Optimizing Post-Concussion Recovery in High School Athletes

Despite growing awareness, concussions continue to sideline high school athletes without a clear roadmap for recovery beyond rest. It is estimated that between 1.1 and 1.9 million sports- and recreation-related concussions occur annually among U.S. children aged ≤18 years. Coaches, athletic trainers, and school administrators have made tremendous strides in recognizing symptoms early and implementing return-to-play protocols. But a critical piece is missing from most protocols: targeted nutritional strategies that support the brain’s healing process as repeated or mismanaged injuries can have lifelong impacts on mental health, cognition, and overall well-being. Early nutritional intervention, medical oversight, and return-to-play protocols are essential not only to support physical recovery, but also to protect long-term brain health and to reduce the risk of repeat injuries.

As a registered dietitian and parent of a teen athlete in lacrosse—a sport with one of the highest concussion risks in youth sports—I bring both personal and professional insight to this topic. In my clinical practice, I work with individuals experiencing ADHD, depression, and anxiety—conditions where cognitive function, focus, and emotional regulation are often impacted. There are some similarities we can draw when talking nutrition. While nutrition isn’t a cure, I’ve seen how it can meaningfully support brain health, reduce inflammation, and help individuals function more effectively. But they need assistance. Just as after a concussion, young athletes may struggle to care for themselves or meet their basic nutritional needs. This is where the guidance of parents, coaches, and school staff becomes essential. My role is to equip your athlete or team with practical, evidence-based strategies that help support full and sustained recovery.

The Role of Nutrition in Brain Injury Recovery

Emerging evidence suggests that certain nutrients may help modulate the physiological cascade that occurs after a mild traumatic brain injury (mTBI). This includes inflammation, oxidative stress, mitochondrial dysfunction, and disruptions in cerebral blood flow and energy metabolism. Nutritional support during this window may provide a low-risk, high-reward adjunct to traditional concussion management.

Omega-3 Fatty Acids: Neuroprotection from the Inside Out

One of the most promising areas of research centers on omega-3 fatty acids—specifically docosahexaenoic acid (DHA)and eicosapentaenoic acid (EPA).

In a randomized controlled trial involving NCAA football players, daily DHA supplementation helped reduce levels of neurofilament light (NFL), a blood biomarker linked to axonal injury.¹ Another study supplementing athletes with both DHA and EPA found similar reductions in markers of neuronal damage.² These findings support the idea that omega-3s may help protect the brain from repeated sub-concussive impacts and promote resilience post-injury.

Yet, in a cross-sectional analysis of over 400 collegiate football players, none met optimal levels of omega-3 in their blood,³ suggesting that dietary intake alone may be insufficient to meet the brain’s needs—especially in high-impact sports.

Creatine: More Than Muscle Support

While creatine is commonly associated with muscle energy and strength gains, it also supports neuronal energy metabolism, particularly after trauma. When brain cells are injured, they struggle to meet energy demands. Creatine has been shown to help maintain ATP levels and may reduce oxidative stress—both key concerns following a concussion.

In athletic populations, creatine supplementation has been linked to reduced injury incidence and muscle cramping, including in studies involving football players.⁴

Sleep, Stress, and Symptom Resolution

Sleep disruption is a common and frustrating post-concussion symptom. Interventions like magnesium and melatonin, when used under supervision, may help regulate circadian rhythms and support cognitive recovery. Magnesium also plays a critical role in neurotransmission and neuroplasticity—both vital during the healing process.

Addressing nutrient gaps like vitamin D, B-complex vitamins, and magnesium is essential not just for symptom resolution but also for long-term neurological health.

Beyond Rest: The Case for a Comprehensive Recovery Protocol

While we often focus on return-to-play benchmarks, recovery doesn’t stop when the athlete is symptom-free. The brain requires time, fuel, and support to return to full function. Targeted nutrition—integrated into a broader post-concussion plan—can enhance healing, reduce the risk of prolonged symptoms, and potentially improve outcomes after future head impacts.

As a practitioner who has developed protocols for athletes, I’ve seen the difference that science-based supplementation and dietary support can make.

Let’s Partner for Safer Recovery

If you’re a parent, an athletic trainer, coach, or athletic director looking to implement evidence-based, individualized nutrition support for your athletes post-concussion—or even proactively during the season—I’d love to collaborate.

Whether you’re exploring supplements, lab testing, or educational resources for families, I can help design a plan that fits your athletes’ needs and aligns with existing return-to-play protocols.

References

1. Oliver, J. M. et al. (2016). Effect of DHA on biomarkers of axonal injury in American football athletes: A randomized controlled trial. PubMed
2. Heileson, J. L. et al. (2022). DHA and EPA supplementation reduce serum neurofilament light in football athletes.PMC
3. Ritz, P. et al. (2019). Omega-3 Index in 404 collegiate football players: implications for health. PubMed
4. Kreider, R. B. et al. (2003). Creatine supplementation reduces muscle cramping and injury incidence in collegiate football players. PubMed