Concussion Rehabilitation/Stepwise Return to Play

Rehabilitation StageFunctional Exercise
1. No activityComplete physical and cognitive rest
2. Light aerobic activityWalking, swimming, stationary cycling at 70% maximum heart rate; no resistance exercises
3. Sport-specific exerciseSpecific sport-related drills but no head impact
4. Noncontact training drillsMore complex drills, may start light resistance training
5. Full-contact practiceAfter medical clearance, participate in normal training
6. Return to playNormal game play
  • Each stage in concussion rehabilitation should last no less than 24 hours with a minimum of 5 days required to consider a full return to competition. If symptoms recur during the rehabilitation program, the athlete should stop immediately. Once asymptomatic after at least another 24 hours, the athlete should resume at the previous asymptomatic level and try to progress again. Athletes should contact their health care provider if symptoms recur. Any athlete with multiple concussions or prolonged symptoms may require a longer concussion-rehabilitation program, which is ideally created by a physician who is experienced in concussion management.