Ice Performance Lab · Hockey Health

Concussion

Recognize the signs. Remove from play. Follow a medically supervised return.

Commotio cerebri needs its own pathway — from the first concern at the rink to recovery and return to hockey.

First actions ↓Return pathway ↓← Hockey Health

At the rink

When in doubt, sit it out.

After a head or body impact, headache, dizziness, confusion, poor balance, visual problems or unusual behaviour can signal concussion. Loss of consciousness is not required; symptoms may appear later.

1 · Remove

Stop participation when concussion is suspected. No same-day return while suspicion remains. Arrange prompt assessment by an appropriately qualified healthcare professional.

2 · Observe

Do not leave the player alone initially. Note the impact, signs, symptoms and their changes. Follow medical observation instructions.

3 · Reassess

A brief symptom check cannot rule out concussion. Reassessment matters when symptoms change or emerge later.

Emergency signs — call 112

Seek emergency help for a worsening severe headache, repeated vomiting, seizures, increasing confusion, unusual drowsiness or inability to wake, weakness or numbness, slurred speech, unequal pupils or double vision.

If neck injury is suspected, avoid unnecessary movement and follow emergency-service instructions.

The first days: recovery with a plan

Use relative rest for the first 24–48 hours, with tolerable daily activity and reduced screen exposure. Avoid prolonged complete inactivity. Gentle activity may be introduced within the clinician’s plan; prevent further head impacts.

Return to learning or work and physical activity should progress according to tolerance. School adjustments may help younger players; full return to learning should precede unrestricted sport.

At follow-up, bring: the injury date and mechanism, symptom changes, sleep, school/work tolerance, activity exposure and the response afterwards. Persistent or worsening problems need reassessment and targeted care.

Clinician-guided progression

Return to hockey, step by step

This educational outline follows the Amsterdam return-to-sport framework. Each step typically takes at least 24 hours. Timing and progression are individual; completing a list does not provide clearance.

1 · Symptom-limited activity

Reintroduce tolerable daily activities.

2 · Aerobic exercise

Progress from light to moderate exercise under the care plan.

3 · Individual sport-specific exercise

Introduce controlled hockey-related work without head-impact risk. Obtain medical authorization first if the activity carries an inadvertent head-impact risk.

4 · Non-contact training

Resume more demanding drills after clinical recovery and medical authorization for activities carrying head-impact risk.

5 · Full-contact practice

Restore normal practice exposure under the approved plan.

6 · Return to sport

Return to game participation after the progression and required medical decision.

Medical gate: before higher-risk stages, concussion-related symptoms, cognitive abnormalities and other clinical findings must resolve, including with exertion. New or returning symptoms require stopping progression and contacting the treating professional.

Recognition tools & useful records

CRT6 supports recognition by non-medical users. SCAT6 / Child SCAT6 and SCOAT6 / Child SCOAT6 are healthcare-professional assessment tools. No single test or score diagnoses or clears a player.

The Player Journal can record load and recovery for discussion. Its general musculoskeletal progress indicator must not be used for concussion clearance.

Educational guidance. Follow individual clinical advice and applicable sport rules. Reviewed: 1 October 2026.

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