How soon after a concussion can you safely fly?

Flying After Concussion: Timing Recommendations

You can safely fly after a concussion once you are completely asymptomatic at rest, which typically occurs within 7-10 days for most individuals, though flying within the first 72 hours after injury does not appear to worsen outcomes based on recent evidence.

Evidence-Based Timeline

Immediate Post-Injury Period (0-72 Hours)

• Flying within 72 hours after concussion is not associated with delayed recovery or worsened symptoms according to a 2020 study of collegiate athletes and military cadets that directly examined this question 1
• The study found no significant differences in time to return to activity, return to school, or symptom resolution between those who flew within 72 hours and those who did not fly 1
• Symptom severity and headache scores were also equivalent between groups 1

Conservative Approach Based on Activity Guidelines

• All individuals with concussion should have complete physical and cognitive rest until asymptomatic at rest, which typically takes 24-48 hours initially 2
• The vast majority of concussed individuals become asymptomatic within 7 days, though cognitive recovery may take 7-10 days or longer, particularly in younger individuals 2
• No physical exertion should occur until the person is asymptomatic at rest 2

Practical Algorithm for Flight Clearance

Step 1: Assess Symptom Status

• If completely asymptomatic at rest: Flying is safe based on available evidence 1
• If any symptoms persist: Delay flying until symptoms resolve to avoid potential exacerbation from travel-related stressors

Step 2: Consider Individual Risk Factors

• Amnesia at time of injury: These individuals had markedly greater deficits and slower recovery trajectories, suggesting more conservative management 3
• Multiple prior concussions: May warrant additional caution, though most still recover within normal timelines 3
• Delayed symptom reporting: Associated with prolonged recovery (average 4.9 additional days), indicating need for more conservative approach 4

Step 3: Timing Considerations

• Optimal timing: Wait until asymptomatic at rest (typically 7-10 days for most individuals) 2, 5
• Minimum safe window: Evidence suggests flying within 72 hours does not worsen outcomes, but this should be reserved for necessary travel only 1
• Most conservative approach: Wait until completion of initial rest period and beginning of light aerobic activity phase (after 24-48 hours of being asymptomatic) 2, 6

Important Caveats and Pitfalls

Travel-Related Stressors to Consider

• Cabin pressure changes and low humidity can cause physiological stress, though the 2020 study found no evidence this worsens concussion outcomes 1
• Physical exertion from travel (carrying luggage, rushing through airports) should be minimized if flying while still symptomatic 2
• Psychological stress from travel complications may exacerbate symptoms 2

Common Mistakes to Avoid

• Do not fly if taking medications to mask concussion symptoms, as this may hide worsening symptoms during travel 2
• Avoid strict prolonged rest beyond initial 24-48 hours, as this may actually worsen outcomes 6
• Do not resume any athletic activity on the same day as injury, regardless of symptom resolution 2, 7

Special Populations

Pediatric and Adolescent Patients

• Require more conservative management with longer cognitive recovery periods (7-10 days or longer) compared to adults 2
• Should wait until completely asymptomatic before flying for non-essential travel 2

Athletes with Multiple Concussions

• May require longer recovery periods and more conservative flight timing decisions 7
• Should be managed by healthcare professionals experienced in concussion management 2

Bottom Line for Clinical Practice

While research demonstrates that flying within 72 hours after concussion does not worsen outcomes 1, the safest approach is to wait until completely asymptomatic at rest before flying, which typically occurs within 7-10 days 2, 5. For essential travel requiring earlier flights, the evidence suggests this can be done safely within the first 72 hours 1, but travelers should minimize physical exertion, avoid symptom-masking medications, and have contingency plans for medical care at their destination.