Return to Physical Education Is Not the Same as Return to Play: Proposed Guidelines for Reintegrating Students Into Physical Education After Concussion

Recommendations for returning students to sports and school after concussion are well developed, but at present there are no specific guidelines for returning students to physical education (PE). Many schools utilize current return-to-play protocols for returning students to PE after concussion, which can result in students being prohibited from participation in the PE curriculum until they are symptom free, fully recovered, and medically cleared for all activities. Amid growing evidence that participation in exercise and other "normal" activities facilitates recovery from concussion, students should be allowed to return to PE class even while still experiencing concussion symptoms. A new return-to-physical education (RT-PE) process is presented here that helps to return students safely and successfully to PE while they are recovering from concussion and are still symptomatic. This process mirrors the existing return-to-play protocol, but with important differences. A key component of the proposed RT-PE process is good communication between the student, parents, PE teacher, school nurse and outside medical providers.