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USA SOFTBALL OF SOUTHERN CALIFORNIA
Concussions Return to Play (RTP) Protocol
California State Law AB 2117, which applies to the California Interscholastic Federation, states that to return to play
(i.e., Competition) cannot be sooner than 7 days after evaluation by a physician (MD/DO) who has made the diagnosis of
concussion, and ONLY after completing a Graduated Return to Play Protocol. Since the State of California, in
implementing AB 2007 (Concussion Law), has including softball organizations outside of the CIF, the following protocol
should be followed before an athlete returns to full competition after suffering a concussion.
Instructions:
● This is an example of a graduated return to play protocol that MUST be completed before you can return to full
competition.
o A certified athletic trainer (AT), physician, or identified concussion monitor (e.g., coach) must initial each
stage after you successfully pass it.
o You should be back to normal activities before beginning Stage II, unless otherwise instructed by your
physician.
● After Stage I, you cannot progress more than one stage per day (or longer if instructed by your physician).
● If symptoms return at any stage in the progression, IMMEDIATELY STOP any physical activity and follow up with your
AT, other identified monitor, or your physician. In general, if you are symptoms-free the next day, return to the previous
stage where symptoms had not occurred.
● Seek further medical attention if you cannot pass a stage after 3 attempts due to concussion symptoms, or if you feel
uncomfortable an anytime during the progression.
You must have written physician (MD/DO) clearance to begin and progress through the following Stages
as outlined below, or as otherwise directed by your physician. Minimum of 6 days to pass Stage I and II.
Initials
Stage Activity Exercise Example Objective of the Stage
I
No physical activity for at least 2 full
symptoms-free days
No activities requiring exertion (weight
Lifting, jogging)
Recovery and elimination of symptoms
II-A Light aerobic activity
10-15 minutes (min) of walking or stationary
biking.
Must be performed under direct
supervision by designated individual
Increase heart rate to no more than 50% of
perceived maximum (max) exertion (e.g., <100
beats per min (bpm))
Monitor for symptom return
II-B
Moderate aerobic activity (Light
resistance training)
20-30 min jogging or stationary biking
Body weight exercises (squads, push-
ups), max 1 set of 10, no more than 10
min total
Increase heart rate to 50-75% max exertion
(e.g., 100-150 bpm)
Monitor for symptom return
II-C
Strenuous aerobic activity (Moderate
resistance activity)
45 min running or stationary biking
Weight lifting ≤ 50% of max
weight
Increase heart rate to > 75% max exertion
Monitor for symptom return
II-D
Non-contact training with drills (No
restrictions for weightlifting)
Non-contact drills, sport activities (cutting,
jumping, sprinting)
Add total body movement
Monitor for symptom return
Prior to beginning Stage III, make sure that written physician (MD/DO) clearance for return to play, after successful complet
has been given to your league/team concussion monitor.
III
Controlled practice drills allowed
Increase training drills
Restore confidence, assess readiness for
return to play
Monitor for symptom return
Full unrestricted practice
Return to normal training
Return to normal unrestricted training
MANDATORY: You must complete at least ONE unrestricted practice before return to competition.
Return to Play (competition)
Normal game play (competitive event)
sports activity without restrictions
Athlete’s Name: _________________________________________ Date of Concussion Diagnosis: ___________________