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Return to Play after Concussion

1. Return to play on the same day of injury:

  • Any athlete who exhibits signs or symptoms of concussion lasting more than 15 minutes, had any loss of consciousness, or has abnormal cognitive testing, WILL NOT be allowed to return to play the day of the injury.
  • Any athlete who denies symptoms but has abnormal cognitive testing will also be held out.
  • When in doubt, hold the athlete out!

2. Return to play after concussion:

  • The athlete must meet all of the following criteria:
    • Asymptomatic at rest and with progressive exertion (including mental exertion in school) for at least 7 days AND:
    • Have written clearance from primary care physician or specialist (not an Emergency Room/Urgent Care physician)

3. If there is a discrepancy between the physician’s medical release to play and the school’s policy, the school’s physician will have the final say.

4. Once the above criteria are met, the athlete may progress back to full participation under the supervision of the Athletic Trainer (ATC). The ATC will keep all pertinent parties informed regarding the status of the athlete.

5. Progression is individualized and will be determined on a case-by-case basis. Factors that may affect the rate of progression include:

  • Previous history of concussion
  • Duration and type of symptoms
  • Age of the athlete
  • Sport/activity the athlete will return to

6. Graduated progression:

  1. Asymptomatic for 24-hours & medical clearance.
  2. Light aerobic exercise- walking, stationary bike. No resistance training.
  3. Sport-specific training (e.g., skating in hockey, running in soccer)
  4. Non-contact training drills
  5. Full-contact training
  6. Gameplay

Note: If the athlete experiences post-concussion symptoms during any phase, the athlete drops back to the previous asymptomatic level and resumes the progression after 24 hours (as long as they are symptom-free).

7. The athlete should see the ATC daily for re-assessment and instructions until progressed to unrestricted activity. The ATC and coach will continue to monitor the athlete for a few days after return to full participation for recurrence of signs or symptoms.