What Is NFL's Return-To-Participation Protocol After Concussion?

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Head injuries in the NFL are not new, but with more spotlight on their long-term effects to player health, the league has instituted protocol to address the diagnosis and management of concussions. In addition to the in-game protocol, there is also a "Return-to-Participation Protocol" that can keep players out of action for more practices or games until they pass through and are cleared to return. It is a five-step process without any set timeline for a full return from a concussion:
  1. Rest and recovery: Until a player returns to the "baseline level of signs and symptoms and neurological examination," only limited stretching and balance activities are recommended. Electronics, social media and team meetings are all to be avoided.
  2. Light aerobic exercise: The NFL recommends 10-20 minutes on a stationary bike or treadmill without resistance training or weight training. The cardiovascular activity is monitored by an athletic trainer to "determine if there are any recurrent concussion signs or symptoms."
  3. Continued aerobic exercise and introduction of strength training: Increased duration and intensity of aerobic exercise with strength training added. An athletic trainer will supervise to watch for recurrent concussions signs or symptoms.
  4. Football specific activities: The cognitive load of playing football will be added and players will participate in non-contact activities for the typical duration of a full practice.
  5. Full football activity/clearance: A player returns to full participation in practice, including contact without restriction.
Keyword: concussion protocol return play