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Premature Return to Play After Concussion

Many people want to know when they can return to play after concussion. In reality, it's a multi-step process, and everyone's recovery looks different.

We're here to talk about when players can consider playing again and what the step-by-step progression should look like. Read on to learn more.


When Is It Safe to Return to Sports and Activities?

It can be difficult to determine when it's safe to return to sports and activities after a concussion. No two injuries are alike, so determining a set timeframe is impossible.

In general, after one to three days of rest, doctors will allow patients to return to normal (non-exercise) activities that aren't too strenuous, but this is only under the care of medical professionals after an evaluation.


If someone is unable to undergo daily testing to ensure their cognitive and mental readiness, many professionals recommend a seven-day minimum period before the person returns to their activities, even if their concussion symptoms have abated.

Ideally, patients will undergo daily testing. During these tests, doctors will track the progression of the patient's cognitive abilities and processes.


As long as the patient is improving over time, it's a sign that they'll be able to return to normal activities soon. If a patient isn't progressing, it's a sign that there may be something wrong, and the patient would need to undergo further testing and potentially, treatment.


Dangers of Premature Return to Play After Concussion


It's crucial for patients to take time off before they return to their sports again. Not doing so can be dangerous and in some cases, deadly.


Some professionals believe in "Second impact syndrome." This means that someone has returned to their sport after a concussion before they were finished healing. Having one concussion makes someone more likely to experience another one, and that second concussion can allegedly cause even more serious damage.


Researchers say that the second concussion is more likely to be deadly.

Again, the prevalence of second impact syndrome is low, so not all doctors believe that it's a legitimate concern. However, it's clear that returning to physical activity too soon after an injury is dangerous.


When someone is still recovering their cognitive abilities, they won't be as balanced, agile, or capable. Even if they don't get another head injury, they may find themselves with another bodily injury due to poor coordination or focus during a game.

This will result in more time spent in recovery and potentially even an inability to return to sports at all. Patients should take their initial recovery period seriously.


Steps for Safe Return to Play Progression


It's always important to take the return to play process slowly to avoid future injuries. The first step is rest. The patient must rest for several days before they start going back to their normal activities after a concussion. There should be no remaining concussion symptoms when the patient goes back to their sports-related activities.

Rest periods tend to last between one and three days unless the patient isn't showing improvement. In that case, further testing may be necessary.

Don't rush through the process. Take your time, and don't be afraid to stay at one stage for longer than what feels necessary. It's always better to be safe rather than sorry, and if that means taking some extra time to acclimate to activities again, so be it.

Here are the stages that on should go through after their rest period.


Return to Normal Daily (Non-Exercise) Activities

The first stage after the "rest" stage is the "return to normal" stage. This doesn't mean returning to physical activity. It means returning to whatever standard daily activities the patient participates in.

They can go back to work or school, do light cleaning duties, and go on walks. They should avoid lifting anything heavy or doing any strenuous workouts. If they feel the need to exercise, walking, yoga, and stretching are all good options if they don't notice any symptoms. Light aerobic exercise is appropriate.


Do Minor Exercises to Raise Heartrate

During the next stage, the patient can begin to exercise again. They should take it easy. Avoid anything high intensity during this stage.

Longer or more intense walks are appropriate during this stage. Cycling at a slow pace is also a viable option, but stationary cycling is ideal because it's safer.

If the patient wants to resume muscle-toning exercises, they should avoid doing anything more strenuous than mat Pilates at this time. Again, it's important to keep an eye on symptoms and if they return, to cease activity.

This isn't the time to start jogging or lifting weights.


Start Minor Sports-Specific Training

The next stage reintroduces sports-specific training. Again, this should be low-intensity training.

This can include skating, swimming, running drills, dribbling, and other no-contact activities. There should be no chance of the patient's head getting hit by a ball or another person.

Increase Training Intensity

Once the previous stage feels comfortable, the patient can start to increase their training intensity. They may start doing drills with other players (like passing drills). Again, all activities should be no-contact.

During this stage, patients can also begin to incorporate resistance training into their routines. They should still take it easy and stop if they begin to feel tired or dizzy.


Normal Game Practice

This next stage is exciting for most people! This is when patients can return to normal game practice. This stage should ideally start after medical clearance and after a coach has assessed their abilities.

This is full-contact practice, but in the case of heavy-contact sports (like football or hockey), it's best to start with minimal contact and progress slowly.


Return to Competing

Once the patient feels comfortable, they're able to return to their sport as normal. People are more likely to experience concussions after their first one, so it's important to be mindful while playing.


Important Considerations

With all of that in mind, there are a few things that people should consider while they're going through this process. Recovering from a concussion isn't easy. Here's a quick breakdown of a few things you should keep in mind throughout recovery.


It's Okay to Fall Back

Often, people get so excited to move to the next stage that they're resistant to slowing down or going backward. When they realize they're not ready for their current stage, they don't want to wait. They let their egos get in the way of recovery.

It's okay, and even normal, to have to fall back or take breaks. One day you may feel ready to move to stage 4, the next you may realize you were more comfortable at stage 3. Don't be afraid to go back to a previous stage when you realize you're not ready.


Everyone's Recovery Is Different

It's common for people to see other people recover and think that their recovery process should look the same. Some athletes can move through their stages of recovery quickly and make it look easy. That doesn't mean that everyone can do this.

Go through recovery at your own pace. Don't worry about what other people are doing. Worry about your own recovery process and comfort level.


Wait for a Minimum of 24 Hours Between Stages

This one is crucial. Patients should wait for a minimum of 24 hours before recovery stages. In many cases, waiting an extra day or two is a good idea. Some concussion symptoms don't show up right away.

Patients may feel fine while doing their activities but realize the next day that they overexerted themselves. If you wait a full 24 hours, you're more likely to notice signs that something is wrong before you move to the next stage.


Take Your Time After a Concussion


Waiting to return to play after concussion can be frustrating, but the recovery process is essential. If players don't take breaks before starting again, they risk severe injuries. A slow and steady recovery is a safe recovery.

Nobody knows when a sports-related concussion will happen, but there are certain steps to help individuals properly recover and return to their old selves. These steps include seeing a certified physician, getting a proper diagnosis, tracking any symptoms, and being kind to your body and mind.


All of these can be achieved with the help of Sallie® from Power of Patients.

Sallie® aims to assist individuals by being an incredibly easy-to-use and free symptom-tracking dashboard. The robust data collection approach includes many symptoms for our users to track.


By using Sallie®, individuals are taking the necessary steps for care and further prevention of Traumatic Brain Injuries. Whether or not you are involved in a sport or dealing with any type of brain injury, just know that Power of Patient’s Sallie® is made for you.

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