Return to School and Activity Protocols

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Living Guideline Return to Activity, Sports, School, and Work Protocol

Begin by resting for the first 1-2 days. After this short rest, the child/adolescent should start activities (physical and thinking) that do not make symptoms worse or bring on new symptoms. These gentle activities are encouraged 1-2 days after a concussion, even if the child/adolescent still has symptoms. Avoid any activity where the child/adolescent could fall or hit their head. Resting completely for more than 1-2 days after a concussion may slow recovery. Missing more than one week of school is not suggested. 

Return-to-activity/sport steps:

Steps

Activity

Example

1

Complete rest (maximum 1-2 days)

Activities at home that do not make the person feel worse. 

Limit activities that increase the heart rate

2

Light physical activity

Jogging or stationary cycling at slow to medium speed. No weight training.

3

Sport-specific exercise

Running or skating drills. No drills with risk of head injury.

4

Non-contact activities

Practice without body contact. Gym class activities without risk of head injury.

5

Full-contact activities

(Clearance from your doctor is required)

Full activities/sports practices after doing full-time school and getting a doctor‘s note

6

Return to all activities and sports

Normal full-contact game play

Return-to-school steps:

Steps

Activity

Example

1

Complete rest (maximum 1-2 days)

Mental and rest. Avoid school work, screened devices, and driving.

Limit activities that increase the heart rate

2

Activities at home that do not make symptoms worse or bring on new symptoms

Reading, texting, screentime, and other activities that do not worsen symptoms. Start at 5-15 minutes at a time. 

3

School activities

Homework, reading, or other activities outside of the classroom

4

Return to school Part-Time

Getting back to school for a few hours or half days

5

Return to school full-time

(Clearance from your doctor is NOT required)

Gradual return to full days at school*

*Complete absence from the school environment for more than one week is not generally recommended

Concussion Information Content from this tool was generated from the May 2022 Living Guidelines for Pediatric Concussion Care and originally adapted with permission from the Parachute Canadian Guideline on Concussion in Sport