Concussion Rehabilitation in Football: What You Need to Know

Editor Carolyn Kent – Women’s Football Hub

Concussion is one of the most serious yet often misunderstood injuries in football. In our latest podcast, I had the pleasure of speaking with Dr Julia Treleaven, an expert in concussion rehabilitation, about the complexities of concussion management and recovery.

Dr Treleaven, a fellow of the Australian College of Physiotherapists and an associate professor at the University of Queensland, has over 150 publications in the field of neck dysfunction, dizziness, and post-concussion symptoms. In our conversation, she shed light on the latest research and best practices for concussion recovery, particularly in women’s football.

What Actually Happens in a Concussion?

Concussion doesn’t always result from a direct blow to the head. As Dr Treleaven explained, whiplash-type movements can also cause the brain to shift within the skull, leading to a stretching or tearing of nerve fibres. This disrupts the brain’s communication pathways, causing a range of symptoms, even though structural damage may not be visible on an MRI scan.

Signs and Symptoms: What to Look Out For

Concussion symptoms can appear immediately or develop over time. Dr Treleaven highlighted key indicators that players, coaches, and medical staff should be aware of:

✅ Loss of consciousness (though this is not always present)

✅ Slow to get up or stumbling after a hit

✅ Headaches, dizziness, and visual disturbances

✅ Memory loss or confusion

✅ Sensitivity to light or noise

Given these symptoms, the advice remains clear: If in doubt, sit them out.

Are There Differences Between Male and Female Athletes?

Research suggests that female athletes tend to experience more prolonged symptoms following a concussion. This could be due to differences in neck strength, hormonal influences, or simply because women are more likely to report symptoms than men. Understanding these differences is essential in tailoring rehabilitation programmes for female footballers.

The Evolution of Concussion Rehabilitation

Previously, concussion treatment often involved complete rest in a dark room. However, Dr Treleaven emphasised that early, sub-symptom aerobic exercise can significantly improve recovery times. Current best practices include:

🔹 24 hours of relative rest (engaging in light, non-exacerbating activities)

🔹 Gradual reintroduction of aerobic exercise to support brain recovery

🔹 Cervical (neck) and vestibular (balance) rehabilitation if necessary

🔹 Structured return-to-play protocols, following sport-specific guidelines

In England, for example, the return-to-play process has been extended to 21 days to better protect players from repeat injuries.

Long-Term Brain Health & Repeated Concussions

One of the most concerning aspects of concussion is the potential long-term impact on brain health. While research is ongoing, studies suggest that repeated concussions—especially those sustained in a short timeframe—can increase the risk of chronic neurological conditions.

Alarmingly, footballers who have suffered a concussion are also at a 50% increased risk of lower limb injuries such as ACL tears and ankle sprains. This highlights the importance of thorough rehabilitation before returning to play.

Key Takeaways for Players and Coaches

🔹 Recognise the symptoms – Concussions aren’t always obvious, so be vigilant.
🔹 Don’t rush recovery – Follow evidence-based rehab strategies, including early aerobic exercise.
🔹 Neck and balance training matter – Strengthening these systems can aid in recovery and injury prevention.
🔹 Use screening tools – The Vestibular Ocular Motor Screen (VOMS) and Buffalo Concussion Treadmill Test can help assess recovery readiness.
🔹 Listen to your body – Returning to play too soon increases the risk of further injury.

Final Thought: The Future of Concussion Research

Concussion management in football is evolving rapidly, with governing bodies like FIFA launching awareness campaigns to improve player safety. While we may not have all the answers yet, one thing is clear: education and evidence-based rehabilitation are key to protecting athletes from long-term consequences.

If you’re a student or clinician interested in concussion rehabilitation, Dr Treleaven recommends exploring resources such as Headway UK and Parachute Canada, which provide up-to-date guidelines and support.

For more expert insights on injury prevention and rehabilitation in women’s football, stay tuned to Women’s Football Hub.

🎧 Listen to the full podcast episode here
📢 Join the conversation! Have you experienced concussion in football? Share your thoughts in the comments.

#WFHPodcast #WomensFootball #ConcussionAwareness #FootballSafety

This blog was made with assistance by AI but checked and edited by an academic.

Reference:
OpenAI. (2025). ChatGPT [Large language model]. Available at: https://openai.com/chatgpt [Accessed 2 March 2025].

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