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Estimate return-to-learn and return-to-play milestone windows from age, symptom severity, trend, prior concussions, and recovery modifiers. Pair with acute neurologic assessment for severe injury—not a substitute for clinician clearance or CDC HEADS UP protocols.
Last updated: June 4, 2026
Modifiers
Risk points: 1
Typical recovery window
Initial improvement: 2-7 days
Return to school/work: 3-14 days (graded return)
Return to sport/contact: 14-28+ days after symptom-free progression
Emergency red flags
Not medical clearance
Return-to-play and return-to-learn decisions must be clinician-supervised and symptom-free through graded exertional stages.
Default (teen, mild, improving)
1 pts
Typical recovery window
Sport: 14-28+ days after symptom-free progression
Moderate + stable + 1 prior + poor sleep
7 pts
Moderately elevated recovery complexity
Child, prolonged, worsening, multiple modifiers
16 pts
Higher risk for prolonged recovery
| Points | Tier | Initial improvement | Return to school/work | Return to sport |
|---|---|---|---|---|
| 0–6 | Typical recovery window | 2–7 days | 3–14 days (graded return) | 14–28+ days after symptom-free exertional progression |
| 7–10 | Moderately elevated complexity | 5–14 days | 1–4 weeks | 3–8+ weeks after staged protocol |
| ≥11 | Higher risk for prolonged recovery | 7–21+ days | 2–6+ weeks (supported return) | 4–12+ weeks, specialist-guided |
| Factor | Points | Teaching note |
|---|---|---|
| Age: child (<13 approx.) | +2 | Pediatric recovery often slower; school accommodations common |
| Age: teen | +1 | Adolescent brain still maturing; RTP protocols often stricter |
| Age: adult | 0 | Baseline; still individualize by sport and comorbidity |
| Severity: mild acute | 0 | Typical brief symptom burden if trend improving |
| Severity: moderate | +2 | More cognitive/physical limitation early |
| Severity: prolonged/persistent | +4 | Symptoms >2–4 weeks pattern; rehab referral often considered |
| Trend: improving | 0 | Favorable sign for shorter windows |
| Trend: stable/plateau | +2 | May need activity prescription adjustment |
| Trend: worsening | +4 | Urgent reassessment if red flags; otherwise clinician review |
| Each prior concussion | +1 each | Incomplete prior recovery raises prolonged risk |
| Migraine or anxiety history | +1 | Overlap with post-concussion headache and mood symptoms |
| ADHD / learning difficulty history | +1 | Return-to-learn may need formal accommodations |
| No strict relative rest first 24–48h | +1 | Early overload may prolong symptoms in some patients |
| Sleep dysregulation present | +1 | Treat sleep—strong modifier of cognition and headache |
| Domain | Goal | Who leads | Key rule |
|---|---|---|---|
| Return-to-learn (RTL) | Restore school/work cognitive load without symptom flare | School nurse, teacher, clinician, family | Symptom-limited progression; accommodations before full workload |
| Return-to-play (RTP) | Restore sport-specific exertion and contact safely | Sports medicine / clinician with exertional testing | Symptom-free at rest, then stepwise aerobic → sport → contact |
| This calculator | Educational planning windows from risk modifiers | User for orientation only | Never replaces documented medical clearance |
| Step | Activity | Note |
|---|---|---|
| 1 | Relative cognitive rest 24–48h | Reduce screens/triggers; not prolonged bed rest |
| 2 | Light cognitive activity at home | Reading, light homework <15–20 min blocks |
| 3 | Part-time school with accommodations | Extended time, quiet room, reduced workload |
| 4 | Full school day with breaks | Symptom-limited; stop and rest if headache worsens |
| 5 | Full academic load | No symptom exacerbation for sustained period before full sport |
| Step | Activity | Note |
|---|---|---|
| 1 | Symptom-limited daily activities | Baseline must be symptom-free at rest |
| 2 | Light aerobic exercise | Walking/cycling HR below symptom threshold |
| 3 | Sport-specific exercise | No head impact; monitor headache/dizziness |
| 4 | Non-contact training drills | Increased coordination load |
| 5 | Full contact practice | Medical clearance required in most protocols |
| 6 | Return to competition | Only after passing prior steps without symptom relapse |
Age (teen): 1 pt
Total 1 → Typical recovery window. School/work: 3-14 days (graded return). Sport: 14-28+ days after symptom-free progression.
Age (child): +2
Severity (prolongedSymptoms): +4
Symptom trend (worsening): +4
Prior concussions (2): +2
Migraine or anxiety history: +1
ADHD / learning difficulty history: +1
No strict relative rest in first 24–48h: +1
Sleep dysregulation: +1
Total 16 → Higher risk for prolonged recovery. Expect specialist-guided timelines; do not self-clear for contact sport.
Education only—not clearance. Return-to-play and return-to-learn require clinician supervision, symptom-free exertional progression, and emergency evaluation for red flags. Timelines are estimates, not guaranteed recovery dates.
For athletes, families, schools, and sports medicine teaching
Suggested hashtags: #Concussion #SportsMedicine #Recovery #MedEd