Each student with a concussion must undergo a supervised stepwise progression management plan. It is advised that a medical professional supervise the program.

Exertional Testing:

Determination to begin the Return to Play progression is done by a physician, WCSD approved MoU Provider, and the Athletic Trainer. This occurs when the athlete’s physical exam has normalized. The athlete returns to a full day of school without symptoms. ImPACT, Tandem Gait, and VOMS testing have approximated the athletes baseline.  The Return to Play Protocol has five stages.

Return to Play Protocol:

Stage 1

Light aerobic activity (without resistance training)

• Start with a 20 min stationary bike workout. Exercise intensity at about 50% maximum heart rate
• If at any point symptoms return, the student athlete will stop and be re-evaluated the next day.
• If the student athlete does not experience symptoms at the conclusion of the bike workout, they will progress to the running workout.
• A light aerobic run can also be completed instead of/or in addition to the bike test

Stage 2

Sport Specific Activity

• The athlete will perform sport specific or position specific drills while out of the practice setting, testing change of direction and agility.
• Run Exertion testing can be conducted at this level - running and sprinting – (for example …This 15 minute workout will consist of anaerobic activity like speed ladder, sprints, and 50+ yard runs plus individual drills specific to their sports.
• If at any point symptoms return, the student athlete will stop and be re-evaluated the next day.
• If the Athlete completes the sport specific drill, the athlete may progress to non-contact practice the next day.

Stage 3

Limited Return to Practice- Non-contact practice with progressive resistance training

• Limited return to practice will consist of non-contact drills and activities.
• Resistance training can begin (weight lifting).
• If at any point symptoms return, the athlete will be pulled from practice and re-evaluated the next day.
• If the athlete does not experience symptoms at the conclusion of the workout, the Athletic Trainer will make the determination if the athlete is ready for progression to full contact.
• If the athlete has no symptoms, the athlete may progress to full contact.

Stage 4

Full Contact Practice (Unrestricted training)

• The last day of the return to play protocol is a full contact day. If at any time the athlete has a return of his/her concussive symptoms, the athlete will be removed from play/practice and will be re-evaluated the following day.

Stage 5

Full Return to competition

• If the student athlete does not experience symptoms at the conclusion of practice/play, he/she will return to full participation.
• Progression of the balance exercises may continue following full return to play.