Return to Play Protocol
There are 6 stages of the return to play protocol for any sports or physical activity. The stages do not correspond to the number of days as it is all dependent on symptoms and your body's response to activity. Each stage must take a minimum 24 hours free of symptoms before you can proceed to the next stage.
Stage 1: No Activity with only complete rest
At this stage, limit school, work and tasks requiring concentration. Refrain from any physical activity until symptom free.
Stage 2: Light General Conditioning Exercises
Once have been symptom free for 24 hours, patient can start with light aerobic exercises; such as walking on treadmill or stationary cycling for 10-15 minutes. Patient should perform this under supervision and have heart rate monitored to avoid over-exertion. If the patient becomes symptomatic again during the exercise, stop immediately and return to rest until symptoms are resolved. Then patient will repeat the step until he or she is able to complete without having recurring symptoms during exercise.
Stage 3: General Conditioning and Hockey Specific Skill Work Individually
NO Contact. Begin with a warm up (stretching/ flexibility) for 5-10 minutes. Then gradually increase the intensity and duration of cardio workout to 20-30 minutes. If patient stays symptoms free, then proceed to begin Hockey specific skill work: Individual stick handling and shooting drills.
Stage 4: Non-contact Sport Specific Drills
At stage 4, patient can start returning to sport specific drills that includes more complex processing and motor control. No contact still but patient is allowed to increase duration of session to 60 minutes and begin resistance training. Also begin on-ice skating warm up and practice of hockey drills with a partner: shooting, passing and other position specific drills. Progress back to pre-injury duration of practice and team drills. Practice team passing, shooting drills and individual defensive skills. Continue with walk throughs and run throughs of plays and patterns without contact.
Stage 5: Full-contact Sport Specific Drills
Once patient is symptom free and have progressed up to Stage 5, the patient is now allowed to participate in full contact practice to get yourself back in the lineup. Coaches must make sure that the patient has regained his/her pre-injury skill-level and is confident in his/her ability to return to activity.
Stage 6: Full-contact Game Play
Upon completion of the 5 stages with no reproduction of symptoms, the patient will then be released medically for return to full contact game play.
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CAUTION: The above is only a guide and should not be used as a substitute for being evaluated by a regulated health care professional that has experience in managing concussions and mild traumatic brain injuries (mTBI). If you have any questions about your condition, please feel free to contact us your convenience. If you feel that this is a medical emergency, please visit your closest hospital emergency department.