What is the return-to-sport sequence after a diagnosed concussion, and what must the athlete give me?

An athlete diagnosed with a concussion is managed under a Return-to-School and football-specific Return-to-Sport strategy, supervised by a medical doctor or nurse practitioner. An initial 24-48 hours of rest is recommended first, and the athlete spends a minimum of 24 hours without symptom increases at each stage before moving on. If new or worse symptoms appear, the athlete goes back to the previous stage. Athletes must return to full-time school activities before stages 5 and 6.

1. Symptom-limiting activity: daily activities that do not provoke symptoms.
2. Light aerobic activity: walking or stationary cycling at slow to medium pace, no resistance training.
3. Sport-specific exercise: low to moderate individual running, agility, kicking, passing and receiving drills; no team drills or head impact activities.
4. Non-contact training drills: high-intensity drills, non-contact individual and team drills; progressive resistance training may start; no head impact activities.
5. Full contact practice: only after medical clearance.
6. Return to sport: normal game play.

Medical Clearance Letter: before returning to full-contact practice and games, the athlete must give their coach a standardized Medical Clearance Letter stating that a medical doctor or nurse practitioner has personally evaluated them and cleared them to return to sport. Because the Medical Assessment Letter contains personal health information, the athlete or their parent or guardian is responsible for giving it to the coaches.

Source: Football Ontario Concussion Protocol/Policy, sections 5 and 7 (based on the Football Canada Concussion Pathway): https://footballontario.net/wp-content/uploads/sites/19/2023/01/Football-Ontario-Concussion-Protocol_Policy.docx.pdf