What is the recommended return-to-play sequence after a concussion?

• A. Direct return to full contact once asymptomatic for 24 hours.
• B. Non-contact drills only until cleared by medical staff.
• C. Symptom-free at rest, then light aerobic activity, sport-specific drills, non-contact, then full contact with medical clearance.
• D. Full contact allowed immediately if pain is tolerable.

Answer: (C)

Concussion return-to-play is a stepwise process that protects the brain by gradually increasing activity while monitoring symptoms and using medical clearance to move to the next stage. Start only when you are symptom-free at rest. Then advance to light aerobic activity to raise heart rate without contact. If symptoms stay absent, progress to sport-specific drills to reintroduce skills. Next, do non-contact training drills to reintroduce team elements without collisions. Finally, return to full contact, but only with medical clearance.

This approach is best because it uses careful progression and symptom monitoring to ensure the brain has recovered enough to handle increasing demands, reducing the risk of a second injury. Rushing back to full contact or using a fixed time or pain tolerance as the sole guide can overlook ongoing recovery needs and safety.