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The NH State Advisory Council on Sport-Related Concussion recommends that athletes be returned to play only after symptoms and objective test results have returned to their baselines, and an appropriate sequence of graded exertional exercises is completed with no return of signs or symptoms. The Council recommends that steps 1-4 are monitored by a Certified Athletic Trainer or a Physical Therapist.

Return to Play

Rehabilitation Stage

Functional exercise at each stage


1. No activity

Complete physical and cognitive Rest


2. Light aerobic exercise

Walking, swimming, stationary bike

Keeping intensity < 70% MPHR

Increase HR

3. Sport-specific exercise

Skating drills in hockey, running drills Soccer

No head impact activities

Add Movement

4. Non-contact training drills

Progression to more complex training drills (e.g. passing drills in football and hockey) May start progressive resistance training

Exercise, coordination,

and cognitive load

5. Full contact practice

Following medical clearance participate in normal training activities.

Restore confidence and

Assess functional skills

By coaching staff

6. Return to normal play