Graduated return to play after concussion

Most athletes who have a concussion are able to recover completely and return to competitive play. But recovering completely from a concussion is not the same as recovering from other injuries.

Some symptoms of a concussion may go away fairly soon — sometimes even within hours of the injury — while other symptoms may not appear until days or even weeks later.

Graduated return to play

For athletes who have had a concussion, UI Sports Medicine recommends a multi-step recovery process known as graduated return to play. This process is performed under the supervision of a health care professional, such as a certified athletic trainer.

The process begins after the athlete has had no symptoms for at least 24 hours. Each step is performed a minimum of 24 hours after the previous step. This extends the full recovery process to at least five days.

The steps include:

  1. Light aerobic activity — walking, jogging, or exercise bike for a brief period of time
  2. Moderate activity — moderate-intensity aerobic activity and moderate-intensity weight training
  3. Non-contact training drills — high-intensity aerobic and weight-training routines and non-contact drills specific to the athlete’s sport
  4. Full-contact practice — the athlete’s normal practice routine
  5. Return to competitive play

An athlete who shows symptoms of concussion at any step of the process must rest for a minimum of 24 hours before returning to try that same step again. This includes physical symptoms (headache, dizziness, blurred vision, etc.) as well as cognitive symptoms (loss of memory, inability to answer questions quickly, mood or behavior changes, etc.).

This graduated approach allows:

  • a safe, gradual return to competition for the athlete
  • thorough monitoring of the athlete’s condition and progress by a trained health care professional

For more information about graduated return to play and our Concussion Clinic, contact the UI Sports Medicine Clinic.

Last reviewed: 
June 2017

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