Rome City School District

Return to play protocol following a concussion

UPDATED: JUNE 2022

The following protocol has been established in accordance to the National Federation of State High School Associations and the International Conference on Concussion in Sport, Prague 2004. In addition it has been fabricated in a collaborative effort with concussive experts within the greater Syracuse area and the Rome City School District Concussion Management Team. As such, it is imperative to remember the safety of the student is the primary concern of the Rome City School District. 

The information contained below is to be used as mere guidelines that are to be implemented in the time following a concussive event. This information is not to be considered as all-inclusive or all encompassing. 

When a student shows signs or symptoms of a concussion or is suspected to have sustained a brain injury after an evaluation by competent medical personal at the time of the incident: 

  1. The student will not be allowed to return to play in the current game, practice or physical education class activity.  

  1. The student should not be left alone, and regular monitoring for deterioration is essential over the initial few hours following injury. 

  1. Following the initial injury, the student must follow up with their Primary Care Physician (PCP) or by an Emergency Department (ER) within the first 24 hours. 

  1. The student must have the initial evaluation filled out, signed and dated when following up in the training room or nurse’s office. 

  1. Before returning to play, the athlete must have 2nd visit with PCP or ER and return to play must follow a medically supervised process. 

The cornerstone of proper concussion management is rest until all symptoms resolve and then a graded program of exertion before return to physical activity. The program is broken down into six steps in which only one step is covered per one 24 hour period. The six steps involve the following: 

  1. No exertion activity until asymptomatic. 

  2. Light aerobic exercise such as walking or stationary bike, etc. No resistance training. 

  3. Specific progressive exercise. 

    1. 15 minute jog 

    2. 2x10 jumping jacks 

    3. 2x10 push-ups 

    4. 2x10 sit-ups  

    5. 2x20sec planks 

    6. 2x10 burpees 

  4. Non-contact training/skill drills. 

  5. Full contact training in practice setting (if a contact of collision sport)

  6. Return to competition 

If any concussion symptoms recur, the student should drop back to the previous level and try to progress after 24 hours of rest. In addition, the student should also be monitored for recurrence of symptoms due to mental exertion, such as reading, working on a computer or taking a test.