Describe the current consensus-based return-to-play progression after a concussion.

• A. Immediate full return to competition after asymptomatic for 24 hours
• B. Graded, symptom-limited progression: rest until asymptomatic, then light aerobic activity, added non-contact drills, non-contact drills with increasing complexity, full contact practice, return to competition; must be symptom-free at each step for at least 24 hours and clinician clearance
• C. Randomly pacing progression by fatigue
• D. Only non-sport activities allowed indefinitely

Answer: (B)

Current consensus supports a graded, symptom-limited progression to return-to-play after concussion. After symptoms resolve with rest, an athlete advances through steps that typically include light aerobic activity, then non-contact drills, then non-contact drills with increasing complexity, followed by full contact practice, and finally a return to competition. Crucially, the athlete must be symptom-free at each step for at least 24 hours and usually receive clinician clearance before moving on. If symptoms recur at any stage, they should return to the previous level and be reevaluated. This approach prioritizes safe brain recovery and minimizes the risk of a subsequent injury, rather than returning immediately after a brief asymptomatic period, pacing by fatigue, or staying away from sport indefinitely.