Each team should have a Return-to-Play Plan under the guidance of a health care professional, so that coaches not responsible for making medical decisions about when and how quickly to return a player to practices and games.

This liability issue will be become a bigger factor for coaches if the current group of concussion lawsuits are settled.  They are likely to hold coaches and schools liable for the injuries to players who are returned to the game without medical clearance after a hit to the head.

Return to Play Progression (Source: The CDC Site)

Baseline (Step 0): The athlete needs to have completed physical and cognitive rest and not be experiencing concussion symptoms for a minimum of 24 hours.  Keep in mind, the younger the athlete, the more conservative the treatment.

Step 1: Light Aerobic Exercise
The Goal: only to increase an athlete’s heart rate
The Time: 5 to 10 minutes
The Activities: exercise bike, walking or light jogging
Absolutely no weight-lifting, jumping or hard running

Step 2: Moderate Exercise
The Goal: limited body and head movement
The Time: reduced from typical routine
The Activities: moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weight-lifting

Step 3: Non-contact Exercise
The Goal: more intense but non-contact
The Time: close to typical routine
The Activities: running, high-intensity stationary biking, the player’s regular weight-lifting routine, and non-contact sport-specific drills. This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2

Step 4: Practice
The Goal: reintegrate in full-contact practice.

Step 5: Play
The Goal: return to competition


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