Someone hands you a date. Two weeks, back to play. No testing, no re-check, just a number on a calendar. That’s a guess dressed up as clearance.
The myth: symptom-free means ready
The usual logic goes like this: once you feel normal at home, at work, at school, you’re cleared. No headaches, no fog, back to your day. So you should be fine for sport too.
The truth: sport asks more of your brain than sitting at a desk does
Feeling fine at rest tells you almost nothing about how your brain handles an elevated heart rate, fast head movement, quick direction changes, or tracking a ball at speed. Those are the exact demands of sport, and none of them get tested by how you feel sitting on the couch.
A proper return-to-play assessment checks more than that. It should include:
- Symptom questionnaires
- Exercise and heart rate tolerance testing, using protocols like the Buffalo bike or treadmill test
- Vestibular and ocular motor screening, meaning how your inner ear and eyes handle movement and tracking
- A graded return: individual practice, then drills, then scrimmage, then contact, then full competitive play
Skip any of those steps and you’re sending someone back into contact sport on a guess.
Physio’s role here is active, not just “wait it out.” Progressive exercise at a prescribed heart rate. Manual therapy for the neck, which is very often involved after a concussion. Vestibular and vision exercises like gaze stabilization and tracking drills.
We also treat this well past the first few weeks: both acute concussions and persistent, longer-running symptoms. If you’re 3 months out and still not right, that’s a different phase of the same rehab, not a lost cause.
What to do about it
If someone in your house got a return-to-play date without any of the testing above, don’t treat that date as final. Ask what was actually assessed and how they know the person is ready.
If you’re in Collingwood and dealing with an athlete, or you are the athlete, stuck somewhere between feeling fine at rest and actually being cleared for sport, that gap is exactly where things go wrong. It’s also exactly what we help sort out.