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Sports concussion — USMLE Step 3 MCQ

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HardPediatrics (Well-child / Chronic Management)Sports concussionUSMLE Step 3

A 17-year-old soccer player is seen 4 days after a concussion. Headache is now mild, but a full school day still worsens concentration and photophobia. Neurologic examination is normal, and there are no danger signs. His team begins contact practice tomorrow, and he asks to participate. Which plan is most appropriate?

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Correct answer: D — Use symptom-limited return to school first, then begin the supervised stepwise return-to-sport progression

The best answer is “Use symptom-limited return to school first, then begin the supervised stepwise return-to-sport progression”. Prolonged strict rest can delay recovery. He should resume regular nonsport activities with symptom-guided school accommodations, but sport still risks a second head injury. CDC guidance places return to regular activities, including school, before the graduated return-to-sport sequence. Each sport step takes at least 24 hours and is advanced only without new symptoms under clinical supervision.

Reference: CDC HEADS UP: Returning to Sports: https://www.cdc.gov/heads-up/guidelines/returning-to-sports.html