ESM Return to Play Protocol (Concussions)

Return to play following a concussion involves a stepwise progression once the individual is symptom free. These steps allow a gradual increase in the volume and intensity of exercise during the return to play process. The process will take several days to complete. A student athlete may not return to full participation until all steps in this process have been completed with the athlete remaining symptom free. The student athlete must remain asymptomatic for 24 hours before moving to the next step.

STEP 1: Rest/No Physical Activity: Once the student athlete is symptom free at rest for 24 hours and has a signed release by the treating clinician, she/he may begin the return to play progression below (provided there are no other mitigating circumstances).

STEP 2: Light Aerobic Activity: Walking/swimming, stationary cycling, 10-15 minutes of exercise, no resistance.

STEP 3: Sport-specific exercise: Running drills, no weightlifting, no head contact.

STEP 4: Non-contact training drills: Progression to more complex training drills; may start progressive resistance training.

STEP 5: Full contact practice: Participation in normal training/practice activities; full exertion.

STEP 6: Return to play: Normal game play, no restrictions.

If any step is failed, the athlete will drop back to the previous step and try to progress after 24 hours of rest. If the athlete continues to have symptoms after failing any 2 steps, the athlete should be referred back to his/her physician.

**Additional information on concussions can be found on the website by clicking PDFs in the Downloads section at the bottom of this page.

Back to Athletic Handbook table of contents