Vanderbilt Orthopaedic Institute

Return to Play Following a Concussion

Brian Richardson, PT, MS, SCS, CSCSVanderbilt Orthopaedic Institute

Vanderbilt Orthopaedic Institute

Objectives• Discuss the development of the Return to play

(RTP) guidelines• Discuss the referral process to VOI PT• Discuss the RTP guidelines

04/18/23

Vanderbilt Orthopaedic Institute

Guideline Development

• Collaborative effort• VOI PT’s/ATC’s• Physicians• Evidence based

04/18/23

Vanderbilt Orthopaedic Institute

Referral Process

• Nontraditional sports– Rodeo– Club sports

• Junior high school• Outside

Metro/Williamson County

• Symptom free 24 hours• Return to school• PT evaluation within 24

hour period• Schedule daily or every

other day• Vestibular involvement– Refer to Pi Beta Phi

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Vanderbilt Orthopaedic Institute

Return to play guidelines

• Day 1: Physical Therapy Evaluation– History– ROM– Strength– Balance– Heart rate/Blood

pressure

• If symptoms occur:– Rest 24 hours and then

repeat phase– If symptoms recur again, refer back to physician

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Vanderbilt Orthopaedic Institute

Return to play guidelines• Day 1: Aerobic

activities– Bike or elliptical for 20

minutes– Rest 15 minutes and

monitor symptoms– Treadmill for 20 minutes– 70% max heart rate

• If symptom free, progress to next phase

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Vanderbilt Orthopaedic Institute

Return to play guidelines• Day 2: Functional

activities– Jogging/Sprinting– Cutting/Lateral

movements– Situps/Pushups/Burpees– Change in

elevation/direction

• If symptom free, progress to next phase

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Vanderbilt Orthopaedic Institute

Return to play guidelines

•Day 3: Sport Specific Activities– More intensive – Sport dependent

• Wide receiver: running routes

•If symptom free, progress to next phase

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Vanderbilt Orthopaedic Institute

Return to play guidelines

• Day 4: Non–contact practice/drills– Perform on the practice

field– Communicate with

treating PT/ATC

• If symptom free, progress to next phase

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Vanderbilt Orthopaedic Institute

Return to play guidelines

• Day 5: Full participation– Communicate with the

PT/ATC– Resume full

contact/previous activity level

– Communicate with physician

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Vanderbilt Orthopaedic Institute

Conclusions• VOI PT:– Symptom free 24 hours– Return to school– Scheduling: 343-9284

• RTP guidelines are a stepwise progression– 5 phases

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Vanderbilt Orthopaedic Institute

Questions?

04/18/23