Concussion Information Series Chapter VI: Return to Play Following a Concussion

For an athlete to return to the playing field or court, it is important that he/she is back to “baseline” first. Baseline refers to how the athlete was performing before the concussion. Have the concussion symptoms gone away? Is the athlete thinking as clearly as before? Is the athlete behaving as before? Does the athlete have any difficulty with balance when standing or moving? Does the athlete have any difficulty with vision or hearing? All of these areas need to be back to baseline before there is a return to sports.

Important Take-Away Points

• After sustaining a concussion it is very important to avoid any activity that places the student at risk of sustaining another concussion. Assure the athlete he/she will be OK and their symptoms will reduce soon by following a plan.
• First and foremost, the athlete should be symptom free before returning to play.
• Returning to play in sports should be determined after all symptoms have subsided, and by how the athlete does when they are physically exerting themselves. Do the concussion symptoms return or worsen? If so, then the individual should wait before returning to play.

Baseline Testing is a useful tool in helping healthcare professionals to determine if an athlete has experienced a concussion during play. It is intended to be done at the beginning of the sports season and provides information in a variety of areas such as thinking skills and physical abilities. Should an athlete be suspected of having sustained a concussion during play then the very first rule is to remove the player from all play. The next step is to get an evaluation from a healthcare professional trained in concussion management. If it is determined that the athlete has sustained a concussion then a plan of recovery should be identified. Once the symptoms of concussion have resolved then the Baseline Testing can be used to determine if the athlete has fully recovered. Use of the pre-season baseline testing information is not effective for use during sporting events – the player suspected of having a concussion must be removed from play, and subsequently evaluated on the baseline test. Unfortunately, baseline testing is not universally done in all sports programs.

Watch the following video for more details on baseline testing and how those results can be used.

A balance between rest and return to activity is important to recovery. There are well designed and researched guidelines that will lead the athlete through the recovery process on their way back into sports. Watch the following video for details on what those steps are.

Athletes might feel like they are letting their teammates down by not participating in practice or the games as they did before. There might be a tendency to hide the concussion symptoms from coaches and teammates. This can actually make the situation worse. Watch the following video for a student’s perspective.

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Read Chapter VII: Accommodations for Concussion