Table 2.

The Graduated Return to Play Protocol. Redrawn from Elliot et al. (2022).

	Stage 1	Stage 2	Stage 3	Stage 4	Stage 5	Stage 6	Stage 7
Activity description	Minimum rest period	Light activity	Frequency of training increases	Duration of training increases	Intensity of training increases	Resume normal training	RETURN TO COMPETITION IN SPORT SPECIFIC TIMELINES
Exercise allowed	Walking, activities of daily living	Walking, light jogging, stationary cycle. No resistance training	Simple movement activities e.g., running drills	Progression to more complex training activities	Normal training activities	Resume normal training progressions
% Heart rate max		<70%	<80%	<80%	<80%	Resume normal training progressions
Duration	10 days	<15 mins	<30 mins	<45 mins	<60 mins	Resume normal training progressions
Objective	Allow recovery time, protect cardio-respiratory system	Increase heart rate	Increase load gradually, manage any post viral fatigue symptoms	Exercise, coordination, and skills/tactics	Restore confidence and assess functional skills	Resume normal training progressions
Monitoring	Subjective symptoms, resting HR, I-PRRS	Subjective symptoms, resting HR, I-PRRS, RPE	Subjective symptoms, resting HR, I-PRRS, RPE	Subjective symptoms, resting HR, I-PRRS, RPE	Subjective symptoms, resting HR, I-PRRS, RPE	Subjective symptoms, resting HR, I-PRRS, RPE

I-PRRS, Injury – Psychological Readiness to Return to Sport; RPE, Rated Perceived Exertion Scale. Note: This guidance is specific to sports with an aerobic component.