Return To Play Readiness - 6 Steps for Prioritizing Concussion Safety

Roughly 2 in 10 youth athletes participating in youth contact sports suffer a concussion. Even more alarming is that 5 in 10 concussions go unreported or undetected. With such critically high concussion rates, parents, coaches and trainers have a duty to prioritize sports safety among athletes. The decision to return to play can be incredibly tough for both coaches and parents, so both parties must be well versed in return-to-play progression to avoid athletes returning to sport prematurely.

Unsurprisingly, most athletes often feel “ready” to return to play sooner than recommended and there are many risks associated with premature return to play. The competitive nature or love of the game may pressure the athlete to return too soon. Ultimately, as the law states, the decision to return to play relies on healthcare provider clearance. Still, coaches and parents must also be educated advocates to monitor symptoms and support their athletes. Once a healthcare provider clears an athlete to return to play, they can follow the Center for Disease Control’s (CDC) 6-Step Return to Play Progression. The athlete may only advance to the subsequent step if they do not display any new concussion symptoms:

Step 1: Back to regular activities (i.e., school)

• The athlete is back to their regular activities and has been cleared by a healthcare provider to begin the return to play process. Begin with a few days of rest (2-3 days) followed by light activity (i.e., short walks) and moderate activity (i.e., stationary bike) that do not increase symptoms.

Step 2: Light aerobic activity

• Begin with light aerobic exercise only to increase the athlete’s heart rate (i.e., 5 - 10 minutes on a bike, walking, or light jogging), No weight lifting.

Step 3: Moderate activity

• Continue with activities to increase heart rate (i.e., moderate jogging, short run, moderate-intensity stationary biking, moderate-intensity weightlifting).

Step 4: Heavy, non-contact activity

• Add heavy non-contact physical activity (i.e., running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills).

Step 5: Practice & full contact

• Athletes may return to practice and full contact in controlled practice.

Step 6: Competition

• Athletes may return to competition.

If coaches and athletes adhere to return-to-play protocols, they lessen the likelihood of future injuries and potentially costly medical visits. As advocates, coaches can support their athletes' and their families' physical and financial well-being. If parents or coaches doubt an athlete's ability to return to play, consult a medical professional.

Click here to learn more from the CDC about Return to Play Progression. 

References

1. Centers for Disease Control and Prevention. (2019, February 12). Returning to sports and activities. Centers for Disease Control and Prevention. https://www.cdc.gov/headsup/basics/return_to_sports.html
2. Concussion statistics and facts: UPMC: Pittsburgh. UPMC. (n.d.). https://www.upmc.com/services/sports-medicine/services/concussion/about/facts-statistics
3. Mishra, D. (2019, April 23). Go or no-go? How to know when an athlete’s ready to return. SportsEngine. https://www.sportsengine.com/athletes-health/go-or-no-go-how-know-when-athletes-ready-return