Because the risk for a second concussion is greatest within 10 days of the first concussion, it's very important to make sure the player is completely recovered before he or she returns to play. After more than one concussion, the player will most likely need a longer recovery time. These general rules apply to return to play after a first concussion. A doctor must always make the final decision about whether a player is ready to return to full-contact play. If one or more symptoms return, the player needs to go back to the previous level of activity with no symptoms for at least 24 hours before trying to do more. The athlete must be symptom-free for 24 hours at the current level of activity before moving on to the next step. This is the final step and allows the athlete to join in normal game play. The athlete can participate in normal training. The athlete may also begin light resistance training. This includes more complex training drills such as passing. This includes skating drills or running drills (depending on the sport) but no head impact. No resistance training is included in this step. This can include walking, swimming, or other exercise at less than 70% maximum heart rate. The athlete can take part in daily activities as long as the activity doesn't increase symptoms or cause new symptoms. The athlete should slowly progress through the following levels of activity: footnote 1, footnote 2 After resting, the athlete can gradually increase activity as long as it does not cause new symptoms or worsen his or her symptoms. The first treatment for a concussion is 1 to 2 days of rest, both physical and mental. In most places, a doctor must give written permission for children and teens to begin the steps and return to sports. So they may have to wait longer before they can return to play. Children and teens have longer recovery times. Medicines must be stopped before an athlete can be considered symptom-free. Using medicine to improve concussion symptoms is not the same thing as being symptom-free.
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