9 Stages for Returning to Sport after a Concussion

by Apr 3, 2018Exercises, Injuries, Physiotherapy

When can you return to sports after a concussion?

It is important to have a graduated return to sport program after a concussion in order to prevent further damage to the brain as well as prolong concussion symptoms. A concussion is an injury to the brain. It is important to give the brain adequate time to rest and recover before returning to your sport.

return to sport timeline
Red Flag Concussion Symptoms
Symptoms of Concussion

STAGE 1: Medical Assessment

It is important to get medically assessed immediately after a concussion occurs to rule out possible internal bleeding or complications. Seek emergency medical treatment right away after a suspected concussion if the athlete displays any of the following symptoms.

STAGE 2: Complete Rest

It is important to respect 24-48 hours of complete physical and cognitive rest until concussion symptoms completely disappear at rest. The goal is to be able to gradually return to work and school activities. Now is a good time to book an appointment with a physiotherapist to arrange a consultation.

STAGE 3: Symptom Limited Activity

Do not participate in any resistance training or contact activity. Begin with slow walking for 10 minutes and gradually increase the time and walking speed. The goal is to gradually begin to monitor heart rate. A physiotherapist can help monitor safe heart rate ranges and help begin your recovery process. 

STAGE 4: Light Exercise

Once you are able to tolerate light aerobic activity without causing any symptoms. It is now time to begin light aerobic exercise. Do not participate in any resistance training or contact activity. Begin to increase heart rate slowly. Participate in aerobic activities including walking, swimming or stationary cycling. A good guideline is 20 minutes at 70% of your maximum heart rate. You can calculate your maximum heart rate by subtracting your age from 208. 

STAGE 5: Sport Specific Exercise

Begin to add sport specific movements into your exercise routine. Aim for a goal of 30 minutes of sport specific aerobic activity at 80% of your max heart rate. At this time do participate in any resistance training or contact activity. Return to the previous stage, if exercise produces any symptoms. 

STAGE 6: Non Contact Training

Once you are able to complete at least 30 minutes sport specific aerobic activity without inducing any concussion symptoms it is now okay to begin resistance training but do not participate in any contact activity. Begin to add coordination and cognitive tasks, and begin the progression to more complex training drills. Our concussion specialists can help you safely begin resistance training, and progress exercises while monitoring your symptoms. 

STAGE 7: Medical Clearance

Once you are able to return to a resistance training program and can complete complex, sport specific movement patterns with no symptoms it is now time to get medical clearance to allow you to return to your sport practice. 

STAGE 8: Full Contact Practice

It is now safe to return to full contact practice. Resume your normal training and practice routine to help build confidence and function. Your physiotherapist might recommend follow up appointments to monitor your progress. 

STAGE 9: Return to Sport

 After a period of time after returning to full contact practice you are now able to return to normal game play. Continue to monitor your symptoms and check in with your physiotherapist and recovery team 

How a Physiotherapist can help

Our physiotherapy team is able to help you recover from your concussion by helping you manage and monitor your symptoms. They will help train the vestibular (balance symptom), treat muscular injury in your neck after concussion and gradually help you return to exercise and your sport. It is important to have a physiotherapy help you monitor your heart rate as you begin to exercise, and be able to determine when you are ready to move to the next stage of recovery. 

In our clinic we have four clinical specialists who have additional training and extensive experience working with concussion patients.