A Practical Checklist for Athletic Directors
Return-to-play after a concussion follows a graduated, six step protocol. From complete rest to light activity, sport specific exercise, non-contact training, full-contact practice, and finally game return with at least 24 hours between each stage and no progression while symptoms persist. Concussions account for 24.2% of all reported high school sports injuries, and with over 300,000 diagnosed annually in youth and high school athletics, they represent one of the biggest liability and duty of care concerns athletic directors face each season.
Head and face injuries, concussions chief among them, make up nearly a quarter of all reported high school sports injuries, which is why a clear, written protocol matters as much for a volleyball or wrestling program as it does for football, where concussion awareness efforts have historically concentrated.
The Six Stages, Step by Step
- Complete physical and cognitive rest until symptoms resolve.
- Light aerobic activity (walking, stationary bike) at low intensity.
- Sport specific exercise without head impact risk.
- Non-contact training drills.
- Full-contact practice, once cleared by a medical provider.
- Return to competitive play. Each stage requires the athlete to remain symptom free for 24 hours before advancing, and any return of symptoms means dropping back a stage.
Red Flags That Mean Your Athlete is Ready to Return to Play
Headache, light or noise sensitivity, difficulty concentrating in class, and sleep disruption can all persist even when an athlete insists they “feel fine.” Standardizing symptom check-ins, not just relying on self-report, protects both the athlete and the program.
Talking to Parents Without Causing Panic
Parents often swing between two extremes after a concussion diagnosis: assuming the worst, or assuming their athlete is fine because they “seem normal.” A standardized protocol gives coaches and ADs a neutral, consistent script to use with families. This is the process, these are the stages, here’s who signs off at each one which reduces both anxiety and pressure to rush the timeline.
Documentation Matters as Much as the Protocol
A written, dated record of each stage, who cleared the athlete to progress, and any symptom recurrence gives your program a defensible record if a return-to-play decision is ever questioned.
Building a Support System Beyond Game Day
This protocol applies to soccer, volleyball, and wrestling, not just football, where concussion risk gets the most attention. Independent recovery and monitoring partners can support your athletic training staff through the process without replacing medical clearance decisions. Total Health works alongside SFV athletic training staff to support athletes through recovery windows between protocol stages. If your program needs a printable version of this checklist for the upcoming season, reach out and we’ll send one over.