Concussion Resources

Return to play. Return to learn.

Our stepwise guidelines for bringing an athlete back to sport and back to school after a concussion, written so team staff, parents, and the athlete can follow the same plan.

Before You Start

One step at a time

Both ladders work the same way. The athlete moves up only when the current step is tolerated, and recovery is individual to the athlete and their injury.

01

Give each step 24 hours

Each return-to-play step takes place over a 24-hour period. With a normal recovery, the six steps take six days from symptom-limited activity to game clearance.

02

Watch for a spike

If concussion symptoms significantly increase in intensity, stop the activity immediately.

03

Rest, then restart

Rest until symptoms improve, for a minimum of 24 hours, then start again from the same step.

04

Get cleared

Full contact and game play need clearance from a medical doctor. No step replaces that.

Concussion Management

Return to Play

Six recommended steps, each taking place over a 24-hour period. With a normal recovery that is six days from symptom-limited activity to game clearance.

Step 1
Symptom-limited activity
  • No activities that raise the heart rate over 125 beats per minute.
Step 2
Light exercise
  • The athlete can begin light exercise such as walking or stationary cycling, for up to 20 minutes.
Step 3
Sport-specific aerobic activity
  • Sport-specific aerobic activity (e.g. skating, running, swimming).
  • May participate in team activities.
  • No contact and no high-intensity training.
Step 4
Non-contact practice drills
  • Sport-specific practice drills (e.g. passing, shooting, footwork).
  • No contact. Identify the athlete with a coloured jersey.
  • Increase cardiovascular activity to include high-intensity training.
Step 5
Full-contact practice
  • Full contact in practice.
  • Clearance from a medical doctor.
Step 6
Return to play
  • Return to play and clearance for game participation.
If symptoms spike

If the athlete experiences a significant increase or "spike" in concussion symptoms, they should stop the activity immediately, rest until symptoms improve (minimum of 24 hours), and start again from the same step. Return to play will be individual to the athlete and their injury.

Concussion Management

Return to Learn

Six steps from limited cognitive activity back to a full school workload.

Step 1
Limit cognitive and social activity
  • Limit cognitive and social activity. This may include absence from school with a physician's note.
Step 2
Introduce cognitive activity
  • Introduce cognitive activity* as tolerated. General guideline: 15-minute sessions, building to 60 minutes.
  • The student may attend school for a portion of the day.
Step 3
Increase school attendance
  • Increase school attendance and continue building the duration of cognitive activity.
Step 4
Build to a full day
  • Increased school attendance as tolerated.
  • Build up to a full day as tolerated.
  • Implementation of school accommodations.
Step 5
Full day of school
  • Full day of school.
  • Continued implementation of school accommodations.
Step 6
Full-time school
  • Full-time school.
  • Resume the full workload and catch up on missed assignments.

*Cognitive activity includes puzzles, Sudoku, word games, school assignments and tests, reading, texting, video games, computer use, television, and conversations.

For Teams

Part of a full protocol

For the organizations we work with, these ladders sit inside a complete concussion protocol: baseline testing before the season, assessment after an injury, and a managed return led by our clinical team. If your organization needs one, we build it with your medical, coaching, and executive staff.

Concussion Protocols & Health Policy

Team-wide baseline testing, return-to-play protocols, and organizational health policy held to the standard elite competition demands.

Team Programs

Keep a copy with your team.