Returning to sport after a concussion

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.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

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About the Author

Kristi Scott, B.Sc., M.Sc.P.T., CAFCI

Kristi is a Registered Physiotherapist. She joined her mother, Shirley Andrusiak, at Guisachan Physiotherapy after graduating from the Masters of Science in Physical Therapy Program at the University of Alberta in 2010. She also holds an Undergraduate Bachelor of Science Degree from the University of Victoria. Since graduating Kristi has completed numerous continuing education courses including manual therapy, vertigo, sport first responder, and golf related rehabilitation.  She has also completed her training with the Acupuncture Foundation of Canada Institute, and is certified to perform acupuncture, holding a designation of CAFCI.

Kristi brings an energetic, exercise based approach to her practice. She focuses on client centered care, education, exercise prescription, and manual therapy techniques. 

You can contact Kristi by email at [email protected]




The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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