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Emergency Department Discharge Instructions

Head injury - return to play instructions

Emergency Care Discharge Instructions - Return to play guidelines

Instruction summary

Return to play guidelines are typically used for patients who have had a sports injury and want to return to playing the sport. However the overall principles are applicable for anyone who has had a head injury and wants to return to physical activities.

Depending on which guidelines you look at, there are 5 or 6 stages to returning to play. Before starting stage 1 you must not have any symptoms. At any stage, if you experience any symptoms, return to the stage where you didn’t have symptoms (some guidelines also advise seeing your healthcare provider to be reassessed). Stay at each stage for 24 - 48 hours before trying the next stage.


No symptoms, for a minimum of 24 hours

Stage 1

Light aerobic exercise such as walking or biking on a stationary bike. No jarring activities like hitting a baseball. Take a few days at stage 2 before moving on to stage 3 (if you have no symptoms).

Stage 2

Sports-specific activities such as skating or throwing, but much reduced from the usual routine. No jarring exercises. No high-speed stops.

Stage 3

Drills without any body contact.

Stage 4

Drills with body contact.

Stage 5

A full game with body contact.

If symptoms return and persist despite decreasing your activities, see your healthcare provider.