Return to Play for Children with Headaches in Football

Assessment and Initial Management

A child with headaches should not return to playing football until the headaches have completely resolved both at rest and with exertion, followed by a stepwise return-to-play protocol that takes a minimum of 5 days, as recommended by the American Academy of Pediatrics 1, 2, 3
Any child with headaches potentially related to head trauma should be immediately removed from play and evaluated by a healthcare professional experienced in concussion management, according to the American Academy of Pediatrics 4

The American Academy of Pediatrics recommends a structured, stepwise return-to-play protocol, which includes:

Each stage of the return-to-play protocol must last a minimum of 24 hours, requiring at least 5 days to complete the full protocol, as recommended by the American Academy of Pediatrics 1, 3
If headaches or any symptoms return during any stage, the athlete must stop activity immediately, according to the American Academy of Pediatrics 1, 3
Once asymptomatic for at least 24 hours, the athlete should return to the previous asymptomatic stage and attempt to progress again, as recommended by the American Academy of Pediatrics 1, 3
Pediatric and adolescent athletes typically have longer recovery times than college or professional athletes, often requiring 7-10 days or longer, according to the American Academy of Pediatrics 2

Any child with headaches potentially related to concussion must be evaluated and cleared by a healthcare professional before returning to play, as recommended by the American Academy of Pediatrics 5
Medical clearance should only be given when the athlete is completely asymptomatic both at rest and with exertion, according to the American Academy of Pediatrics 5

Athletes with multiple concussions or prolonged symptoms may require a longer rehabilitation program, as recommended by the American Academy of Pediatrics 3, 6
Consider retirement from contact sports for athletes with history of multiple concussions or prolonged symptoms, according to the American Academy of Pediatrics 5