In my last column I discussed the assessment of concussions using both the SCAT3 and the new technology of the X2 patches. Today, I will discuss the steps players or athletes should follow after a concussion when returning to play. Returning to normal activities, which include sport participation, is a step-by-step process, which is as follows:
1. Rest Only (no activity)
Tasks that require concentration such as school or work should be limited. Do not participate in any physical activity until you can perform tasks requiring concentration without any symptoms. Proceed to Step 2 only when there are no concussion symptoms present at rest.
2. Light Aerobic Activity
Start with light exercise such as walking or cycling on a stationary bike. Refrain from performing any resistance training (lifting weights). Your symptoms should be monitored while performing the exercise. If symptoms occur, stop exercising immediately and return to rest (Step 1). If there are no concussion symptoms you may proceed to step 3 the following day.
3. Sport Specific Activity (low impact)
Perform activities that pertain to your sport. For example, if you play hockey try some light skating. If you play baseball then try throwing a ball. Refrain from any body contact or high impact motions. This would include any checks to the boards in a hockey practice or hitting a ball with a bat in baseball practice. If symptoms are present then return to rest (Step 1) until they have resolved. If there are no symptoms proceed to step 4.
4. Practice - Drills without Body Contact
Participate in practices with your team. Ensure that you do not participate in any drills that require body contact. If symptoms occur then return to rest in Step 1. Progressing to step 5 will vary with the severity of the concussion of each athlete. If there are no symptoms present then proceed to step 5 only after you have received medical clearance.
5. Practice - Drills with Body contact
Slowly incorporate drills that require body contact. If you have symptoms return to step 1. If there are no symptoms you can proceed to step 6.
6. Game Play
Hooray! You’re back in the game! Be safe and have fun.
Remember that if you have concussion like symptoms in any of the above steps, please return to step 1 (Rest). Once symptoms have resolved you may start the step wise process again. If symptoms persist please consult with your physician. These return to play guidelines were established by the Consensus Statement on Concussion in Sport.