Are children at higher risk from brain injury in sport?
Yes. Children are more vulnerable to brain injury in sport because their brains are still developing. During childhood and adolescence, the brain is still forming and refining the networks that support learning, memory, movement, attention, behaviour and emotional regulation. In youth sport, children are exposed to repeated sub-concussive impacts that produce no visible symptoms but still transmit rotational forces to the brain. The best risk mitigation is to reduce the transmission of rotational forces to the brain.
Children are not small adults
Their brains are still developing. During childhood and adolescence, the brain is forming and refining the pathways that support learning, memory, movement, attention, emotional regulation and decision-making. Central nervous system development continues through processes such as cell migration, differentiation and myelination, and continues into the mid-20s [1].
This matters across youth sport. A child will experience head impacts through tackles, heading, falls, collisions, ball strikes or accidental contact. A child playing rugby or AFL, for example, will be exposed to collision and tackle forces before their neck strength, anticipation and motor control are fully developed. They will be exposed to repeated sub-concussive head impacts, which are 500 times more frequent than concussions, but which still damage the brain [2].
A developing brain is more vulnerable to mechanical forces because the structures and networks that support cognition, behaviour and movement are still maturing.
So when a child experiences a head impact, the concern is not only whether they show signs of concussion. The concern is how much rotational force has been transmitted to a developing brain. That is why headguards for kids should focus on reducing the transmission of rotational forces.
The developing brain is more vulnerable to rotational forces
The important factor in head impacts in sport is not what happens to the surface of the head, but what happens to the brain inside the skull.
The brain sits inside the skull, surrounded by fluid. When the head accelerates or rotates rapidly during a head impact, the brain moves and deforms. Rotational forces are especially important because they create shear strain across brain tissue, disrupt neural networks, affect small blood vessels and contribute to neuro-inflammatory processes.
For children, this matters even more because the brain is still developing.
And it’s not just concussion that matters. A smaller-force, sub-concussive, head impact that appears minor still transmits rotational forces to the brain. And because children are still developing the pathways that support learning, attention, emotional regulation and decision-making, the consequences of repeated exposure matter far beyond the playing field.
In sport it is important to look beyond isolated concussion events and consider also the cumulative damage from sub-concussions.
Why visible symptoms do not tell the whole story
Symptoms matter. But symptoms are not the whole injury.
The CDC notes that concussion signs and symptoms may not appear immediately and can take hours or days to be noticed [4]. It also notes that concussion can be harder to spot in young children and in children who cannot easily communicate how they feel [4]. The recovery from concussion symptoms also does not mean the brain has fully recovered.
For parents, teachers and coaches, this creates a serious problem. Recognising and reacting to concussion symptoms alone is not enough.
The end of symptoms does not always mean the end of brain vulnerability. Evidence from athlete imaging studies suggests that brain changes can persist after clinical recovery and return-to-play clearance. A 2025 Neurology study reported persistent post-concussion changes in cerebral blood flow and white matter at return to play and up to one year later [5].
For children, that distinction matters even more because the brain is still developing.
The brain remains vulnerable long after symptoms improve
For many children, concussion symptoms improve within weeks. But not all recovery is visible.
The CDC states that most children with concussion feel better within 2–4 weeks, but some children experience symptoms affecting behaviour, mood, memory or emotions for months or longer [6]. The Canadian Paediatric Society also states that most children and youth recover within four weeks, while some experience prolonged symptoms, and identifies risk factors including high initial symptom burden, mental health issues, cervical injury, ocular dysfunction, age under 18 and female sex [7].
But symptom duration is only one part of the issue.
The more important point for youth sport is this: A child’s brain may still be vulnerable even after obvious symptoms improve, and is always vulnerable to sub-concussive impacts that produce no symptoms at all.
Brain protection in youth sport is not as simple as return to play protocols; it also needs to address rotational force transmission in head impacts that are ‘just part of the game’.
Parent Testimonial: Returning to field hockey after a serious concussion, which left Aaron unable to sit his GCSE exams.
Why brain protection must start in youth sport
One of the most important facts in youth brain protection is that we do not know which children will go on to face higher long-term risk.
We do not know which children may have genetic risk factors that increase vulnerability to brain injury or neurodegenerative disease. We do not know which children will continue into higher-contact sport as teenagers, students or adults. We do not know who will play rugby, football, hockey or other head-impact sports for years and accumulate a lifetime of sub-concussive exposure.
That uncertainty is exactly why brain protection must start early.
Youth sport is the beginning of exposure, not the end of the risk story.
If a child continues playing contact or collision sport, the impacts they experience at 8, 10 or 12 may become part of a cumulative lifetime dose. Boston University’s CTE Center describes chronic traumatic encephalopathy as a progressive degenerative brain disease found in people with a history of repetitive head impacts, including both symptomatic concussions and non-concussive hits that do not cause symptoms [8].
This does not mean every child who plays sport will develop CTE. It means repeated head impacts are not irrelevant simply because they are spread across time.
Brain protection should begin before a child has a diagnosed concussion, not after.
Schools and clubs have a duty of care beyond protocols
Schools and clubs cannot outsource brain protection to concussion protocols alone.
Protocols are essential, but they depend on a suspected injury being noticed, reported and acted on. That is a limitation in children’s sport, where symptoms may be delayed, children may struggle to describe how they feel, and sub-concussive impacts may produce no obvious symptoms at all.
A stronger duty-of-care approach should ask not only whether a child was removed after a suspected concussion, but whether reasonable steps were taken to reduce exposure to the forces that create risk in the first place.
For schools and clubs, that means brain protection should include education, recognition, return-to-learn support, sensible exposure management and protective equipment designed to reduce rotational force transmission to the brain.
Concussion protocols are not enough
Concussion protocols are essential.
They help adults recognise suspected concussion, remove a child from play, seek medical assessment and manage return-to-learn and return-to-sport decisions.
But a concussion protocol is not the same as brain protection. It is a response system.
Parachute Canada’s Canadian Guideline on Concussion in Sport covers education, head injury recognition, onsite medical assessment, medical assessment, concussion management, interdisciplinary care and return to sport [9]. These steps are important, but they operate around suspected or diagnosed concussion.
For children, this distinction is critical.
A protocol can help after suspected injury. Brain protection must also reduce the forces that reach the developing brain before injury is diagnosed.
“Rezon Halos® reduces the cumulative dose of sub-concussive impacts to the brain in contact sports. Sub-concussive impacts are the primary cause of Chronic Traumatic Encephalopathy (CTE), today’s most feared complication of rugby, football and other contact sports.”
Dr Emer MacSweeney, Consultant Neuroradiologist and co-founder of Re:Cognition Health, is part of Rezon’s expert team.
The best mitigation is to reduce rotational force transmission to the brain
The central issue in youth sport is not only whether concussion is recognised after it happens. It is whether enough is being done to reduce the rotational forces transmitted to the developing brain during impact.
Protocols are essential, but they begin after suspected injury. Conventional head protection can reduce superficial injury, but it was not designed primarily to protect the brain from rotational forces. The most direct mitigation is to reduce the forces that reach the brain in the first place. That is the purpose of Rezon Halos®.
Rezon Halos® use patented Rotection® technology and are designed to reduce rotational force transmission to the brain. Rezon’s product testing states that Halos® reduce rotational acceleration by up to 61% in head-to-head impacts, carry a Virginia Tech 5-Star safety rating, and showed a 74% reduction in concussion risk using Virginia Tech methodology. Rezon also states that Halos® are the first and only CE/UKCA Category II PPE-certified protective headband [12].
For children’s sport, this distinction matters.
A protocol can help after suspected concussion. A conventional headguard may reduce cuts or abrasions. But brain protection must focus on the mechanical problem: reducing rotational force transmission to the brain.
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Frequently Asked Questions
- Principles of Pediatric Environmental Health: Why Do a Child’s Age and Developmental Stage Affect Physiological Susceptibility to Toxic Substances? CDC/ATSDR.
- What are sub-concussions? Further Reading. Rezon.
- Subconcussive Head Impact Exposure and White Matter Tract Changes over a Single Season of Youth Football. Bahrami N, Sharma D, Rosenthal S, et al. Radiology. 2016.
- Signs and Symptoms of Concussion. CDC HEADS UP.
- Post-Concussion Brain Changes Relative to Pre-Injury White Matter and Cerebral Blood Flow: A Prospective Observational Study. Churchill NW, et al. Neurology. 2025.
- What to Do After a Concussion. CDC HEADS UP.
- Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications. Canadian Paediatric Society.
- Frequently Asked Questions About CTE. Boston University CTE Center.
- Canadian Guideline on Concussion in Sport. Parachute Canada.
- What does sport governing body approval mean? Further Reading. Rezon.
- Rezon’s Expert Team.
- Product Testing. Further Reading. Rezon.
- Incidence of Sports-Related Concussion among Youth Football Players Aged 8–12 Years. Kontos AP, Elbin RJ, Fazio-Sumrock VC, et al. Journal of Pediatrics. 2013
