Hockey Canada’s Return to Play Guidelines
Hockey Canada Concussion Card 4
The return to play strategy is gradual, and begins after a medical doctor, sports medicine doctor or nurse practitioner has given the player clearance to return to activity. If any symptoms/signs return during this process, the player must be re-evaluated by a medical doctor or nurse practitioner. No return to play if any symptoms or signs persist. Remember, symptoms may return later that day or the next, not necessarily when exercising!
IMPORTANT – CONSULT WITH THE TREATING MEDICAL DOCTOR OR NURSE PRACTITIONER ON RETURN TO LEARN PROTOCOLS. PLAYERS SHOULD HAVE THE ABILITY TO RETURN TO SCHOOL FULL TIME PRIOR TO PROCEEDING THROUGH STEPS 5 AND 6 OF THE RETURN TO PLAY STRATEGY.
IMPORTANT – FOLLOWING A CONCUSSION AND PRIOR TO STEP 1, A BRIEF PERIOD OF PHYSICAL AND MENTAL REST IS RECOMMENDED.
STEP 1
Light activities of daily living which do not aggravate symptoms or make symptoms worse. Once tolerating step 1 without symptoms and signs, proceed to step 2 as directed by your physician.
STEP 2
Light aerobic exercise, such as walking or stationary cycling. Monitor for symptoms and signs. No resistance training or weight lifting.
STEP 3
Sport specific activities and training (e.g. skating).
STEP 4
Drills without body contact. May add light resistance training and progress to heavier weights. The time needed to progress from non-contact to contact exercise will vary with the severity of the concussion and the player. Go to step 5 after medical clearance (reassessment and written note).
STEP 5
Begin drills with body contact.
STEP 6
Game play. (The earliest a concussed athlete should return to play is one week.)
Note: Players should proceed through the return to play steps only when they do not experience symptoms or signs and the medical doctor or nurse practitioner has given clearance. Each step should be a minimum of one day (but could last longer depending on the player and the situation). If symptoms or signs return, the player should return to step 2 and be re-evaluated by a physician.
IMPORTANT – Young players will require a more conservative treatment. Return to play guidelines should be guided by the treating physician.