Return to Play Protocol
There are 6 stages of the return to play protocol for any sports or physical activity. The stages do not correspond to the number of days as it is all dependent on symptoms and your body's response to activity. Each stage must take a minimum 24 hours free of symptoms before you can proceed to the next stage.
Stage 1: No Activity with only complete rest
At this stage, limit school, work and tasks requiring concentration. Refrain from any physical activity until symptom free.
Stage 2: Light Aerobic Exercises
Once have been symptom free for 24 hours, patient can start with light aerobic exercises; such as walking on treadmill or stationary cycling for 10-15 minutes. Patient should perform this under supervision and have heart rate monitored to avoid over-exertion. If the patient becomes symptomatic again during the exercise, stop immediately and return to rest until symptoms are resolved. Then patient will repeat the step until he or she is able to complete without having recurring symptoms during exercise.
Stage 3: Sport Specific Activities
Activities such as skating, throwing, running can begin at stage 3 once patient is able to complete exerting without recurring symptoms from the last stage. There should be no body contact and the goal is to continuously exert the body in control while monitoring symptoms.
Stage 4: Non-contact Sport Specific Drills
At stage 4, patient can start returning to sport specific drills that includes more complex processing and motor control. However, they will still remain non-contact at this stage while focusing on adaptations of brain and body to the more complex situation.
Stage 5: Full-contact Sport Specific Drills
Once the patient is able to process and control sport specific drills without symptoms, patient will then proceed to full contact practices either with coaches or teammates to continue challenging the brain function.
Stage 6: Full-contact Game Play
Upon completion of the 5 stages with no reproduction of symptoms, the patient will then be released medically for return to full contact game play.