Return to Play Guidelines

There are 6 steps to getting back on the ice/field healthy:

ThinkFirst Canada recommends athletes to follow the Return-to-Play Guidelines when recovering from a concussion. These guidelines breakdown concussion recovery into 6 steps as seen in the figure below. Each step should take a MINIMUM of ONE DAY, but could take longer depending on the specific player and his or her situation. If at any time during this recovery period the athlete is experiencing symptoms, REST for 24 hours (or longer). Once the athlete is symptom free, they should return to the previous step and continue their recovery.

Return-to-Play Guidelines

Here is a more detailed explanation of the Return-to-Play guidelines:

1) REST

-Absolutely NO PHYSICAL ACTIVITY while experiencing symptoms

-If possible, try to minimize activities requiring concentration and/or stimulation

Cognitive relaxation also important, not just physical (see concussion management for more information)

Do not return to any form of physical activity until all symptoms are resolved

-This return should be approved by a family or team doctor


2) Light Aerobic Exercise

-Once symptoms have subsided, minimal physical activity can resume

-Preferably supervised on a stationary bike or a light walk

-For no more than 10-15 min.

-Low resistance, low impact activities only

-Slowly increase exertion and workout length over time

-Goal = gradual increase in heart rate

If symptoms return:
-REST for 24 hours
-RETURN to previous step
If NO symptoms are felt:
-Move on to the next step of recovery the following day

3) Sport Specific Physical Activity

-It is now safe to return to the ice/field

-Drills should still NOT be high-intensity or include sudden stops

-For no more than 20-30 min.

NO PHYSICAL CONTACT

-Goal = return to movement

If symptoms return:
-REST for 24 hours
-RETURN to previous step
If NO symptoms are felt:
-Move on to the next step of recovery the following day

4) Non-Contact Drills

-More drills can be incorporated into practice, such as those involving passing, and shooting

-Still NO PHYSICAL CONTACT

-Resistance training program allowed to resume gradually

-Goal = increased exertion, overall coordination and cognitive functioning

If symptoms return:
-REST for 24 hours
-RETURN to previous step
If NO symptoms are felt:
-Move on to the next step of recovery the following day

5) Full-Contact Drills

-Practice with body contact can begin once medical clearance has been received

-Regular practice routine prior to the concussion can resume

-Goal = athlete regaining confidence in abilities

-Also allows for observation by coaches to ensure a safe return to game action

If symptoms return:
-REST for 24 hours
-RETURN to previous step
If NO symptoms are felt:
-Move on to the next step of recovery the following day

6) Return To Game Action

-Game play!

Remember

-The recovery process can vary greatly depending on the athlete and the severity of the concussion

-Each step should take a minimum of 1 full day (24hrs)

-Frustration is common with the return of symptoms and extension of recovery time, but guidelines are in place to protect your brain

Honesty in reporting your symptoms is key to protecting yourself and your future

-There are no same day guidelines for returning to game action

-Recovery is extremely important, but so is prevention


For more information visit Parachute Canada’s website at http://www.parachutecanada.org/thinkfirstcanada

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