Return to sport

Returning to contact sport after a concussion should follow a structured, individualised graded return-to-play protocol under the guidance of a clinician experienced in concussion management; athletes must complete a progressive exertion program without significant symptom exacerbation, and demonstrate normal balance, cognition and sport-specific skills before contact is reintroduced.

Clearance should be based on objective assessment where possible (neurocognitive testing if indicated, vestibular/oculomotor exam, and balance testing) alongside clinical judgement, with extra caution for adolescents and those with previous concussions who have longer recovery trajectories.

Protection strategies, communication with coaches and schools, and a plan for immediate removal from play if symptoms recur are essential; when in doubt, delay return—premature return to contact increases the risk of prolonged recovery and repeat injury.