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Return-to-Play Decisions


Most concussions resolve quickly without complication. Here at SCCNJ, we believe in the motto: Love your brain…Love your sport. We want to get you back in the game and we want you to take care of your brain. If each concussion is managed carefully, then the likelihood of a long, enjoyable athletic career is increased.


Especially with youth, whose brains are still developing and more vulnerable to the effects of concussion, it is important that recovery from concussion has occurred prior to return to sports and risk of contact. At SCCNJ, we recommend the following protocol as a guide to help make the best decision as to when the athlete can return to the sport.


  1. The athlete must feel 100%, asymptomatic from the concussion, as he or she felt PRIOR to the concussion.

  2. Post-concussion neurocognitive testing should be at or better than baseline testing. If there is no baseline, test results should have plateaued and are no longer improving.

  3. The athlete must be back to all cognitive activity (at school or work without accommodations that may have been provided as a result of the concussion) with no exacerbation of symptoms.

  4. The athlete should pass physical exertional testing, ideally by a certified athletic trainer or physical therapist with concussion expertise, and have completed the Zurich protocol with no return of symptoms.

  5. For youth, we recommend waiting three weeks with no symptoms before returning to sport or gym, although the youth may do reconditioning, non-contact exercise under the direction of the athletic trainer.

  6. For athletes with a history of other recent or multiple concussions, a longer period of avoidance of contact risk may be recommended. In some cases, consideration may be given as to the risk of re-concussion and whether it is advisable to return to the sport.


Importantly, we consider the above protocol the ideal; however, there are exceptions and adjustments made because each concussion and each athlete is unique, and thus treatment and management must be tailored to the individual case. 


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