Return to Physical Activity Following Concussion‐Gymnastics

Stage	Activity	Gymnastic Specific Exercise	Objective of the Stage
1	No physical activity; Complete physical and cognitive rest	No activity	Recovery and elimination of symptoms
2	Light aerobic activity	10‐15 min of walking at home or at gym, or stationary bike	Add light aerobic activity and monitor for symptom return
3	Moderate aerobic activity Light resistance training	20‐30 min jogging Resistance training ‐body weight squats and pushups 1 set of 10 reps each	Increase aerobic activity and monitor for symptom return
4	Vertical work	Level 1‐2‐ handstands, choreography on low beam no jumps/turns, swings on bar, no vault Level 3‐4‐ vault run with peel off, glide swings on bars, cast to block on bar, tap swings Level 5‐6‐ cast above horizontal Level 7‐8‐ cast to HS return to block Level 9+‐ any skill listed above Note: it is acceptable of a higher level skilled athlete to perform a lower level skill	Maximize aerobic activity Introduce rotational head movements Monitor for symptoms
5	Intro level tumbling	Ll‐2‐ cartwheel, bridge kick‐overs, backward and forward rolls, jumps and leaps, turns and spins, competition vault, round‐off on tumble track L3‐4‐ walkovers, backward roll to HS, vault drills‐ no full vaults, round‐off, kips on bars, back and front hip circles, front and back HS on tumble track L5‐6‐ clear hips, stalder, sole circles, long hang pullover, tumbling on tumble track with saltos L7‐8‐ giants on bars, handsprings on vault, back handsprings on low beam L9+‐ straight tumbling on tumble track no twisting (may progress to full twist provided symptom free), no releases on bars. Handsprings on vault, Yurchenko timers (vaulting preferably into pit)	Maximize aerobic activity Add deceleration/rotational forces in controlled setting Monitor for symptoms
6	Full practice (after medical clearance)	Normal training activities	Reassess for symptoms every 30 minutes throughout the practice Monitor for symptoms
7	Unrestricted workouts	Return to competition	Assess frequently Monitor for symptoms

• Progress to the next stage may occur every 24 hours as long as symptoms do not return.
• It is recommended that you seek further medial attention if you fail more than 3 attempts to pass a stage