Return to Play/Activity Protocol Following Concussion
Return to play following a concussion involves a step-wise progression once the individual is symptom free. There are many risks to premature return to play including: a greater risk for a second concussion because of lower concussion threshold, second impact syndrome (abnormal brain blood flow that can result in death), exacerbation to any current symptoms, and possibly the risk for additional injury due to alteration in balance. The NYSPHSAA current returns to play recommendations are based on the most recent international expert opinion.* No student athlete should return to play while systematic. Students are prohibited from returning to play the day concussion is sustained. If there is any doubt as to whether a student has sustained a concussion, it should be treated as a concussion. Once the student athlete is symptom free at rest for 24 hours and has a signed release by the Chief Medical Officer, he/she may begin the return to play progression below (provided there are no other mitigating circumstances).
Return to Play Progression
- Day 1: Light aerobic activity, non-strenuous such as walking
- Day 2: Higher impact and moderate activity such as running
- Day 3: Sport specific non-contact activity, low resistance weight training
- Day 4: Sport specific activity, non-contact drills, higher resistance weight training
- Day 5: Full contact training drills and intense aerobic activity
- Day 6: Return to full activities without restrictions
Each step should take 24 hours so that an athlete would take approximately one week to proceed through the full rehabilitation protocol once they are asymptomatic at rest and with provocative exercise. If any post-concussion symptom occurs while in the stepwise program, then the student should drop back to the previous asymptomatic level and try to progress again after a further 24 hour period of rest has passed.
*These NYSPHSAA current returns to play recommendations are based on the most recent international expert opinion.