Return to Play Following a Concussion

The student-athlete must meet ALL of the following criteria in order to progress to activity:

1. Medical clearance note if seen by a Medical Doctor

2. Medical clearance from the Certified Athletic Trainer

3. Symptom free for at least 24-hours:

a. ImPACT test once symptom free that is performed by the Certified Athletic Trainer or a licensed medical professional experienced in the management of concussions. Post-test results must be provided to the Certified Athletic Trainer prior to the student-athlete being cleared to play.

i. You can also ImPACT test within 24-48 hours of the injury, even if student-athlete has symptoms, if deemed appropriate

4. Be cleared by a Medical Doctor regarding Post-Concussion ImPACT test score:

a. Once Post-Concussion ImPACT is back to baseline:

i. Return-to-Play Protocol can begin as long as student-athlete remains symptoms free

The Return-to-Play Protocol for concussion is a series of steps wherein the student-athlete will only progress to the next level if he/she remains symptom free for 24-hours post exercise. The program will only begin once symptom free at least 24-hours and once Post-Concussion ImPACT test score are back to baseline. Also, student-athlete should have completed at least one full day of school with no restrictions:

Day 1 (only if symptoms free for at least 24-hours): Non-contact
Light aerobic activity/exercise can begin which includes, but is not limited to, stationary bike, seated elliptical, UBE, treadmill walking, submaximal isometric strengthening, ROM and stretching, low level balance activities. All activity other than cardio machines should be accompanied by the Certified Athletic Trainer. Cardio can last between 10-15 minutes and should be very low level, being sure to keep the heart rate low (30-40% of maximum exertion if possible).

Day 2 (if still symptom free from Day 1): Non-contact
Light to moderate activity/exercise can begin which includes, but is not limited to, stationary bike, elliptical, UBE, treadmill walking, light weight strength exercises, Resistance band exercises, wall squats, lunges, step up/downs, stretching, Romberg exercises, walking with eyes focused and head turned, single leg exercises, and swiss ball exercises. All activity other than cardio machines should be accompanied by the Certified Athletic Trainer. Cardio can last between 20-25 minutes and should be a low to moderate level, being sure to keep the heart rate low to moderate (40-60% of maximum exertion if possible).

Day 3 (if still symptom free from Day 2): Non-contact
Moderately aggressive activity/exercise can begin which includes but is not limited to treadmill jogging, stationary bike, elliptical, UBE, resistance weight training including free weights, functional squats, dynamic stretching/strength activities, agility drills (zig-zag, side shuffle, etc.), jumping on boxes, higher level balance activities such as a med ball toss on to the floor, balance discs, bosu ball squats, etc. All activity other than cardio machines should be accompanied by the Certified Athletic Trainer. Cardio can last between 25-30 minutes and should be moderate level, being sure to keep the heart rate up in a higher zone (60-80% of maximum exertion if possible). The student-athlete may participate in practice drills with no contact.

Day 4 (if still symptom free from Day 3): Non-contact athletes may resume full game participation on this day. 
Aggressive activity/exercise can begin which includes, but is not limited to, interval training sport-specific drills, plyometric, and full strength training. The purpose of this day is to restore confidence of the athlete and assess their ability to return to contact sports. Athletes who are on a contact sport team may resume full practice but may not resume game play. Exertion should exceed moderate levels and be in a higher zone (80% to maximum effort if possible).

Day 5 (if still symptom free from Day 4): Contact athletes may resume full game participation on this day.
Full activity can be resumed for contact athletes.