Return-to-Play and Return-to-Learn Concussion Programs

Return-to-play programs run the graduated, stepwise protocol that takes an athlete from rest back to full competition, and issue the clearance that schools and leagues require. Return-to-learn does the same for the classroom, which usually comes first and matters more.

The protocol is stepwise for a reason: each stage adds load, and symptoms returning at any stage sends the athlete back a step rather than out of the process. What a program adds over following a printable chart at home is exertion testing, symptom monitoring by someone who does this weekly, and a clinician whose signature the league will accept.

Return-to-learn is the half that gets skipped, and it should not be. Cognitive load is load. A student sent back to a full timetable and two exams while still symptomatic is being asked to do the equivalent of a training session, and the CDC's guidance is that most children can return to school within 1 to 2 days of a concussion — with accommodations, not with absence.

One thing worth knowing before you start calling: the return-to-play listings in this directory sit in 44 states, not all 51 jurisdictions the directory covers. In the states without one nearby, a multidisciplinary concussion clinic or a sports medicine physician is the realistic route to clearance.