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Return to Play Procedures

  1. Returning to play on the same day of injury
    • An athlete who exhibits signs or symptoms of concussion, any loss of consciousness, or has abnormal cognitive testing, should not be permitted to return to play on the day of injury. Any athlete who denies symptoms but has abnormal sideline cognitive testing should also be held out of activity.
    • "When in doubt, hold them out"
  2. Return to play after concussion
    The athlete must meet all of the following criteria in order to return to activities:
    • Asymptomatic at rest and with progressive exertion (including mental exertion in school) for at least seven days AND
    • Have written clearance from primary care physician or specialist (athlete must be cleared for progression to activity by a physician other than an Emergency Room 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 ATC with clearance from a physician. 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 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:
    • No activity for two days - do not progress to step 2 unless asymptomatic
    • Light aerobic exercise - walking, stationary bike
    • Sport-specific training (i.e. skating in hockey, running in soccer)
    • Non-contact training drills
    • Full-contact training after medical clearance
    • 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.
  7. The ATC and athlete will discuss appropriate activities for the day. The athlete will be given verbal and written instructions regarding permitted activities.
  8. The athlete should see the ATC and/or school nurse daily for reassessment and instructions until progressed to unrestricted activity, and is given a written report from the ATC. The ATC will continue to monitor the athlete after full participation for recurrence of signs and symptoms for the next few days.