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
04/18/23
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
04/18/23
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
04/18/23
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
04/18/23
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
04/18/23
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
04/18/23
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
04/18/23
Vanderbilt Orthopaedic Institute
Conclusions• VOI PT:– Symptom free 24 hours– Return to school– Scheduling: 343-9284
• RTP guidelines are a stepwise progression– 5 phases
04/18/23