Return to Play Guidelines
An athlete should not return to play until all of his symptoms — physical and cognitive — have cleared up.
See more videos with Dr. Jeffrey Barth.
After a player has experienced a concussion, our concern is that we not return them to play until they have fully recovered. And the best way to do that is, first of all, rest. But then introduce light exercise and be monitoring their symptoms since then. And the symptoms would be the physical symptoms of headache, dizziness, balance-types of problems, and so on. But we're also concerned about whether they're thinking well or not. In the process, this may take several days to get to the point where we're assessing their level of symptom expression. And by, hopefully, 7 days or so, any particular athlete may be back to normal functioning. It is important, though, to stress the system when you are assessing whether they are appropriate to return to play. For example, a student may tell you that they don't have any headaches anymore after the second day. Fine, that's great. We'll start some mild exercise. If the headache comes back, we cut back on the exercise again. If it doesn't come back, eventually we have them do a heavier exercise and see if the headache has returned. So we're constantly checking to see that all symptoms clear up even when you put them under stressful conditions. And that includes a brain being under a stressful condition of increased intracranial pressure, which is what happens when you actually exercise.
Posted on BrainLine October 20, 2010. Reviewed December 20, 2017.
Jeffrey Barth, PhD, is a Professor Emeritus in the UVA Medical School and the Brain Injury and Sports Concussion Institute.
Produced by Victoria Tilney McDonough and Brian King, BrainLine.