1

Setting the Scene

The rule of thumb is you should not do anything which increases your symptoms. 

• Light cognitive (thinking) activity such as reading, using mobile phones or watching TV. 

• Light physical activity such as gentle swimming or medium paced walking.  

• Deep breathing exercises or meditation 

Take it easy! Do not provoke symptoms and do not do anything where your head is at risk of being hit. Once you can do 15-minute stints of cognitive tasks (on their phone or reading), then you can progress to Stage 2. 

2

Light Cognitive Activity

This stage is straightforward! The goal in this stage is to be able to tolerate 45 minutes of cognitive activity without an increase in your symptoms. This could include 45 minutes of homework, being on your phone or reading a book. If you do feel an increase in symptoms – that is OK! Take a break and to try again a little bit later. 

3

 A Half Day of School/Work

Certain academic accommodations may be provided, including: 

• Allowing periods of rest 

• No tests or P.E. class 

• No recess or lunch (but a supervised learning break) 

It is important to remember your brain is still healing and a second knock may lead to a subsequent concussion with potentially serious consequences.  If you are feeling 100%, we still want you to head home and not push yourself yet. 

4

A Full Day of School/Work

Exactly the same idea and the same restrictions as Stage 3. The only difference is you are allowed to stay at school for the entire day. If they get through the day with no symptom provocation, then you are welcome to move to Stage 5. 

1

Treadmill Test

During Stage 1 you will attempt the Buffalo Concussion Treadmill Test (BCTT) at Sydney Concussion Centre. 

What is the Buffalo Concussion Treadmill Test (BCTT)? 

The BCTT is a walking test where you will be put on a treadmill which gradually increases in its incline. We will look at your heart rate and symptoms closely to ensure you are safe at all times. To pass, you will need to reach a sufficiently high level of intensity without a sufficient increase in your symptoms. Don’t worry, it’s just a walking test and you won’t need to run! 

• If you pass:  You are allowed to progress to stage 2. 
• If you fail:  We will prescribe a sub-symptom heart rate intensity that you are allowed to exercise with at home (for example, between 120-125 beats per minute). We will try the test again later as you get stronger. 

 

4

Medical Clearance

You allowed to restart any resistance or strength training. Ease into it. Feel free to really try and elevate your heart rate. Typical drills included in Stage 3 are: 

• Squats/deadlifts 

• Dribbling around cones and shooting a soccer ball 
• Non-contact team drills 
• High-intensity agility drills 
• Sprints 

You will need to be completely symptom-free to complete Stage 3 and progress onwards to Stage 4. 

2

Light Practice

After passing the BCTT you are allowed to start some sport-specific activities.  

Stage 2 includes: 

• Running and easy agility 
• Kicking/passing/shooting a soccer ball 

• Passing and catching a rugby ball 

 

5

Contact Training

You are fully cleared to participate in a full contact training session with your team. It may take you a bit of time to get back into the swing of things. You may get tired a little easier on your first session back, but you should get your fitness back, with time!