#40 - Concussion Return to Play Protocol

Return to play is a stepwise process based on a patient’s heart rate and presence of their symptoms. All cognitive and physical activities should be supervised by a trained concussion care provider to make adjustments when needed.

To begin this phase of rehab, patients should meet the following return to play criteria:

• They are symptom-free at rest, with cognitive exertion, and physical exertion. Activities such as reading, checking emails, going for a walk, or attending a yoga class do not aggravate symptoms
• They score within normal limits on BESS and VOMS
• They are back to (or better than) baseline results on neurocognitive tests

Keep in mind patients suffering from post-concussion syndrome will still have symptoms that worsen with cognitive and physical exertion. You will have to bend the guidelines and encourage them to move through their symptoms to interrupt the chronic pain cycle. A trained concussion rehabilitation specialist can help determine this balance of activity.