Tips & Techniques to Get You Back to Full Strength

Returning to School and Sports Following a Concussion

Dana Tress 
December 16, 2019
Returning to School and Sports Following a Concussion

Helping your child return to their normal lives following a concussion can seem like an overwhelming task. Fortunately following a concussion, there is a recommended progression to guide your child’s ability to return to school and return to sports. These steps are important to follow because not doing enough activity or doing too much activity can delay the healing process.

In order to progress from one step to the next, your child must be able to tolerate the step without any increase in their concussion symptoms. There should also be 24-hours between each step. (For example, your child tolerates Step 2 of the return to learn protocol on Monday, so they will be able to progress to Step 3 on Tuesday.) Should a stage increase the child’s symptoms, you go back to the previous step. Returning to sports can not occur until your child is tolerating a full day of school, including gym class without accommodations.


The Return to Learn Protocol is as follows:

Step One: Full Rest For Your Brain

You should spend the first 1-2 days resting your brain. This means no video games, no computers, and no other screen time. You should be primarily resting.

Step Two: Modified Return to School

Once your child can tolerate light mental activity at home, you can return to school with some accommodations such as going to school part-time, no homework or tests, rest breaks in the nurses office and/or no note taking.

Step Three: Full Day of School With Modifications

During this phase, you should be able to tolerate being in school for a full day, but accommodations will still need to be made. Priority should be given to what assignments need to be completed each day, and you should not take more than one test per day. You still might need rest breaks in the nurses office, less note taking, etc.

Step Four: Full Day of School Without Modifications

You should be able to tolerate a full work load with help from teachers to complete necessary missed work without any further special accommodations. You may return to gym class as well (if approved by physician).

Step Five: Full Day of School With Gym Class

You will be able to participate if a full day of school and physical education class without any special accommodations. You may also return to extracurricular activities, including clubs and sports.

The Return To Play Protocol is as follows (and should be supervised by a trained professional!):

Step One: Light Activity

This step is typically 5-10 minutes of light aerobic exercise, such as walking or riding a bicycle, designed to increase the athlete’s heart rate.

Step Two: Moderate Activity

This step incorporates more movement into activities designed to increase the athlete’s heart rate with greater head and body movements, and can begin to include moderate weight lifting.

Step Three: Heavy, Non-Contact Activity

This step progresses the intensity of aerobic exercise, returning to regular weightlifting routine, and adding in sport-specific drills and training exercises.

Step Four: Return to Practice

The athlete may begin to return to full contact during a controlled practice setting.

Step Five: Return to Play

The athlete is cleared at this stage to return to full competition with no further restrictions.


Please remember we are always here to answer your questions!

Dana Tress
Meet the Author
Dana Tress, PT, CEAS, AIB-CON is a physical therapist specializing in the management of concussion, balance dysfunction, headaches and dizziness in Crystal Lake, Illinois at Smith Physical Therapy Balance + Concussion Center, an award winner in concierge physical therapy services for McHenry County and surrounding regions.