What are the graduated return-to-sport steps after a diagnosed concussion?

Ontario's sample protocol lists these steps, each lasting at least 24 hours, after typically 24 to 48 hours of rest:

1. Symptom-limiting activities: daily activities that do not make symptoms worse, such as moving around the home and simple chores.
2. Light aerobic activity: walking or a stationary bike at slow to medium pace for 10 to 15 minutes.
3. Sport-specific exercise: individual activity such as running or skating, with no contact or head-impact activities.
4. Non-contact training and practice drills: harder drills, with resistance training if appropriate.
5. Unrestricted training and practice: with contact where applicable; clearance from a physician or nurse practitioner is obtained before this step.
6. Return to sport: unrestricted competition.

An athlete is typically ready to move on when they can do the current step without new or worsening symptoms. If symptoms get worse at any step, they should stop and go back to the previous step; if symptoms do not improve or keep worsening, they should return to the physician or nurse practitioner. Recovery times vary, and some people need longer.

Source: https://files.ontario.ca/mhstci-rowans-law-protocols-en-2020-05-13.pdf