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CATA's Return to Play Protocol

Heads Up Institute


Concussion: Signs and Symptoms

Loss of consciousness

Neck pain Feeling like 'In a fog' Drowsiness
Seizure or convulsion Nausea or vomiting Difficulty concentrating More emotional
Amnesia Dizziness or blurred vision Difficulty remembering Irritability
Headache Balance problems Fatigue or low energy Sadness
Pressure in head Sensitivity to light or noise Confusion Nervous or anxious



Managing a Concussion

Remember that problems could arise in the next 24 - 48 hours. Go to the hospital at once if the athlete:
  • has a headache that gets worse
  • has the appearance of new symptoms
  • Is very drowsy and can't be woken
  • cannot recognize people or places
  • vomits repeatedly
  • behaves unusually, seems confused or is irritable
  • has seizures
  • has weak or numb arms or legs
  • is unsteady on his/her feet
  • has slurred speech
The athlete should also:
  • Rest and avoid activity until medically cleared
  • NOT drink alcohol or take sleeping tablets/pills
  • NOT drive until medically cleared
  • Use all medication (incuding over-the-counter) with the supervision of a physician
  • NOT train or play sports or participate in any activiites with risk of further contact until medically cleared.


Return to Play Protocol

Athletes should not be returned to play the same day of injury. They should:

  1. Rest until asymptomatic. Rest must be both physical and mental ie. no computer games, online chats, no texting, no television, etc.
  2. Begin with light aerobic exercise (such as stationary bike)
  3. Sport-specific exercise
  4. Non-contact training drills (start light resistance training)
  5. full contact training after medical clearance
  6. return to competition (game play)

Each of the above stages should be 24 hours or longer. If symptoms recur, the athlete should return to the previous stage. Resistance training should only be statrted in the later stages.

Medical clearance must be given prior to return to play!
CATA strongly encourages that concussion management be under the supervision of a professional sport health practitioner such as a sports physician, certified trainer, athletic therapist, and/or neuropsychologist.

For quick reference, download this one-page summary of Signs & Symptoms of Concussion and Return to Play Protocol: one-page summary created by the Canadian Athletic Therapists Association.