Is it normal for symptoms to get a bit worse during the return steps?

Q: Is it normal for symptoms to get a bit worse during the return steps?

Yes, a slight worsening is expected as long as it is mild and brief: Mild: symptoms worsen by only one to two points on a zero-to-10 scale (the guideline's sample scale runs from "feel great, no symptoms" to "worst I have ever felt"). Brief: symptoms settle back down to pre-activity levels within an hour. If symptoms worsen more than this, the athlete should stop the activity and try again the next day at the same step. For return to school, the student should pause and adapt activities as needed. Source: Parachute, Canadian Guideline on Concussion in Sport, 2nd edition: https://parachute.ca/wp-content/uploads/2019/06/Concussion-Guideline-2024.pdf

Question

Accepted Answer

Yes, a slight worsening is expected as long as it is mild and brief:

Mild: symptoms worsen by only one to two points on a zero-to-10 scale (the guideline's sample scale runs from "feel great, no symptoms" to "worst I have ever felt").
Brief: symptoms settle back down to pre-activity levels within an hour.

If symptoms worsen more than this, the athlete should stop the activity and try again the next day at the same step. For return to school, the student should pause and adapt activities as needed.

Source: Parachute, Canadian Guideline on Concussion in Sport, 2nd edition: https://parachute.ca/wp-content/uploads/2019/06/Concussion-Guideline-2024.pdf