Concussion Protocol

Return To Play Guidelines

Best practice guidelines recommend a short period of physical and cognitive rest following concussion (24-48 hours) to help ease symptoms and support recovery. During this period, it is still OK to participate in light household tasks like making your bed, caring for your pets, talking on the phone with a friend for example, or going for a short walk, as long as those activities do not increase your symptoms. Studies show that early, graded aerobic exercise, particularly in the adolescent population may be beneficial for recovery as long as it remains below the threshold of symptom aggravation. Your Shift Concussion Provider will support you all the way from injury to return-to-play.

Step 1:

Suspected Injury: Medical Evaluation by Physician

Step 2: Rest Phase

Short period of physical and cognitive rest (24-48 hours)

Step 3: Persistent Symptoms?

Shift Concussion Evaluation to determine Care Pathway

Step 4: Implement Care Plan

Clinical rehabilitative strategies, graded sub-symptom aerobic exercise program, academic accommodations, etc

Step 5: Adjust, modify, & re-assess while maintaining safe and sub-symptom activity

Get back to normal routines with some restrictions; reintegrate back to school

Step 6: Exertion Testing

When symptoms are gone, and before returning to sport, it is important to test higher- level exercise tolerance and sport-specific performance in a controlled and supervised setting to ensure symptoms do not return. This testing involves a variety of agility, foot work, coordination, reaction time and sport specific drills. This may involve 1-2 sessions depending on the case

Step 7: Practice (non contact)

Providing no symptoms arise during, or within 24 hours of exertion testing…

Step 8: Final Clearance for Return to Sport

A Medical Physician must clear you for full return to sport. In some cases, he/she may recommend you participate in a full contact practice prior to game play

Return To Play Guidelines

Best practice guidelines recommend a short period of physical and cognitive rest following concussion (24-48 hours) that may require an absence from school in those early stages to help ease symptoms. During this period, it is still OK to participate in light household tasks like making your bed, caring for your pets, talking on the phone with a friend for example, as long as those activities do not increase your symptoms. Screens, and tasks requiring a lot of visual focus should be avoided as much as possible. As symptoms improve, it is important to gradually build in more activity (both cognitive and physical) as tolerated. No two concussions are alike, and recovery rates can vary considerably from individual to individual. It is critical to ensure students are returning to school in a timely manner. The longer that students are kept out of the classroom, the more potential there is for the development of:

  • Anxiety & Depression
  • Deconditioning
  • Social Isolation
  • Sleep Dysregulation
Step 1:

Suspected Injury: Medical Evaluation by Physician

Step 2: Rest Phase

Short period of physical and cognitive rest (24-48 hours)

Step 3: Persistent Symptoms? –

Initiate Gradual Return-to-Learn Plan with the help of Physician and/or Shift Concussion Provider

Step 4: Implement Environmental and Academic Accommodations

Back to school with accommodations. Some examples of this include shortened days, preferential seating, limiting times in busy environments (ex. hallways, assemblies), limit note taking, more time for testing and assignments, reduced workload

Step 5: Continued Clinical Rehabilitation with Shift Provider/Team (as needed)
Step 6: Adjust, Modify, & Re-assess While Maintaining Safe and Sub-symptom Activity

Get back to normal routines with some restrictions before gradually returning to full participation including regular attendance, homework, tests and extracurriculars.

** Children and youth should not be returning to sport until they have returned to school full time with no restrictions

Additional Information –