What are the steps for returning to sports after a concussion?

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Accepted Answer

CDC HEADS UP uses a six-step return-to-sports progression. It starts only once the athlete's health care provider gives the go-ahead, and should be done with that provider's approval and supervision. Where the team has a certified athletic trainer, work closely with them. Step Activity Examples 1 Back to regular activities School and daily life, plus the provider's green light to begin 2 Light aerobic activity Walking, stationary bike or light jogging; no weightlifting 3 Moderate activity Moderate jogging, brief running, lighter-than-usual weight training 4 Heavy, non-contact activity Sprinting, high-intensity stationary biking, sport-specific drills without contact 5 Practice and full contact Full-contact practice, if the sport has contact, in a controlled setting 6 Competition Return to games Rules between steps: Each step typically takes at least 24 hours. Move up only if no new symptoms appear at the current step. Return to sports can run alongside return to school, but the athlete should be back to all regular non-sports activities without accommodations before finishing the progression. NFHS guidance (2023) likewise says to complete return-to-learn before unrestricted return to sport. For coaches planning practice: an athlete in steps 2 to 4 can do the activity for that step but must not take part in contact drills until step 5.

Step	Activity	Examples
1	Back to regular activities	School and daily life, plus the provider's green light to begin
2	Light aerobic activity	Walking, stationary bike or light jogging; no weightlifting
3	Moderate activity	Moderate jogging, brief running, lighter-than-usual weight training
4	Heavy, non-contact activity	Sprinting, high-intensity stationary biking, sport-specific drills without contact
5	Practice and full contact	Full-contact practice, if the sport has contact, in a controlled setting
6	Competition	Return to games