If you think you’ve sustained a concussion, you may be wondering what your first steps should be in the initial hours and days after your injury.

The actions you take immediately following a head injury are critical. They can dramatically influence how quickly and successfully you recover.

Here’s a step-by-step guide for the first few hours and days after a suspected concussion:

  1. Recognize a potential concussion.
  2. Rule out dangerous red flags.
  3. Get assessed at a qualified concussion clinic.
  4. Limit strict rest—but stay lightly active.
  5. Begin an anti-inflammatory diet.
  6. Optimize your sleep hygiene.

Let’s break it down step by step!

1. Recognition of a Potential Concussion.

The first step is recognizing that a concussion may have occurred. Missing this step can lead to mismanagement or worsening of the injury.

A concussion is a trauma-induced brain dysfunction caused by a direct or indirect impact to the head or body. Symptoms often appear quickly but can sometimes emerge hours later.

Symptoms to Look For:

  • Headache, dizziness, or nausea
  • Blurred vision, sensitivity to light/noise
  • Balance problems or confusion
  • Feeling “slowed down” or “foggy”
  • Fatigue, irritability, or sadness

Observable Signs (What others might see):

  • Loss of consciousness
  • Stumbling, disorientation, or slowed movement
  • Blank stare or vacant expression
  • Vomiting or clutching the head

Tip: Tools like the Concussion Recognition Tool 6 (CRT6) and the Concussion Tracker App make identifying and monitoring concussions more effective and manageable.

Medication Warning: Avoid NSAIDs or analgesics (learn why here) in the first 48 hours, as they may mask red flag symptoms.

2. Rule out Red Flags.

The hours following a concussion are crucial for identifying red flags, which could signal a severe brain injury, like bleeding or skull fracture.

Red Flags That Require Immediate Emergency Care:

  • Neck pain/tenderness
  • Seizures, “fits,” or convulsions
  • Loss of consciousness
  • Double vision
  • Increased confusion or deteriorating conscious state (e.g., becoming less responsive/drowsy)
  • Weakness, numbness/tingling in more than one arm or leg
  • Repeated vomiting
  • Severe/increasing headache
  • Increasingly restless, agitated, or combative
  • Visible deformity of the skull

Monitor symptoms closely for the first 48 hours. If any red flags appear, head to the emergency department immediately.

3. Get Assessed at a Qualified Concussion Clinic.

Timing is everything. Research (Kontos et al., 2020) shows that early assessment—within the first 7 days—leads to faster, more complete recovery. Delays in care can prolong symptoms for months.

It’s critical to see a concussion-trained specialist, not just a general practitioner.

Find a Specialist: Use the Complete Concussions Clinic Locator to connect with a provider near you.

4. Limit Strict Rest—But Stay Lightly Active.

Gone are the days of “absolute rest” for concussion recovery. While rest is essential, too much can delay recovery (Buckley et al., 2016).

Here’s the Plan:

  • Limit complete rest to 24–48 hours post-injury.
  • Gradually reintroduce light, symptom-limited activities (e.g., short walks, reading, gentle socializing).
  • Avoid increasing symptoms by more than 2 points on a 10-point scale.

Gentle activity helps stimulate brain recovery without overloading it. Think of this as finding a healthy middle ground.

5. Begin an Anti-Inflammatory Diet.

Inflammation is part of the body’s response to injury, but excessive inflammation can delay healing—both in the brain and the gut.

Foods to Avoid:

  • Sugar, alcohol, gluten, and dairy
  • Ultra-processed foods (refined carbs, trans fats, additives)

Foods to Prioritize:

Supplements like omega-3 fatty acids, creatine, and curcumin may further support recovery—talk to your clinician for guidance.

Rule of Thumb: If it wasn’t food 100 years ago, it’s probably not food now. Choose real, whole foods.

And how about caffeine? Caffeine may be beneficial in moderate amounts. For a more in-depth discussion of caffeine and concussion, click here.

6. Optimize your Sleep.

Sleep isn’t just “rest”—it’s an active process critical to brain recovery.

Why Sleep Matters:

  • Deep Sleep: Activates the glymphatic system, clearing inflammation and waste from the brain.
  • REM Sleep: Supports neuroplasticity—the brain’s ability to reorganize and repair itself.
  • Circadian Rhythm (General): Regulates hormones, brain energy, and recovery processes.

Poor sleep worsens neuroinflammation, increases cortisol (the stress hormone), and delays recovery timelines. As neuroscientist Matthew Walker explains:

“Inadequate sleep—even moderate reductions for just one week—disrupts essential physiological processes.”

Sleep Optimization Tips:

  • Go to bed and wake up at the same time every day.
  • Avoid caffeine after noon to prevent sleep disruption.
  • Limit screens two hours before bed to boost melatonin production.
  • Exercise in the morning to enhance sleep quality.
  • Keep your bedroom cool, dark, and quiet for optimal deep sleep.

For a deeper dive into improving sleep quality, click here.

Main Takeaways.

What you do in the first hours and days after a concussion matters. Recovery depends on taking the right steps early:

  1. Recognize symptoms.
  2. Rule out red flags.
  3. Get assessed by a concussion specialist.
  4. Balance rest with light activity.
  5. Eat to reduce inflammation.
  6. Sleep like your recovery depends on it—because it does.

By following these steps, you’ll lay the groundwork for a smoother, faster recovery.

Click Here to find a concussion-trained clinician near you today!

Sources
  1. Patricios, J. S., Schneider, K. J., Dvorak, J., Ahmed, O. H., Blauwet, C., Cantu, R. C., … & Meeuwisse, W. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022. British journal of sports medicine, 57(11), 695-711.
  2. Echemendia, R. J., Ahmed, O. H., Bailey, C. M., Bruce, J. M., Burma, J. S., Davis, G. A., … & Patricios, J. S. (2023). The concussion recognition tool 6 (CRT6). British journal of sports medicine, 57(11), 692-694.
  3. Kontos AP, Jorgensen-Wagers K, Trbovich AM, et al. Association of Time Since Injury to the First Clinic Visit With Recovery Following Concussion. JAMA Neurol. 2020;77(4):435–440. doi:10.1001/jamaneurol.2019.4552
  4. Mychasiuk R, Hehar H, Ma I, Esser MJ. Dietary intake alters behavioral recovery and gene expression profiles in the brain of juvenile rats that have experienced a concussion. Front Behav Neurosci. 2015 Feb 5;9:17. doi: 10.3389/fnbeh.2015.00017. PMID: 25698949.
  5. John O’Leary, Chloé Georgeaux-Healy, Lucy Serpell, The impact of continuous calorie restriction and fasting on cognition in adults without eating disorders, Nutrition Reviews, 2024; nuad170, https://doi.org/10.1093/nutrit/nuad170 
  6. Buckley TA, Munkasy BA, Clouse BP. Acute Cognitive and Physical Rest May Not Improve Concussion Recovery Time. J Head Trauma Rehabil. 2016 Jul-Aug;31(4):233-41. doi: 10.1097/HTR.0000000000000165. PMID: 26394292; PMCID: PMC4724554.
  7. Walker, M. (2018). Why we sleep. Penguin Books.
  8. DuPrey, K. M., Char, A. S., Loose, S. R., Suffredini, M. V., Walpole, K., & Cronholm, P. F. (2022). Effect of sleep-related symptoms on recovery from a sport-related concussion. Orthopaedic Journal of Sports Medicine. Jul 15;10(7).
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