went up for a header in the second half, landed awkwardly, and jogged off the field on his own. He said he was fine. But something looked a little off, and by the time you got to the car, he had a headache. Two days later, he is still not quite himself, and you are not sure what to do or who to call.

That uncertainty is one of the hardest parts of navigating a youth concussion. Parents are often working with incomplete information, reassurance from a child who wants to keep playing, and a coach who does not have the training to make a clinical call. Northwest Primary Care’s sports medicine team evaluates and manages concussions for youth athletes across the Portland area. This guide covers what a concussion actually looks like, what recovery involves, and when a formal evaluation is the right next step. To schedule an evaluation, call our scheduling team at 503.659.4988.

Key Takeaways

Here is a brief overview of what follows:

• Concussion symptoms are not always obvious right away. Some develop over hours, not immediately on the field. Knowing the full range of signs helps you catch what is easy to miss.
• Returning to play too soon carries real risk. A second impact before the brain has fully recovered can be significantly more serious than the first injury. Return-to-play decisions should always involve a provider.
• Oregon requires written provider clearance. Any athlete under 18 removed from play with a suspected concussion must be cleared by a licensed healthcare provider before returning, regardless of age or sport.
• Most youth concussions resolve within a few weeks. Recovery looks different at different ages, and there is a lot providers can do to support it.
• You do not need to wait until symptoms are severe to be seen. If something seems wrong after a head impact, getting an evaluation is the right call.

Ready to be seen? Call 503.659.4988 to schedule a concussion evaluation at Northwest Primary Care.

What a Concussion Is

A concussion is a traumatic brain injury caused by a bump, blow, or jolt to the head or body that makes the brain move rapidly inside the skull. It does not require a loss of consciousness. Most concussions in youth athletes do not involve blacking out at all, which is one reason they go unrecognized as often as they do.

The injury disrupts normal brain cell function in ways that are functional rather than structural. That means a concussion typically does not appear on a standard CT scan or MRI. A normal imaging result does not mean nothing happened. What you can observe are the effects of that disruption: headaches, difficulty concentrating, sensitivity to light and sound, balance problems, sleep changes, and mood shifts.

Recognizing Symptoms in Youth Athletes

Most parents focus on the most dramatic signs, such as vomiting, confusion, or losing consciousness. Those are genuine emergencies and covered later in this post. But the symptoms that follow in the days after a concussion are often subtler and easy to attribute to something else.

Watch for headaches that do not go away or that are brought on by activity. Fatigue that seems out of proportion. Difficulty remembering things from before or after the impact. Trouble concentrating in school. Feeling foggy or slow. Irritability or unusual sadness. Sensitivity to screens or noise. Sleep patterns that are notably off in either direction.

In adolescents, emotional symptoms like low mood, anxiety, or feeling “not like themselves” are commonly reported alongside physical ones. These are real parts of the injury. If your child seems off after a head impact, that observation matters. You know their baseline better than anyone, and a provider can do the clinical piece from there.

Why Returning Too Soon Is Dangerous

Maya was 14 and playing competitive soccer. She took a head impact during a tournament on Saturday and reported a headache that evening. By Monday she felt better, and by Wednesday she was telling her parents she was completely fine. She wanted to play in the regional qualifier that weekend.

Her parents brought her in for a formal evaluation before letting her return to the field.

The evaluation found she was still in the early recovery phase. Her processing speed and reaction time had not returned to her personal baseline. She sat out that weekend and returned to play the following week after provider clearance.

That decision mattered. Return-to-play protocols exist because of a condition called second impact syndrome. If an athlete sustains a second concussion before the first has fully healed, the consequences can be significantly worse than the original injury. The risk is highest in the first weeks after the initial impact, exactly when many young athletes are feeling well enough to want to be back at practice. Feeling fine is a meaningful first step. It is not the same as being ready.

Oregon’s Return-to-Play Law

Oregon’s Concussion Law requires that any athlete under 18 suspected of having a concussion be removed from play immediately and not return until evaluated and cleared in writing by a licensed healthcare provider. This applies to all youth sports, school-based and club alike.

Coaches are required to complete annual concussion training. Schools must have a return-to-play protocol on file. If your child’s coach or school is asking for written clearance before returning to sports, that is exactly what the law requires, and it reflects what research has consistently shown about the vulnerability of the developing brain.

NWPC providers can conduct the evaluation, document the recovery process, and provide the written clearance your athlete’s program needs.

What to Expect at an NWPC Evaluation

A concussion evaluation at Northwest Primary Care begins with a thorough review of the injury and how symptoms have evolved since. The provider will ask about the mechanism of impact, what happened immediately afterward, and how your child has been doing in school and in daily activities. Prior concussion history is always reviewed carefully.

The clinical assessment typically includes balance and coordination testing along with cognitive screening to evaluate memory, processing, and attention. For athletes whose recovery is not progressing as expected, additional evaluation may be recommended.

If your child is dealing with balance problems, headaches triggered by movement, or physical symptoms affecting daily function, Northwest Therapy is available within the same practice for vestibular rehabilitation and post-concussion physical therapy support. That coordination happens within a shared electronic health record, so nothing needs to be explained twice or hand-carried between offices.

For families already established at NWPC through pediatric and adolescent care or family medicine, the concussion evaluation can be coordinated within the same care team that already knows your child’s history. A provider who has seen your child over several years has a much clearer baseline to work from during recovery.

The Return-to-Play Protocol

Recovery from a concussion follows a stepwise process. The goal is to gradually reintroduce physical demand while monitoring for any return of symptoms. Full-contact sport comes at the end of that progression, not the beginning.

The protocol moves through phases: rest, then light aerobic activity with no head impact risk, then sport-specific exercise, non-contact drills, full-contact practice with medical clearance, and finally return to competition. Each phase requires the athlete to remain symptom-free before moving forward.

A straightforward first concussion in a teenager who gets prompt evaluation and appropriate rest often resolves within two to four weeks. If school accommodations are needed during recovery, such as reduced screen time or modified testing, NWPC providers can document the injury and supply the information schools typically require to make those adjustments.

When to Go to the Emergency Room

Some symptoms after a head impact require emergency care, not a scheduled appointment. Call 911 or go to an emergency room immediately if your child loses consciousness, has a seizure, vomits repeatedly, develops a severe headache that keeps worsening, shows significant confusion or disorientation, cannot recognize familiar people, or develops weakness or numbness in their arms or legs.

These are signs of a potentially serious brain injury. They are distinct from a typical concussion presentation, and they should not be managed with a wait-and-see approach.

For everything that does not meet that threshold but still concerns you, scheduling an evaluation is the right move. You do not need to be certain a concussion occurred to come in. Call our scheduling team at 503.659.4988 or visit the clinic locations page to find the Northwest Primary Care location nearest to you.

Frequently Asked Questions

How do I know if my child’s headache after a hit is a concussion?

A headache following a blow to the head or body should be taken seriously, especially if it comes with other symptoms like nausea, light sensitivity, difficulty concentrating, or unusual fatigue. If the headache persists, worsens, or additional symptoms appear in the hours or days after the impact, schedule an evaluation with a sports medicine or primary care provider.

Does my child need to go to the ER for a concussion?

Most concussions do not require emergency care. Emergency evaluation is appropriate if your child loses consciousness, has a seizure, vomits repeatedly, develops a severe or worsening headache, or shows signs of significant confusion. For a typical concussion presentation, a scheduled evaluation with a sports medicine or primary care provider is the appropriate starting point.

How long does concussion recovery take in youth athletes?

Most first concussions in adolescents resolve within two to four weeks with appropriate rest and a gradual return to activity. Younger children sometimes take longer than older teens. Recovery tends to be extended for athletes who have had multiple concussions, who return to activity before they are ready, or who have other factors affecting healing. Your child’s provider can give you a more specific timeline after evaluation.

Can my child go to school during concussion recovery?

In most cases, yes, though modifications are often necessary. Attending school is appropriate during recovery as long as it does not significantly worsen symptoms. Accommodations like reduced screen time, extra time on assignments, a quieter environment, and a lighter workload are common. NWPC providers can document the injury and provide the information your child’s school needs to put those adjustments in place.

Does clearance have to come from a sports medicine specialist, or can a primary care provider sign off?

Oregon’s law requires clearance from a licensed healthcare provider, which includes primary care and family medicine providers, not only sports medicine specialists. For most straightforward concussions, a primary care provider familiar with return-to-play protocols can evaluate and provide written clearance. Sports medicine involvement is particularly helpful for athletes with complicated presentations, a history of multiple concussions, or a recovery that is not progressing as expected.