Return to learn and work

It will be important to note that not everyone will need this return to learn and work protocol. You are guided by your symptoms. If you have minimal or no symptoms you can start at a later stage. If your symptoms are more severe you can start at stage one. Talk to your concussion health care provider for more guidance.

Your return to play protocol should be completed at the same time as your return to learn or work protocol.

Stage one: Light cognitive activity that is limited by symptoms

This includes, watching TV, device use, light reading that doesn’t increase symptoms more than 2 points.
A helpful method to use is the 2 point tolerance rule. Rate your symptoms on a scale from 0 (no symptoms) to 10 (unbearable). If an activity increases your symptoms by more than 2 points, you should either stop or modify the activity. For example, if a headache intensifies from 3/10 to 5/10 while using your phone, it’s time to put the phone down and switch to a different activity.
This stage is all about balance! Remember to take it easy and listen to your body.
If you are watching TV or using a device make sure you sit with good posture rather than slouched on the couch. Your neck will have been involved in your concussion injury and putting pressure on the neck by sitting poorly can increase your symptoms. Sit tall or alternatively lie on your side if you are watching TV.
Lying in bed all day is not going to be helpful but neither is doing too much and stirring up your symptoms.

Stage two: Increasing cognitive load

Homework, reading and working from home is encouraged during this stage.
Use the 2 point tolerance rule to complete tasks until symptoms have mildly increased by 2 points then change activity – for example: go for a walk, make a drink, rest. Then you can try again later.
Once you are able to tolerate 45 min – 1 hour with a minimal increase in symptoms then move onto the next stage.

Stage three: Half or part days at school and work

Once you are able to tolerate some homework or work from home then we encourage you to get back to your normal working environment.
It is important to let your school and teachers, or employer/manager know that you have had a concussion.
It is helpful if your school and employer are supportive during your return. Reducing pressure by extending deadlines and limiting homework is encouraged.
Be kind to yourself and know that you may need more breaks during this return to learn and work stage.
If the environment is increasing your symptoms more than 2 points then remove yourself and allow your symptoms to reduce. You can go to a quiet space or for a gentle walk or try some slow breathing. Once they have settled, return to the environment again. This allows your tolerance to slowly increase.
Remember pushing too hard is not helpful – stick to the 2 point tolerance rule.

Stage four: Full days

Once you can tolerate your part day, continue to increase the time you are at school or work until you can complete a full day.

Stage five: Full days with full capacity

Your next step is to increase your workload and homework back to previous levels.

You should be able to complete full days at work or school and social activities before you return to contact based training and competition.