Concussion Protocol

Recovering from a concussion? In this blog post, CRYSC Head Athletic Trainer Julie Graves has put together a step-by-step guide for an effective and healthy rehabilitation process. From encouraged activities, things to avoid when having a concussion, things to do to recover, and return-to-play steps, the guide below will assist you through every part of the healing process. By emphasizing pain-free progressions and a gradual return to play, this is your roadmap to a resilient and sustainable recovery.

UCHealth + CU Sports Medicine and Orthopedics has a variety of different locations to help your child get back to the soccer field at 100%. If this is something you think your child may be dealing with, please reach out to our Head Athletic Trainer, Julie Graves at [email protected], for assistance. Below is the at-home rehab program for hamstring injuries.

Exercise Progression is NOT ALLOWED until the symptom sheet checklist has reached 0s in all categories for at least 24 hours. The child CANNOT return to play until cleared by a physician/primary care provider unless the physician gives permission for an athlete to be cleared by the athletic trainer. Check out the steps to take below or more local resources from the Colorado Concussion Clinic.

How should you care for your child following a concussion:

Schedule an Appointment

Schedule an appointment with a primary care provider as soon as possible.

Encouraged Activites

1. REST
2. SLEEP (please do not prevent your child from going to sleep following a concussion)
3. A dark cave-like environment if your child is experiencing sensitivity to light.
4. Hydration
5. Proper nutrition

Things your child should avoid until symptom score sheet reaches 0:

Activities that require concentration, such as but not limited to:

1. School work
2. Watching TV
3. Phone use
4. Loud Music

Things that can help your child recover:

1. Vestibular Rehab, especially if your child is experiencing dizziness during the exercise return to play protocol
2. Avoiding setbacks by trying to rush through steps to return
3. Soft tissue treatments to help with neck pain if your child experienced whiplash
   1. Massage
   2. Acupuncture or dry needling
   3. Cupping
   4. Active/Passive Release Therapy

Exercise Return to Play Steps:

An athlete’s parent(s) and coach(es) need to watch for concussion symptoms after each day’s return to play progression activity. An athlete should only move to the next step if they do not have any new symptoms at the current step. If an athlete’s symptoms come back or get new symptoms, this is a sign that the athlete is pushing too hard. The athlete should stop these activities, and the athlete’s medical provider should be contacted. After more rest and no concussion symptoms for at least 24 hours, the athlete can start at the previous step.

• 24 hours between steps: Each step should take 24 hours or more so that, assuming the athlete does not experience a recurrence of concussion symptoms at rest or with exercise as he/she progresses through the exercise program, he/she will be able to return to sports in about a week after symptoms have cleared.
• Fall back if symptoms return: If the student-athlete experiences a recurrence of concussion symptoms during any of the steps, they need to drop back to the previous level at which they were symptom-free and try to progress again after a further 24-hour period of being symptom-free.

Step 1: Back to regular activities (such as school)

The athlete is back to their regular activities (such as school) and has the green light from their healthcare provider to begin the return-to-play protocol. An athlete’s return to regular activities involves a stepwise process. It starts with a few days of rest (2-3 days) and is followed by light activity (such as short walks) and moderate activity (such as riding a stationary bike) that do not worsen symptoms. You can learn more about the steps to return to regular activities.

Step 2: Light aerobic activity

Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about ~20 minutes on an exercise bike, walking, or light jogging. At this point, do not lift weights. The goal is 30- 50% of Max. Heart Rate.

Step 3: Moderate activity

Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting (less time and/or less weight from their typical routine) for 30-45 minutes. No head impact activities. I am looking for a 50–80% Max Heart Rate.

Step 4: Heavy, non-contact activity

Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, and non-contact sport-specific drills (in 3 planes of movement).

Step 5: Practice & full contact

Athletes may return to practice and full contact (if appropriate for the sport) in controlled practice.

Step 6: Competition:

Athlete may return to competition with full clearance from their physician.

Find out more about the CRYSC Sports Medicine Program by visiting our website. If you would like more information on natural solutions and the athlete, please don’t hesitate to reach out to CRYSC’s Head Athletic Trainer, Julie Graves, at [email protected].