Concussion Protocol - Return to Play
Medical Clearance by an appropriate physician is mandatory before return to play
The ThinkFirst Canada Concussion resources were developed based on the Zurich Guidelines outlined in the Consensus Statement on Concussion in Sport and have been reviewed with great thanks to the ThinkFirst Concussion Education and Awareness Committee.
A concussion is a serious event, but you can recover fully from such an injury if the brain is given enough time to rest and recuperate. Returning to normal activities, including sport participation, is a step-wise process that requires patience, attention, and caution.
Step 1: No activity, only complete rest
- Limit school, work and tasks requiring concentration.
- Refrain from physical activity until symptoms are gone.
- Once symptoms are gone, a physician, preferably one with experience managing concussions, should be consulted before beginning a step wise return to play process.
Step 2: Light aerobic exercise
- Activites such as walking or stationary cycling. The player should be supervised by someone who can help monitor for symptoms and signs. No resistance training or weight lifting. The duration and intensity of the aerobic exercise can be gradually increased over time if no symptoms or signs return during the exercise or the next day.
- Symptoms? Return to rest until symptoms have resolved. If symptoms persist, consult a physician.
- No Symptoms? Proceed to Step 3 the next day.
Step 3: Sport specific activities
- Activities such as skating or throwing can begin at step 3. There should be no body contact or other jarring motions such as high speed stops or hitting a baseball with a bat.
- Symptoms? Return to rest until symptoms have resolved. If symptoms persist, consult a physician.
- No Symptoms? Proceed to Step 4 the next day.
Step 4: Begin drills without body contact.
- Symptoms? Return to rest until symptoms have resolved. If symptoms persist, consult a physician.
- No Symptoms? The time needed to progress from non-contact exercise will vary with the severity of the concussion and with the player. proceed to Step 5 only after medical clearance.
Step 5: Begin drills with body contact
- Symptoms? Return to rest until symptoms have resolved. If symptoms persist, consult a physician.
- No Symptoms? Proceed to Step 6 the next day.
Step 6: Game play
Never return to play if you still have symptoms!
A player who returns to active play before full recovery from the first concussion is at high risk of sustaining another concussion, with symptoms that may be increased and prolonged.