What are the six steps of the return-to-sport strategy?

Each step takes at least 24 hours. The strategy begins at the same time as return to school, and the two can happen at the same time.

1. Activities of daily living and relative rest (first 24 to 48 hours). Typical home activities such as preparing meals, social interactions and light walking, with minimal screen time.
2. Aerobic exercise. 2A: light effort, such as stationary cycling or walking at a slow to medium pace (up to about 55% of maximum heart rate); light resistance training may begin. 2B: moderate effort, such as brisk walking or stationary cycling (up to about 70% of maximum heart rate).
3. Individual sport-specific activities without risk of inadvertent head impact. For example running, changing direction and individual drills, supervised by a teacher, parent/caregiver or coach, until the athlete is free of concussion-related symptoms even when exercising.
   Medical clearance is required before step 4.
4. Non-contact training drills and activities. High-intensity exercises with no body contact, such as passing drills, multi-athlete training and practices.
5. Return to all non-competitive activities, full-contact practice and physical education activities. No competitive gameplay yet.
6. Return to sport. Unrestricted sport and physical activity.

The guideline calls this a guideline that does not replace medical advice; with direction from a healthcare professional, timelines and activities may vary.

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