Concussion Return-to-Play Protocols: Baseball

Spend 1-2 days at each level before moving to the next. You should take approximately 1 week to complete the protocol.

If you develop symptoms, NOTIFY YOUR COACH OR TRAINER IMMEDIATELY. Rest one day, then resume at previous level

• LEVEL 1 - Light aerobic exercise (increase heart rate); begin running, < 70% effort. Begin with 5-10 minutes, 10 min of rest, then another 5-10 minutes. Following days, gradually increase time up to 30 minutes continuous. Include upper and lower body stretching.
   
• LEVEL 2 - Sport specific exercise (add movement); Advance to full speed running. Begin skills practice (running, throwing, catching, outfield fielding). No in-field, pitcher, or catcher position practice.
   
• LEVEL 3 - Progress to Non-contact training drills (exertion, coordination, cognitive load); Advanced drills; batting cage or coach pitch, throwing from the mound (pitchers), base running, In-field practice & catcher practice. Multiple player (2 or more) drills. May begin resistance exercise (push-ups, sit-ups, weights).
   
• LEVEL 4 - Full contact training after medical clearance; live drills, full team scrimmage, hitting live pitches. If you are able to train at Level 4 without symptoms, you may proceed to Level 5.
   
• LEVEL 5 - Game play (may return to full participation)

Note: These return to play protocols are patterned after the generic return to play protocol proposed by the 4th International Conference on Concussion(1), and may differ from the UIL recommended protocol.

---

(1) McCrory P, Meeuwisse WH, Aubry M, et al.  Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.  Br J Sports Med 2013; 47: 250-258.