Return to Play Head Injury Protocol


Step 2 cannot be taken until Step 1 is complete


Step 1: Physical and cognitive rest. No exertional activity until asymptomatic (light aerobic exercise can begin at 72 hours if healthcare provider believes appropriate)

Step 2: Return to school full-time /normal cognitive daily activities.

Step 3: Low impact, light aerobic exercise.

Step 4: Moderate exercise. No contact.

Step 5: Non-contact, sports specific training. No helmet or other equipment. Weight training can begin.

Step 6: Full contact practice or training.

Step 7: Normal competition.

NOTE: Generally, each step should take a minimum of 24 hours. If concussion symptoms occur at ANY step, the student must stop the activity and their licensed health care provider as defined in Iowa Code Section 280.13C should be contacted.

If any post-concussion symptoms occur during this process, the student should drop back to the previous asymptomatic (no symptoms) level and begin the progression again after an additional 24-hour period of rest has taken place.

DMPS will adhere to the graduated return to learn strategy, leading to the graduated return to play strategy, as outlined by the IDPH concussion guideline/REAP manual: