RTO is the only protocol in the system intended for the first year after a concussion, and it is the only one that assumes a doctor is involved.
Hard rule
This protocol is not a substitute for medical care. It is a structure to follow alongside it. If symptoms worsen at any point, stop and contact your doctor.
01Overview
RTO is a structured, conservative 8-week protocol for returning to training after a mild concussion. It progresses through four phases — Acute Rest & Stabilization, Light Aerobic & Movement, Strength Re-Introduction, and Return to Operations — each gated by a daily 10-symptom self-assessment and the 48-hour rule.
Every day in the protocol includes a symptom check, a physical prescription (with exact durations, reps, and intensity targets), a mindfulness component, nutrition and hydration cues, and a cognitive load prescription. The protocol does not chase load — it chases tolerance. Each phase has clear advance / repeat / step-back criteria.
Who this is for: Adults recovering from a mild, medically diagnosed concussion who have been cleared by a healthcare provider to begin a structured return-to-training program. Useful for athletes, tactical professionals, and anyone who needs a templated path back to physical activity.
What makes RTO different: Most return-to-play guidance is a vague 5-step staircase. RTO turns it into 56 dated, prescribed sessions — with built-in mindfulness, nutrition, and cognitive load management. It treats the brain as the bottleneck, not the muscles. Aerobic stress is introduced before resistance training. Contact is the last variable added, not the first.
02Medical Clearance & Red Flags
Seek immediate medical attention if you experience any of:
- Repeated vomiting
- Seizures or convulsions
- Loss of consciousness (any duration)
- Progressively worsening headache
- Slurred speech or confusion
- Unequal pupils or vision loss
- Weakness, numbness, or loss of coordination on one side
- Clear fluid drainage from nose or ears
- Inability to recognize people or surroundings
These are emergency signs. Do not start or continue this protocol if any are present.
This protocol is for mild concussion recovery only. Moderate or severe traumatic brain injuries require specialist-supervised rehabilitation, not a self-directed protocol. If your symptoms worsen during any phase, stop and consult your provider before continuing.
03Specs
Duration
8 weeks (56 days)
Frequency
Daily prescription
Equipment (W1–4)
None / minimal
Equipment (W5+)
DBs, bench
Gating
Daily symptom + 48-hr rule
Bridge to
Foundation / Ghost / Sentinel
04The 4-Phase Framework
| Phase |
Weeks |
Focus |
Key Milestone |
| Phase 1: Acute Rest & Stabilization | Week 1 | Cognitive & physical rest, baseline symptoms, gentle movement | Symptom score reduced 50% by Day 7 |
| Phase 2: Light Aerobic & Movement | Weeks 2–3 | Stationary bike, walking, jogging intervals, vestibular work | 3-min jog intervals tolerated |
| Phase 3: Strength Re-Introduction | Weeks 4–6 | Extended running, agility, resistance training, sport-specific drills | 20–25 min continuous run, full DB strength session |
| Phase 4: Return to Operations | Weeks 7–8 | Contact integration (if applicable), full practice, return to play | Full practice / full training with no symptoms |
Each phase ends with a Sunday assessment day. The assessment defines explicit advance / repeat / step-back criteria. The protocol assumes you will sometimes repeat a week — that is the design, not failure.
05Daily Symptom Tracking System
Every morning, before any activity, rate each of these 10 symptoms on a 0–10 scale (0 = none, 10 = severe):
- Headache
- Dizziness
- Nausea
- Light sensitivity
- Noise sensitivity
- Difficulty concentrating
- Memory problems
- Fatigue
- Fogginess
- Balance problems
Sum the scores. Day 1 total is your baseline. Every subsequent day compares to baseline and to the prior day.
Progression Decision Rules
- Same or lower than yesterday: Proceed with prescribed protocol.
- Increased by 2 or more on any single symptom: Step back to the previous day session, or take a complete rest day.
- Symptoms last more than 48 hours after a session: 48-Hour Rule — next session is automatically a rest or step-back, no matter where you are in the program.
- End-of-week assessment misses criteria: Repeat the week.
The 48-Hour Rule is non-negotiable. If neurological symptoms (headache, fog, dizziness, light/noise sensitivity) persist more than 48 hours after a session, your nervous system is telling you the load was too high. Step back. Repeat the prior week. This is the single most important rule in the protocol.
06Phase 1: Acute Rest & Stabilization (Week 1)
01
Phase 1 of 4 // Days 1–7
Acute Rest & Stabilization
Relative rest, symptom stabilization, baseline recovery protocols, gentle reintroduction of movement.
Focus
Cognitive & physical rest with gentle movement
Physical RPE
1–2 (Very Light)
Screen Time
30-minute blocks maximum
Sleep Target
8–10 hours nightly
"Your brain is in an energy crisis. The goal this week is NOT training — it is creating the optimal environment for neurological healing."
Morning Symptom Assessment
Rate each symptom 0–10 before any activity: Headache | Dizziness | Nausea | Light sensitivity | Noise sensitivity | Difficulty concentrating | Memory problems | Fatigue | Fogginess | Balance problems
Log total score. This is your baseline.
Indoor, flat surface preferred
RPE 1–2 (barely any effort)
Stop immediately if symptoms increase
This is NOT exercise — it is gentle movement to prevent deconditioning. If any symptom increases by 2+ points, return to rest.
Slow chin tucks × 10 (2-second hold each)
Gentle neck rotations × 5 each direction
Shoulder shrugs × 10
Many concussions involve neck strain. Keep movements slow and controlled.
Box Breathing — Morning (5 min)
Position: Seated or lying down, dim lighting
• Inhale through nose: 4 seconds
• Hold: 4 seconds
• Exhale through mouth: 4 seconds
• Hold empty: 4 seconds
Repeat for ~12–15 cycles
Box Breathing — Evening (5 min)
Timing: 1 hour before bed
Environment: Dark/dim room, no screens, quiet
Same 4-4-4-4 pattern
Body Scan — Pre-Sleep (5–10 min)
Lie flat, eyes closed. Take 3 deep breaths.
Focus on top of head — notice sensations without judgment.
Slowly move attention: forehead → eyes → jaw (release tension) → neck → shoulders → arms → chest → abdomen → hips → legs → feet.
End with 3 breaths and drift to sleep.
Hydration: 80+ oz water throughout day
Omega-3: 2000–2500mg fish oil (DHA/EPA)
Magnesium: 300–400mg evening (supports sleep)
Avoid: Alcohol, caffeine, high sugar
Meals: Small, frequent — nausea is common
Your brain uses 20–40% of daily calories during healing. Anti-inflammatory foods: fatty fish, berries, leafy greens, turmeric.
Screen time: Essential only, 30-min blocks max
Reading: 15–20 min light reading if tolerated
Avoid: Video games, intense TV, work emails, social media
Environment: Reduce bright lights, loud noises
Evening Wind-Down
No screens 1 hour before bed
Body scan meditation
Dark, cool room for sleep
Target: 8–10 hours
Morning Symptom Assessment
Compare to Day 1 baseline. Improved, same, or worse?
If worse: Complete rest. Contact provider if significantly worse.
If same/improved: Proceed with today protocol.
Indoor or outdoor (sunglasses if needed)
Flat terrain, easy pace
RPE 1–2
Neck circles: 5 each direction (slow)
Shoulder rolls: 10 forward, 10 backward
Seated forward fold: 30 seconds
Supine knee-to-chest: 30 seconds each
Supine spinal twist: 30 seconds each side
Keep head above heart. Avoid positions that increase head pressure.
Morning: Box Breathing (5 min)
4-4-4-4 breathing pattern
Midday: 5-4-3-2-1 Grounding (5 min)
Close eyes, breathe naturally. Notice:
• 5 things you can hear
• 4 sensations in your body
• 3 things you can smell
• 2 things you can feel with hands
• 1 thing you are grateful for
Evening: Body Scan (5–10 min)
Full body scan before bed
Continue Day 1 protocol
Add: Creatine 5g (supports brain ATP production)
Focus foods: Salmon, blueberries, spinach
Reading: 20 minutes (physical book preferred)
Puzzle: 10–15 min crossword/sudoku if tolerated
Social: Light conversation is beneficial
Journaling: 5 minutes — write how you are feeling
Evening Protocol
Magnesium with dinner
No screens after 8 PM
Body scan meditation
Consider melatonin 0.5–1mg if sleep disrupted
Morning Symptom Assessment
Log symptoms. Compare to Days 1–2.
Progression criteria: Symptoms same or lower than baseline.
Outdoor if tolerated (sunglasses recommended)
Flat to gentle terrain
RPE 2
Cat-cow: 10 reps (slow, controlled)
Thread the needle: 5 each side
Hip circles (hands and knees): 5 each direction, each leg
Prone press-up: 5 reps, 2-sec hold
Child pose: 60 seconds
Tandem stance (heel to toe): 30 seconds
Single leg stance (wall support): 20 seconds each
Weight shifts side to side: 10 reps
Balance is often impaired post-concussion. Use wall support as needed.
Morning: Box Breathing (6 min)
Extending duration by 1 minute
Post-Walk: Mindful Standing (3 min)
After walking, stand still. Close eyes.
Feel feet grounded. Notice breath. Notice body sensations.
Evening: Extended Body Scan (10 min)
Full body scan + 2 minutes focusing on breath at belly
Continue base protocol + creatine
Focus: Adequate protein (0.8–1g per lb bodyweight)
Meal idea: Grilled salmon, roasted broccoli, sweet potato, olive oil
Reading: 25–30 minutes in blocks
Memory: Read paragraph, close book, write key points
Dual-task: Walk slowly while counting backward from 100 by 7s
Dual-task may be challenging. Go slow. Stop if symptoms increase.
Evening Protocol
Consistent sleep schedule
Supplements: Magnesium, Vitamin D 2000IU
Body scan meditation
Morning Symptom Assessment
If Day 3 caused symptom increase, repeat Day 3.
Green light: Symptoms stable or improving.
Walking in place: 1 minute
Arm circles: 10 each direction
Hip circles: 5 each direction
Ankle circles: 5 each direction
Outdoor preferred (nature benefits recovery)
Gentle inclines if tolerated
RPE 2
Cat-cow: 10 reps
Bird-dog: 6 each side (2-sec hold)
Glute bridge: 10 reps (2-sec hold top)
Dead bug: 6 each side (slow)
Prone Y-T-W raises: 5 each position
Activation, not strength work. Focus on control and body awareness.
Single leg stance (no support): 30 sec each
Single leg stance eyes closed: 15 sec each
Tandem walk: 20 steps forward, 20 backward
Morning: Box Breathing (7 min)
Try 5-5-5-5 pattern if 4-4-4-4 feels easy
Midday: Mindful Walking (5 min)
During walk, slow deliberate pace
Focus on: heel strike → weight transfer → toe push-off
Evening: Gratitude + Body Scan (10 min)
Begin with 3 things you are grateful for
Then full body scan
Continue base protocol
Add: B-Complex vitamin
Check: Urine should be pale yellow
Reading: 30 minutes
Listening: 20-min podcast (low stimulation)
Work: 1–2 hours if needed (30-min breaks)
Cool-down
Gentle stretching: 5 minutes
Quad stretch: 30 sec each
Hip flexor stretch: 30 sec each
Child pose: 60 seconds
Morning Symptom Assessment
Log symptoms. Should see improvement by now.
If unchanged/worse after 5 days: Contact healthcare provider.
Walking: 1 minute
Arm circles: 10 each direction
Leg swings (front/back): 8 each
Leg swings (side/side): 8 each
Hip circles: 5 each direction
Varied terrain (gentle hills) if tolerated
Can increase pace slightly if no symptoms
RPE 2–3
Round 1 (3 min): Cat-cow × 8, Bird-dog × 6 each, Child pose 30s
Round 2 (4 min): Glute bridge × 12, Dead bug × 8 each, Prone Y-T-W × 6 each
Round 3 (5 min): Bodyweight squat × 10, Wall push-up × 10, Hip circles × 8 each
First squat and push-up introduction. Keep RPE 2–3. Stop if head pressure.
Single leg stance eyes closed: 20 sec each
Tandem walk forward/backward: 20 steps each
Gaze stabilization: Thumb at arm length, move head side-to-side keeping eyes on thumb × 20
Head turns with fixed gaze: 10 each direction
Gaze stabilization retrains vestibular-ocular reflex. Reduce range if dizzy.
Morning: Breath Awareness (8 min)
Natural breathing (no counting)
Observe without controlling — notice where you feel breath most
Afternoon: Progressive Muscle Relaxation (10 min)
Lie down. Starting with feet:
• Tense muscles 5 seconds
• Release and notice relaxation 10 seconds
Progress: calves → thighs → glutes → abdomen → hands → arms → shoulders → face
Skip neck tensing — just relax
Evening: Body Scan (10 min)
Standard body scan protocol
Reading: 30–40 minutes
Work: Up to 3 hours (45-min breaks)
Social: Light activity (dinner with family/friends)
Dual-task: Walk while listening to podcast
Cool-down & Evening
Gentle stretching: 5 min
Plan low-key weekend
Body scan meditation
Check: How does today compare to Day 1?
Morning Symptom Assessment
Log symptoms. Compare to beginning of week.
Nature walk preferred (park, trail)
Varied terrain okay
RPE 2–3
Practice mindful walking for 5-min portion
Hip (5 min): 90/90 stretch 60s each, Pigeon 60s each, Hip flexor 60s each
Spine (5 min): Cat-cow × 10, Thoracic rotations × 8 each, Thread needle × 6 each
Shoulder (5 min): Wall slides × 10, Doorway pec stretch 45s each, Prone I-Y-T × 8 each
Dead bug: 10 each side
Bird-dog: 8 each side
Plank hold: 20 sec × 2 (breathe normally)
Side plank (from knees): 15 sec each side
First plank introduction. Stop if any head pressure.
Extended Morning Practice (12–15 min)
• 3 min: Box breathing (settling)
• 5 min: Natural breath awareness
• 5 min: Open awareness (sounds, sensations, thoughts without attachment)
• 2 min: Set intention for the day
Evening: Gratitude Journaling + Body Scan
Write 5 things you are grateful for this week
Write 3 things your body did well
Write 1 intention for next week
Then body scan (10 min total)
Meal prep: Prepare brain-healthy meals for Week 2
Stock up: Fatty fish, berries, leafy greens, nuts, olive oil
Cool-down & Evening
Extended stretching: 10 min
Light social activity if desired
Avoid alcohol (still acute phase)
Extended sleep — no alarm tomorrow if possible
Week 1 Complete: Assessment Day
◆ Morning Assessment
Complete full symptom assessment (same as Day 1)
Compare scores: Day 7 vs Day 1
Progression criteria for Week 2:
• Total symptom score reduced by 50%+ OR
• All symptoms rated 3 or below OR
• Completed Week 1 without symptom increase
If NOT meeting criteria: Repeat Week 1
◆ Physical Activity (Optional)
Gentle walking: 15–20 minutes
Light stretching: 10–15 minutes
No structured exercise — rest and assessment only
◆ Mindfulness
Morning: 10-min meditation of your choice
Evening: Reflection journaling + body scan
◆ Week 1 Reflection Questions
What symptoms improved most?
What activities were most challenging?
How is your sleep quality?
What mindfulness practice resonated most?
Are you ready to progress?
◆ Week 1 Complete ◆
Acute phase complete. If symptoms allow, proceed to Week 2: Light Aerobic Introduction.
07Phase 2: Light Aerobic & Movement (Weeks 2–3)
02
Phase 2 of 4 // Days 8–21
Light Aerobic & Movement
Stationary bike introduction, walking progression, jogging intervals, vestibular work, sport-specific movement prep.
Week 2: Light Aerobic Introduction
Focus
Light aerobic introduction, expanded movement
Physical RPE
2–4 (Light to Moderate)
Cardio
Stationary bike 10–20 min
Heart Rate Target
50–60% of max HR
"Controlled aerobic activity improves cerebral blood flow and supports recovery — but only if symptoms remain stable. Listen to your body."
Morning Symptom Assessment
Log symptoms. Confirm Week 1 progression criteria met.
Today introduces stationary bike — stop immediately if symptoms increase by 2+ points.
Walking: 2 minutes easy pace
Arm circles: 10 forward, 10 backward
Hip circles: 8 each direction
Leg swings (front/back): 10 each leg
Leg swings (side/side): 10 each leg
Intensity: 50–60% max HR (RPE 3)
Cadence: 60–70 RPM, low resistance
Position: Upright, hands on handlebars
First cardio introduction. This should feel EASY. Stop immediately if headache, dizziness, or nausea increases.
Outdoor if possible
Include gentle inclines
RPE 2–3
2 rounds:
Glute bridge × 12
Bird-dog × 8 each side
Wall push-up × 10
Bodyweight squat × 10
Plank hold × 20 seconds
Rest: 60 seconds between rounds
Single leg stance: 30 sec each, eyes open then closed
Gaze stabilization (head side-to-side): 20 reps
Gaze stabilization (head up-down): 20 reps
Tandem walk with head turns: 20 steps
Morning: Box Breathing (8 min)
4-4-4-4 or 5-5-5-5 pattern
Complete before exercise
Post-Exercise: Seated Recovery (5 min)
After exercise, sit quietly
Close eyes, natural breathing
Observe heart rate settling
Notice body sensations without judgment
Evening: Body Scan (10 min)
Full body scan before bed
Continue Week 1 supplements
Pre-exercise: Light snack 30–60 min before (banana, toast)
Post-exercise: Protein + carbs within 30 min
Hydration: Extra 16oz water around exercise
Work: 4–6 hours with 45-min breaks
Reading: 40 minutes
Dual-task: Bike while listening to audiobook (light content)
Cool-down
Walking: 3 minutes easy
Quad stretch: 45 seconds each
Hip flexor stretch: 45 seconds each
Calf stretch: 30 seconds each
Child pose: 60 seconds
Morning Symptom Assessment
How did yesterday bike feel? Any symptom increase?
If symptoms increased: Skip bike today, walking only.
Walking: 2 minutes
Cat-cow: 10 reps
World greatest stretch: 4 each side
Inchworm: 5 reps
Varied terrain, moderate pace
Include 5-minute mindful walking segment
RPE 2–3
Hip sequence (5 min):
90/90 transitions × 8
Pigeon pose: 60s each side
Frog stretch: 60s
Spine sequence (5 min):
Cat-cow × 10
Thread the needle × 8 each
Scorpion stretch × 6 each
Upper body (5 min):
Wall slides × 12
Doorway pec stretch: 45s each
Prone I-Y-T × 8 each
Dead bug: 12 each side
Bird-dog: 10 each side
Plank: 30 seconds × 2
Side plank (from knees): 20 sec each × 2
Glute bridge march: 10 each leg
Gaze stabilization (all directions): 15 each
VOR cancellation: Focus on thumb, move head and thumb together × 15 each direction
Standing on foam/pillow: 30 sec each leg
Morning: Breath Counting (10 min)
Count exhales 1–10, then restart
If you lose count, simply start over at 1
During Mobility: Body Awareness
Focus attention on stretched area
Notice sensations without judgment
Breathe into tight areas
Evening: Progressive Relaxation + Body Scan (12 min)
Combined practice before bed
Work: Full workday with hourly breaks
Memory exercise: Read article, summarize in writing 30 min later
Processing: Simple math problems (5–10 min)
Cool-down
Seated forward fold: 60 seconds
Supine spinal twist: 45 sec each
Happy baby: 60 seconds
Corpse pose with breathing: 2 minutes
Morning Symptom Assessment
If bike was tolerated Day 8, increase duration today.
Progression: Add 2–3 minutes if symptoms stable.
Walking: 2 minutes
Arm circles: 10 each direction
Hip circles: 8 each direction
Leg swings: 10 each leg, each direction
Bodyweight squats: 10
Intensity: 50–60% max HR (RPE 3–4)
Structure: Steady state, no intervals
Can slightly increase resistance if comfortable
Post-bike recovery walk
Easy pace, can include hills
RPE 2
2 rounds:
Glute bridge with march × 16 total
Incline push-up × 10
Bodyweight squat × 12
Dead bug × 10 each side
Superman hold × 15 seconds
Plank × 25 seconds
Rest: 60 seconds between rounds
Single leg stance on pillow: 30s each leg
Tandem stance eyes closed: 30 seconds
Single leg Romanian deadlift (bodyweight): 6 each leg
Heel-to-toe walk backward: 20 steps
Morning: Box Breathing (8 min)
5-5-5-5 pattern
During Bike: Breath Awareness
Notice breathing rhythm
Coordinate with pedal cadence if helpful
Evening: Body Scan (10 min)
Full body scan, noticing areas of tension from exercise
Continue base protocol
Focus: Post-workout recovery meal within 30 min
Example: Greek yogurt, berries, handful of walnuts
Cool-down
Easy walking: 3 minutes
Quad stretch: 45 sec each
Hamstring stretch: 45 sec each
Hip flexor stretch: 45 sec each
Child pose: 60 seconds
Morning Symptom Assessment
Mid-week check: How are symptoms trending?
Today is active recovery — lighter intensity.
Park, trail, or neighborhood
Relaxed pace, RPE 2
Practice 10 min of mindful walking
No headphones — be present with environment
Child pose: 60 seconds
Cat-cow: 10 slow breaths
Downward dog: 30 seconds
Low lunge: 45 sec each side
Pigeon: 60 sec each side
Seated twist: 45 sec each side
Supine butterfly: 60 seconds
Corpse pose: 2 minutes
Move slowly and mindfully. Focus on breath with each pose.
Dead bug: 8 each side (slow)
Bird-dog: 8 each side (slow)
Glute bridge hold: 30 seconds × 2
Morning: Loving-Kindness Meditation (10 min)
Sit comfortably, close eyes
Repeat silently for yourself:
"May I be healthy. May I be at peace. May I be free from suffering."
Then extend to loved ones, acquaintances, all beings
Afternoon: Gratitude Journaling (5 min)
Write 3 things you are grateful for today
Write 1 thing your body did well
Evening: Body Scan (10 min)
Extended body scan with focus on relaxation
Work: Normal schedule with regular breaks
Reading: 30–45 minutes
New: Try a memory game or puzzle app (15 min)
Evening Protocol
Epsom salt bath (optional)
Light stretching
Early bedtime
Morning Symptom Assessment
Pushing bike duration today — longest session yet.
Only progress if symptoms stable all week.
Walking: 2 minutes
Jumping jacks (low impact): 20
Arm circles: 10 each direction
Leg swings: 10 each direction, each leg
Bodyweight squats: 10
Hip circles: 8 each direction
Intensity: 55–65% max HR (RPE 3–4)
Structure: Steady state
Can vary resistance slightly for terrain simulation
Longest cardio session so far. Stay at low end of duration if any symptom concerns.
Include varied terrain
Moderate pace, RPE 3
3 rounds:
Glute bridge × 12
Push-up (incline or knee) × 8
Bodyweight squat × 12
Bird-dog × 8 each side
Plank × 30 seconds
Rest: 45 seconds between rounds
Single leg stance on pillow, eyes closed: 20s each
Gaze stabilization with walking: 30 steps
Tandem walk with head turns: 20 steps forward and back
Morning: Breath Awareness (10 min)
Natural breathing, no counting
Notice qualities: depth, temperature, rhythm
Evening: Progressive Relaxation (12 min)
Tense-release through body groups
Skip neck tensing
End with body scan
Work: Full day with regular breaks
Dual-task challenge: Walk while doing mental math
Social: Plan light evening activity
Cool-down
Easy walking: 3 minutes
Full lower body stretch sequence: 8 minutes
Child pose: 60 seconds
Morning Symptom Assessment
How did yesterday longer session feel?
Today is recovery focus before assessment tomorrow.
Park, trail, or beach
Relaxed pace, RPE 2–3
Can include gentle hills
Practice mindfulness for 10 min of walk
Ankles/Feet (3 min):
Ankle circles × 10 each
Calf stretch: 45s each
Toe stretches: 30s
Hips (6 min):
90/90 stretch: 60s each position
Pigeon: 60s each
Hip flexor: 60s each
Frog stretch: 60s
Spine (5 min):
Cat-cow: 10 reps
Thread the needle: 8 each
Prone press-up: 10 reps
Seated twist: 45s each
Shoulders/Upper Back (6 min):
Wall slides: 12 reps
Doorway pec stretch: 45s each side
Prone I-Y-T: 8 each
Lat stretch: 45s each side
Thoracic rotation: 8 each side
Dead bug: 10 each side
Bird-dog: 10 each side
Side plank (from knees): 20s each side
Glute bridge: 15 reps
Extended Morning Practice (15 min)
5 min: Box breathing
5 min: Open awareness
5 min: Set intentions for Week 3
Evening: Gratitude + Reflection
Journal: 5 things grateful for this week
Reflect: How has your capacity improved?
Body scan before bed
Meal prep: Prepare brain-healthy meals for Week 3
Hydrate: Increase water intake today
Sleep: No alarm tomorrow if possible
Evening Protocol
Light social activity okay
Continue avoiding alcohol
Extended sleep target: 9+ hours
Body scan meditation
Week 2 Complete: Assessment Day
◆ Morning Assessment
Complete full symptom assessment
Compare: Day 14 vs Day 7 vs Day 1
Progression criteria for Week 3:
• Symptoms continue to improve OR stable at low levels
• Tolerated 15–20 min cardio without symptom increase
• No symptom flares requiring step-back
If NOT meeting criteria: Repeat Week 2
◆ Physical Activity (Optional)
Light walking: 20–30 minutes
Gentle stretching: 10–15 minutes
No structured cardio — rest and assess
◆ Mindfulness
Morning: 10-min meditation of choice
Evening: Week 2 reflection journaling + body scan
◆ Week 2 Reflection Questions
How did your body respond to the bike?
What was your longest cardio duration achieved?
Did any activities trigger symptoms?
How is your sleep quality?
Are you ready for increased intensity?
◆ Week 2 Complete ◆
Light aerobic foundation established. If symptoms allow, proceed to Week 3: Moderate Aerobic Training.
Week 3: Moderate Aerobic Training
Focus
Jogging introduction, sport-specific prep
Physical RPE
4–5 (Moderate)
Heart Rate Target
60–70% of max HR
New Elements
Run/walk intervals, agility basics
"You have proven your brain can handle light aerobic stress. Now we methodically increase intensity while maintaining vigilant symptom monitoring."
Morning Symptom Assessment
Confirm Week 2 progression criteria met.
Today introduces jogging — first running since injury. Start conservative.
Walking: 3 minutes, gradually increasing pace
Leg swings (front/back): 12 each leg
Leg swings (side/side): 12 each leg
High knees (walking): 20 steps
Butt kicks (walking): 20 steps
Arm circles: 10 each direction
Hip circles: 8 each direction
Structure: 1 min jog / 2 min walk × 6–7 rounds
Jog pace: Conversational, RPE 4–5
Heart rate: 60–70% max HR
Surface: Flat, even terrain (track ideal)
First jogging since injury. This should feel easy. If any symptoms increase, immediately return to walking only.
3 rounds:
Bodyweight squat × 12
Push-up (modify as needed) × 8
Reverse lunge × 8 each leg
Bird-dog × 8 each side
Plank × 30 seconds
Rest: 45 seconds between rounds
Lateral shuffles: 10 yards × 4 (slow, controlled)
Carioca/grapevine: 10 yards × 4 (slow)
Forward/backward transitions: 10 reps
First lateral movement introduction. Go slow. Focus on control, not speed.
Morning: Box Breathing (8 min)
5-5-5-5 pattern before exercise
During Intervals: Breath-Pace Sync
During jog: Find natural breath rhythm
During walk: 4 steps inhale, 4 steps exhale
Stay present with body sensations
Evening: Body Scan (10 min)
Pay attention to any new sensations from jogging
Pre-workout: Light carbs 45–60 min before (banana, oatmeal)
During: Water every 10–15 min
Post-workout: Protein + carbs within 30 min
Continue all supplements from Weeks 1–2
Work: Full day, regular breaks
Dual-task: Walk intervals while listening to podcast
New: Reaction time games/apps (10 min)
Cool-down
Walking: 5 minutes easy
Quad stretch: 45s each
Hamstring stretch: 45s each
Hip flexor stretch: 45s each
Calf stretch: 30s each
Child pose: 60 seconds
Morning Symptom Assessment
How did yesterday jogging feel? Any delayed symptoms?
If symptoms increased: Rest today, repeat Week 2 protocol.
Walking: 2 minutes
Cat-cow: 10 reps
World greatest stretch: 5 each side
Inchworm: 6 reps
Hip circles: 8 each direction
Varied terrain, brisk pace
Include hills if available
RPE 3–4
Hip complex (5 min):
90/90 transitions × 10
Pigeon: 60s each
Hip flexor with reach: 45s each
Spine (5 min):
Cat-cow × 10
Thread the needle × 8 each
Thoracic rotations × 10 each
Ankles/calves (5 min):
Ankle circles × 10 each
Calf stretch: 45s each
Soleus stretch: 45s each
3 rounds:
Glute bridge × 15
Push-up × 10
Split squat × 8 each leg
Dead bug × 10 each side
Side plank × 25 seconds each
Superman × 12
Rest: 45 seconds between rounds
Single leg stance on pillow, eyes closed: 30s each
Single leg Romanian deadlift: 8 each leg
Gaze stabilization with head movement: 20 each direction
Tandem walk with cognitive task (count by 3s): 30 steps
Morning: Breath Awareness (10 min)
Natural breathing, observe without controlling
During Mobility: Body Awareness
Focus attention on each stretched area
Notice differences left vs right
Breathe into tight areas
Evening: Progressive Relaxation (12 min)
Tense-release sequence followed by body scan
Work: Full day
Memory: Read article, summarize key points 1 hour later
Processing: Sudoku or crossword (15 min)
Cool-down
Seated forward fold: 60 seconds
Supine spinal twist: 45s each
Happy baby: 60 seconds
Legs up wall: 2 minutes
Morning Symptom Assessment
48 hours post-jogging introduction. Symptoms stable?
Green light: Progress jogging intervals today.
Walking: 3 minutes progressive
High knees: 20 steps
Butt kicks: 20 steps
Leg swings: 10 each direction, each leg
Arm circles: 10 each direction
Lateral shuffles: 10 yards × 2
Structure: 2 min jog / 2 min walk × 5–6 rounds
Jog pace: Conversational, RPE 4–5
Heart rate: 60–70% max HR
Progression: Increased jog duration from Day 15
If 2-min jog feels too challenging, drop back to 90 seconds. Listen to your body.
Recovery spin, low resistance
RPE 2–3
Focus on leg turnover, not intensity
2 rounds:
Dead bug × 12 each side
Bird-dog × 10 each side
Plank × 35 seconds
Side plank × 25 seconds each
Glute bridge march × 12 each leg
Rest: 30 seconds between rounds
Morning: Box Breathing (8 min)
5-5-5-5 pattern
Post-Run: Standing Recovery (3 min)
After intervals, stand still
Close eyes, hands on belly
Feel heart rate return to normal
Notice body sensations
Evening: Body Scan (10 min)
Notice any running-related sensations
Dual-task during walk intervals: Mental math (7s, 8s tables)
Reaction: Reaction time app (10 min)
Work: Full day with regular breaks
Cool-down
Easy walking: 5 minutes
Full lower body stretch: 8 minutes
Child pose: 60 seconds
Morning Symptom Assessment
Mid-week recovery day. How is your body responding to increased intensity?
Park, trail, or neighborhood
Relaxed pace, RPE 2–3
Include 10 min mindful walking
No headphones — be present
Child pose: 60 seconds
Cat-cow: 10 breaths
Downward dog: 45 seconds
Low lunge: 45s each side
Warrior I: 30s each side
Warrior II: 30s each side
Triangle pose: 30s each side
Pigeon: 60s each side
Seated twist: 45s each side
Supine twist: 45s each side
Corpse pose: 3 minutes
Dead bug: 8 each side (slow, controlled)
Bird-dog: 8 each side
Glute bridge hold: 30 seconds × 2
Extended Morning Practice (15 min)
5 min: Box breathing
5 min: Loving-kindness meditation
5 min: Open awareness
Afternoon: Gratitude Journaling
Write 3 things grateful for
Write 2 things body did well this week
Write 1 intention for remainder of week
Evening: Body Scan (12 min)
Extended practice with focus on relaxation
Work: Normal schedule
Reading: 30–45 minutes
Social: Light evening activity
Evening Protocol
Epsom salt bath (optional)
Light stretching
Early bedtime — prioritize recovery
Morning Symptom Assessment
Post-recovery day. Ready for longest jogging session yet?
Only progress if symptoms stable all week.
Walking: 3 minutes progressive
High knees: 25 steps
Butt kicks: 25 steps
Leg swings: 12 each direction
Lateral shuffles: 10 yards × 2
Carioca: 10 yards × 2
A-skips: 10 each leg
Structure: 3 min jog / 2 min walk × 5 rounds
Jog pace: Conversational, RPE 5
Heart rate: 65–70% max HR
Surface: Can include gentle terrain variation
Longest continuous jogging intervals so far. Stay conservative — you can always do less if needed.
3 rounds:
Bodyweight squat × 15
Push-up × 10
Reverse lunge × 10 each leg
Superman × 12
Plank × 40 seconds
Rest: 45 seconds between rounds
Lateral shuffles: 10 yards × 4 (moderate pace)
Carioca: 10 yards × 4
Forward/backward runs: 10 yards × 4
T-drill (walk through): 3 reps
Rest: 30 seconds between sets
Building multi-directional movement foundation. Keep controlled — speed comes later.
Morning: Breath Awareness (10 min)
Natural breathing, notice qualities without judgment
During Run: Present-Moment Awareness
Notice feet striking ground
Feel breath rhythm
Observe surroundings
Stay present, not future-focused
Evening: Progressive Relaxation (12 min)
Full tense-release sequence with body scan
Dual-task during walk: Alphabet backward
Reaction: Reaction time training (10 min)
Social: Plan light weekend activity
Cool-down
Easy walking: 5 minutes
Comprehensive lower body stretch: 10 minutes
Child pose: 60 seconds
Morning Symptom Assessment
Recovery focus after yesterday longer session.
How are you feeling after the week progression?
Option 1: 40 min walk (varied terrain)
Option 2: 10 min walk, 15 min easy jog, 15 min walk
Choose based on how you feel
RPE 3–4 max
Nature setting preferred
Feet/Ankles (4 min):
Ankle circles × 10 each
Calf stretch: 45s each
Soleus stretch: 45s each
Toe yoga: 30 seconds
Hips (6 min):
90/90: 60s each position
Pigeon: 60s each
Hip flexor with rotation: 45s each
Spine (5 min):
Cat-cow × 12
Thread the needle × 8 each
Prone press-up × 10
Scorpion stretch × 6 each
Upper body (5 min):
Wall slides × 12
Doorway pec stretch: 45s each
Lat stretch: 45s each
Thoracic rotations: 10 each
Dead bug: 10 each side
Bird-dog: 10 each side
Side plank (from knees): 20s each
Glute bridge: 15 reps
Extended Morning Practice (15 min)
5 min: Box breathing
5 min: Open awareness
5 min: Set intentions for Week 4
Evening: Gratitude + Reflection
Journal: Week 3 accomplishments
Reflect: How has your running capacity improved?
Body scan before bed
Meal prep: Prepare meals for Week 4
Focus: Anti-inflammatory foods
Hydration: Extra focus today
Evening Protocol
Light social activity okay
Continue avoiding heavy alcohol
Extended sleep: 9+ hours target
Body scan meditation
Week 3 Complete: Assessment Day
◆ Morning Assessment
Complete full symptom assessment
Compare: Day 21 vs Day 14 vs Day 7 vs Day 1
Progression criteria for Week 4:
• Tolerated 3-min jog intervals without symptom increase
• No symptom flares requiring step-back
• Stable or improving symptom scores
If NOT meeting criteria: Repeat Week 3
◆ Physical Activity (Optional)
Light walking: 20–30 minutes
Gentle stretching: 15 minutes
No structured cardio — rest and assess
◆ Mindfulness
Morning: 12-min meditation of choice
Evening: Week 3 reflection journaling + body scan
◆ Week 3 Reflection Questions
How did your body respond to jogging?
What was your longest jog interval achieved?
How did agility movements feel?
Any symptoms during or after exercise?
Are you ready for increased running duration?
◆ Week 3 Complete ◆
Jogging foundation established. If symptoms allow, proceed to Week 4: Extended Aerobic Training.
08Phase 3: Strength Re-Introduction (Weeks 4–6)
03
Phase 3 of 4 // Days 22–42
Strength Re-Introduction & Sport-Specific Preparation
Extended running intervals, agility progression, resistance training (DBs, bodyweight), sport-specific movement, and pre-contact preparation.
Week 4: Extended Aerobic Training
Focus
Extended running, agility progression
Physical RPE
5–6 (Moderate-Hard)
New Elements
5-min continuous runs, T-drills
"Halfway through recovery. Your brain has proven resilience. Now we build toward full operational capacity."
Morning Symptom Assessment
Confirm Week 3 criteria met. Today: longest continuous running intervals yet.
Walk → light jog: 3 min progressive
High knees: 25 steps
Butt kicks: 25 steps
A-skips: 12 each
B-skips: 10 each
Leg swings: 12 each direction
Lateral shuffles: 15 yd × 2
Carioca: 15 yd × 2
Structure: 5 min jog / 2 min walk × 4 rounds
Pace: Moderate, RPE 5–6
HR: 70–75% max
First 5-minute continuous runs. Significant progress. Reduce to 4 min if needed.
3 rounds: Lateral shuffles 15 yd × 2
Carioca 15 yd × 2
Pro agility (5-10-5): 2 reps
Backpedal to sprint 10 yd × 2
Rest: 45 sec between rounds
3 rounds: Squat × 15
Push-up × 12
Walking lunge × 10 each
Plank × 45 sec
Rest: 30 sec
Morning: Box Breathing (8 min)
5-5-5-5 or 6-6-6-6 pattern
Evening: Body Scan (10 min)
Notice how body responds to extended running
Cool-down
Easy walk: 5 min
Comprehensive stretch: 10 min
Foam rolling: 5 min
Morning Symptom Assessment
How did yesterday 5-min intervals feel? Today: mobility and strength focus.
Walk: 2 min
Cat-cow: 12 reps
World greatest stretch: 5 each
Inchworm: 6 reps
Hip circles: 8 each direction
Varied terrain, hills if available
RPE 3–4
Include 5 min mindful walking
Hips: 90/90 × 60s each
Pigeon × 60s each
Hip flexor × 45s each
Spine: Cat-cow × 12
Thread needle × 8 each
Thoracic rotations × 10 each
Ankles: Circles × 10 each
Calf stretch × 45s each
3 rounds: Glute bridge × 15
Push-up × 12
Split squat × 10 each
Dead bug × 12 each
Side plank × 30s each
Superman × 12
Rest: 45 sec
Single leg on pillow, eyes closed: 30s each
Single leg RDL: 8 each
Gaze stabilization: 20 each direction
Tandem walk with cognitive task: 30 steps
Morning: Breath Awareness (10 min)
Natural breathing, observe without controlling
Evening: Progressive Relaxation (12 min)
Tense-release sequence with body scan
Cool-down
Seated forward fold: 60s
Supine twist: 45s each
Happy baby: 60s
Legs up wall: 2 min
Morning Symptom Assessment
Mid-week aerobic session. Building running endurance.
Walk → jog: 3 min
High knees: 25
Butt kicks: 25
A-skips: 12 each
Leg swings: 12 each
Lateral shuffles: 15 yd × 2
Carioca: 15 yd × 2
Structure: 6 min jog / 2 min walk × 3–4 rounds
Pace: RPE 5–6
HR: 70–75% max
Extend jog if feeling good
Progressing toward longer continuous runs. Stay in control.
T-drill: 4 reps (moderate pace)
Pro agility: 4 reps
Box drill: 3 reps each direction
Rest: 30–45 sec between sets
2 rounds: Dead bug × 12 each
Bird-dog × 10 each
Plank × 45 sec
Side plank × 30 sec each
Mountain climbers × 20
Rest: 30 sec
Morning: Box Breathing (8 min)
6-6-6-6 pattern if ready
Evening: Body Scan (10 min)
Standard body scan before bed
Cool-down
Easy walk: 5 min
Full lower body stretch: 10 min
Morning Symptom Assessment
Mid-week recovery. How is body responding to increased intensity?
Option 1: 35 min walk (varied terrain)
Option 2: 10 min walk, 15 min easy jog, 10 min walk
Choose based on how you feel
RPE 3 max
Child pose: 60s
Cat-cow: 10 breaths
Down dog: 45s
Low lunge: 45s each
Warrior I: 30s each
Warrior II: 30s each
Triangle: 30s each
Pigeon: 60s each
Seated twist: 45s each
Corpse pose: 3 min
Dead bug: 10 each (slow)
Bird-dog: 10 each
Glute bridge hold: 30s × 2
Extended Morning Practice (15 min)
5 min box breathing
5 min loving-kindness
5 min open awareness
Evening: Gratitude + Body Scan
Journal 3 gratitudes
Body scan before bed
Evening Protocol
Epsom salt bath optional
Early bedtime
Prioritize recovery
Morning Symptom Assessment
Post-recovery day. Ready for week longest session?
Walk → jog: 3 min
High knees: 30
Butt kicks: 30
A-skips: 15 each
Lateral shuffles: 15 yd × 2
Carioca: 15 yd × 2
Hip circles: 10 each
Structure: 8 min jog / 2 min walk × 3 rounds OR 10 min jog / 2 min walk × 2 rounds + 5 min jog
Pace: RPE 5–6
HR: 70–75% max
Longest running session yet. Choose structure that works for you. Quality over quantity.
T-drill: 4 reps
Pro agility: 4 reps
Lateral shuffles with direction change: 6 reps
Sprint starts: 4 × 10 yards
Rest: 30–45 sec
3 rounds: Squat × 15
Push-up × 12
Reverse lunge × 10 each
Superman × 12
Plank × 45 sec
Rest: 30 sec
Morning: Breath Awareness (10 min)
Natural breathing observation
Evening: Progressive Relaxation (12 min)
Full tense-release with body scan
Cool-down
Easy walk: 5 min
Comprehensive stretch: 12 min
Foam rolling: 5 min
Morning Symptom Assessment
Recovery focus before assessment tomorrow.
Option 1: 40 min walk
Option 2: 15 min walk, 15 min easy jog, 10 min walk
Nature setting preferred
RPE 3 max
Feet/Ankles (4 min): Circles, calf stretch, soleus stretch
Hips (6 min): 90/90, pigeon, hip flexor, frog
Spine (5 min): Cat-cow, thread needle, thoracic rotation
Upper (5 min): Wall slides, pec stretch, lat stretch
Dead bug: 10 each
Bird-dog: 10 each
Side plank (knees): 20s each
Glute bridge: 15
Extended Morning Practice (15 min)
5 min box breathing
5 min open awareness
5 min set intentions for Week 5
Evening: Gratitude + Reflection
Journal Week 4 accomplishments
Reflect on running progress
Body scan
Evening Protocol
Light social activity okay
Extended sleep: 9+ hours
Meal prep for Week 5
Week 4 Complete: Halfway Point Assessment
◆ Morning Assessment
Complete full symptom assessment
Compare: Day 28 vs Day 21 vs Day 14 vs Day 1
Progression criteria for Week 5:
• Tolerated 8–10 min continuous jogging
• Completed agility drills without symptoms
• Stable/improving symptom scores
If NOT meeting criteria: Repeat Week 4
◆ Physical Activity (Optional)
Light walking: 20–30 min
Gentle stretching: 15 min
No structured cardio
◆ Week 4 Reflection Questions
What was your longest continuous run?
How did agility drills feel?
Any symptom concerns during exercise?
Are you ready for resistance training?
◆ Week 5 Preview: Phase 3 Begins
• Phase 3: Non-Contact Training Drills
• Introduction of resistance training (bodyweight → light weights)
• Extended continuous running (15–20 min)
• Sport-specific movement patterns
• Increased agility complexity
◆ Week 4 Complete ◆
Halfway point reached. Aerobic foundation solid. Proceed to Week 5: Resistance Training Introduction.
Week 5: Resistance Training Introduction
Focus
Resistance training, extended cardio
Physical RPE
5–7 (Moderate-Vigorous)
Running Target
15–20 min continuous
New Elements
Light weights, compound movements
"Your brain has proven it can handle aerobic stress. Now we add controlled resistance to rebuild total-body strength."
Morning Symptom Assessment
Confirm Week 4 criteria met. Today introduces resistance training — start light.
Easy jog: 5 min
High knees: 20
Butt kicks: 20
Leg swings: 10 each
Arm circles: 10 each
Hip circles: 8 each
BW squats: 10
Push-ups: 5
Inchworms: 5
Weight: Light DB (10–20 lbs)
Tempo: 3 sec down, 1 pause, 2 up
Rest: 60 sec
First weighted exercise. Focus on form over load. Stop if head pressure.
Weight: Light DB (10–15 lbs)
Hand/knee on bench
Rest: 60 sec
Weight: Light DBs (10–15 lbs each)
Slow, controlled
Keep head neutral
Modify as needed
Rest: 60 sec
Dead bug × 12 each
Bird-dog × 10 each
Plank × 45 sec
Side plank × 30 sec each
Rest: 30 sec
Steady pace, RPE 4–5
Recovery focus
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Evening: Body Scan (10 min)
Notice how body responds to resistance training
Cool-down
Walk: 3 min
Full body stretch: 10 min
Morning Symptom Assessment
How did yesterday strength work feel? Any delayed symptoms?
Walk → jog: 3 min
High knees: 25
Butt kicks: 25
A-skips: 12 each
Leg swings: 12 each
Lateral shuffles: 15 yd × 2
Carioca: 15 yd × 2
Pace: Moderate, RPE 5–6
HR: 70–75% max
Goal: Complete without walk breaks
First 15-min continuous run. Stay controlled.
3 rounds: T-drill × 2
Pro agility × 2
Box drill × 2 each direction
Lateral shuffle with change × 4
Rest: 45 sec
Build-ups (50% → 75%): 4 × 30 yd
Sprint starts: 4 × 10 yd (75–80%)
Rest: Walk back
First higher-intensity sprinting. Stay controlled.
Morning: Breath Awareness (10 min)
Natural breathing, notice qualities
Evening: Progressive Relaxation (12 min)
Full tense-release with body scan
Cool-down
Easy walk: 5 min
Lower body stretch: 10 min
Morning Symptom Assessment
Second strength session. Any DOMS from Day 29?
Easy jog: 4 min
Cat-cow: 10
World greatest stretch: 5 each
Leg swings: 10 each
Arm circles: 10 each
BW squats: 10
Weight: Light DBs at sides
Controlled
Rest: 60 sec
Weight: Light-moderate DBs
Rest: 60 sec
Single DB between legs
Focus: Hinge, not squat
Weight: Light DBs
Seated or standing
Rest: 60 sec
First overhead pressing. Keep core tight. Stop if head pressure.
Pallof press: 10 each
Dead bug with weight: 10 each
Side plank with reach: 8 each
Bird-dog row: 8 each
Rest: 30 sec
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Evening: Body Scan (10 min)
Notice muscle soreness, tension
Cool-down
Walk: 3 min
Full body stretch: 12 min
Foam rolling: 5 min
Morning Symptom Assessment
Mid-week recovery. How is body handling strength + cardio?
Option 1: 35 min walk
Option 2: 15 min walk, 12 min easy jog, 8 min walk
RPE 3 max
Nature preferred
Sun salutation A × 3
Down dog: 45s
Pigeon: 60s each
Low lunge: 45s each
Warrior I/II flow
Triangle: 30s each
Seated twist: 45s each
Corpse pose: 3 min
Dead bug: 8 each (slow)
Bird-dog: 8 each
Glute bridge: 10
Extended Morning Practice (15 min)
5 min box breathing
5 min loving-kindness
5 min open awareness
Evening: Extended Body Scan (12 min)
Focus on recovery and relaxation
Evening Protocol
Epsom salt bath recommended
Early bedtime
Morning Symptom Assessment
Post-recovery. Ready for week most challenging session?
Easy jog: 5 min
High knees: 25
Butt kicks: 25
A-skips: 15 each
Lateral shuffles: 15 yd × 2
Carioca: 15 yd × 2
BW squats: 10
Push-ups: 8
4 rounds: Goblet squat × 10
Push-up × 10
DB Row × 8 each
Reverse lunge × 8 each
Plank × 30 sec
Rest: 90 sec between rounds
Pace: Moderate, RPE 5–6
HR: 70–75% max
Build toward 20 min continuous
Extending running capacity. Walk briefly if needed, but push toward goal.
T-drill: 3 reps
Pro agility: 3 reps
Backpedal to sprint: 4 × 10 yd
Rest: 30–45 sec
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Evening: Body Scan (10 min)
Notice fatigue patterns
Cool-down
Walk: 5 min
Comprehensive stretch: 12 min
Foam rolling: 5 min
Morning Symptom Assessment
Recovery focus before assessment tomorrow.
Option 1: 40 min walk
Option 2: 20 min walk, 15 min easy jog, 5 min walk
Nature setting
RPE 3 max
Feet/Ankles: Circles, calf/soleus stretch
Hips: 90/90, pigeon, hip flexor, frog
Spine: Cat-cow, thread needle, thoracic rotation
Upper: Wall slides, pec stretch, lat stretch
Dead bug: 10 each
Bird-dog: 10 each
Side plank (knees): 20s each
Extended Morning Practice (15 min)
5 min box breathing
5 min open awareness
5 min intentions for Week 6
Evening: Gratitude + Reflection
Journal Week 5 accomplishments
Reflect on strength progress
Body scan
Evening Protocol
Light social activity okay
Extended sleep: 9+ hours
Meal prep for Week 6
Week 5 Complete: Assessment Day
◆ Morning Assessment
Complete full symptom assessment
Compare: Day 35 vs Day 28 vs Day 1
Progression criteria for Week 6:
• Tolerated resistance training without symptoms
• Completed 15–20 min continuous running
• No symptom flares during or after exercise
If NOT meeting criteria: Repeat Week 5
◆ Physical Activity (Optional)
Light walking: 20–30 min
Gentle stretching: 15 min
No structured training
◆ Week 5 Reflection Questions
How did resistance training feel?
Any head pressure during lifting?
Longest continuous run achieved?
Are you ready for increased intensity?
◆ Week 6 Preview
• Increased resistance training load
• 20–25 min continuous running
• Sport-specific drills progression
• Higher-intensity agility work
• Preparing for contact activities (Week 7)
◆ Week 5 Complete ◆
Resistance training foundation established. Proceed to Week 6: Sport-Specific Preparation.
Week 6: Sport-Specific Preparation
Focus
Sport-specific drills, increased load
Physical RPE
6–8 (Vigorous)
Running Target
20–25 min continuous
New Elements
Higher intensity sprints, complex agility
"This week bridges training and sport. Intensity increases significantly — your brain must prove it can handle near-game conditions."
Morning Symptom Assessment
Confirm Week 5 criteria met. Intensity increases significantly this week.
Jog: 5 min
High knees: 25
Butt kicks: 25
A-skips: 15 each
Leg swings: 12 each
Lateral shuffles: 15 yd × 2
BW squats: 15
Push-ups: 10
Jump squats: 5
Weight: Moderate DB (20–35 lbs)
Tempo: 2-1-1
Rest: 60 sec
Increase weight from Week 5 if form is solid.
Weight: Moderate DBs
Rest: 60 sec
Weight: Moderate DBs
Focus: Hip hinge, hamstring stretch
Weight: Moderate DB
Rest: 60 sec
Box jump or squat jump × 6
Medicine ball slam × 8
Push-up with clap (or explosive) × 6
Rest: 60 sec
First explosive/power work. Start conservative. Stop if any head symptoms.
Dead bug × 12 each
Plank × 45 sec
Side plank × 30 sec each
Russian twist × 20 total
Rest: 30 sec
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Evening: Body Scan (10 min)
Notice how body responds to increased intensity
Cool-down
Walk: 3 min
Full body stretch: 12 min
Foam rolling: 5 min
Morning Symptom Assessment
How did yesterday power work feel? Any symptoms from explosive movements?
Jog: 5 min progressive
High knees: 30
Butt kicks: 30
A-skips: 15 each
Lateral shuffles: 20 yd × 2
Carioca: 20 yd × 2
Build-up sprints: 3 × 20 yd (60–70%)
Pace: Moderate, RPE 5–6
HR: 70–75% max
Goal: Complete 20 min continuous
4 rounds: T-drill × 2 (80% speed)
Pro agility × 2 (80%)
L-drill × 2
Reactive shuffles (partner cue or random): 6 reps
Rest: 45 sec between rounds
40-yd sprints: 4 reps (80–85% effort)
Flying 20s: 4 reps (build then hold speed)
Rest: Walk back + 30 sec
Highest intensity sprinting yet. Stay controlled — not all-out max effort.
If applicable to your sport, add 10–15 min of non-contact skill work: ball handling, shooting, catching, etc. NO CONTACT.
Morning: Breath Awareness (10 min)
Natural breathing observation
Evening: Progressive Relaxation (12 min)
Tense-release with body scan
Cool-down
Easy walk: 5 min
Lower body stretch: 10 min
Hip mobility: 5 min
Morning Symptom Assessment
Any symptoms from yesterday speed work?
Jog: 4 min
Cat-cow: 10
World greatest stretch: 5 each
Leg swings: 12 each
Arm circles: 10 each
BW squats: 10
Push-ups: 8
Weight: Moderate DBs
Tempo: Controlled
Rest: 60 sec
Weight: Moderate DBs
Rest: 60 sec
Weight: Moderate DBs
Focus: Hamstring stretch
Weight: Light-moderate DBs
Rest: 60 sec
Lateral lunge × 8 each
Face pulls (band) × 15
Glute bridge march × 10 each
Farmers carry × 40 yd
Rest: 45 sec
Pallof press × 10 each
Dead bug × 12 each
Plank × 45 sec
Bird-dog × 10 each
Rest: 30 sec
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Evening: Body Scan (10 min)
Notice fatigue, soreness patterns
Cool-down
Walk: 3 min
Full body stretch: 12 min
Foam rolling: 5 min
Morning Symptom Assessment
Mid-week recovery. How is body handling increased intensity?
Option 1: 35 min walk
Option 2: 20 min easy jog, 15 min walk
RPE 3–4 max
Nature setting preferred
Sun salutation A × 3
Down dog: 45s
Pigeon: 60s each
Low lunge: 45s each
Warrior I/II
Half splits: 45s each
Seated twist: 45s each
Corpse pose: 3 min
Dead bug: 8 each
Bird-dog: 8 each
Glute bridge: 12
Extended Morning Practice (15 min)
5 min box breathing
5 min loving-kindness
5 min open awareness
Evening: Extended Body Scan (12 min)
Focus on recovery and preparation for Friday
Evening Protocol
Epsom salt bath recommended
Quality sleep priority
Early bedtime
Morning Symptom Assessment
Post-recovery. Ready for week most challenging session?
Jog: 5 min progressive
High knees: 30
Butt kicks: 30
A-skips: 15 each
Lateral shuffles: 20 yd × 2
Carioca: 20 yd × 2
Build-up sprints: 3 × 30 yd
3 rounds: Goblet squat × 10
Push-up × 12
DB Row × 8 each
Reverse lunge × 8 each
Plank × 30 sec
Rest: 60 sec between rounds
Pace: Moderate, RPE 6
HR: 75–80% max
Goal: Build toward 25 min continuous
Longest continuous run of the protocol. Push toward goal but listen to body.
3 rounds: T-drill × 2 (85–90%)
Pro agility × 2 (85–90%)
Reactive change of direction × 6
Rest: 60 sec
40-yd sprints: 4 reps (85–90%)
20-yd sprints: 4 reps (90%)
Rest: Walk back + 45 sec
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Prepare mentally for challenging session
Evening: Progressive Relaxation (12 min)
Full recovery focus
Cool-down
Easy walk: 5 min
Comprehensive stretch: 15 min
Foam rolling: 8 min
Morning Symptom Assessment
Recovery focus before assessment tomorrow. How do you feel after yesterday intensity?
Option 1: 40 min walk
Option 2: 25 min easy jog, 15 min walk
Nature setting
RPE 3 max
Feet/Ankles: Full routine
Hips: 90/90, pigeon, hip flexor, frog, adductor stretch
Spine: Cat-cow, thread needle, thoracic rotation, prone press-up
Upper: Wall slides, pec stretch, lat stretch, shoulder circles
Dead bug: 10 each
Bird-dog: 10 each
Glute bridge: 15
Extended Morning Practice (15 min)
5 min box breathing
5 min open awareness
5 min set intentions for Week 7
Evening: Gratitude + Reflection
Journal Week 6 accomplishments
Reflect on intensity progression
Body scan
Evening Protocol
Light social activity okay
Extended sleep: 9+ hours
Meal prep for Week 7
Week 6 Complete: Pre-Contact Assessment
◆ Morning Assessment
Complete full symptom assessment
Compare: Day 42 vs Day 35 vs Day 1
Progression criteria for Week 7:
• Completed 20–25 min continuous running
• Tolerated high-intensity agility (85–90%)
• No symptom flares during explosive movements
• Stable symptom scores throughout week
CRITICAL: Before Week 7 contact activities, consider medical clearance
If NOT meeting criteria: Repeat Week 6
◆ Physical Activity (Optional)
Light walking: 20–30 min
Gentle stretching: 15 min
No structured training
◆ Week 6 Reflection Questions
How did high-intensity work feel?
Any symptoms during sprints or agility?
Longest continuous run achieved?
Are you ready for contact activities?
◆ Week 7 Preview: Phase 4 Begins
• Phase 4: Full-Contact Practice
• Introduction of contact drills (with clearance)
• Full-intensity training
• Sport-specific practice integration
• Final preparation for return to play
Medical clearance recommended before contact activities
◆ Week 6 Complete ◆
Sport-specific preparation complete. Proceed to Week 7: Contact Integration (with medical clearance).
09Phase 4: Return to Operations (Weeks 7–8)
04
Phase 4 of 4 // Days 43–56
Full-Contact Practice & Return to Operations
Controlled contact introduction, full practice integration, return to competition or unrestricted training, and maintenance protocols.
Week 7: Contact Integration
Medical Clearance Required Before Week 7. Before beginning contact activities: obtain written medical clearance from your provider, complete baseline neurocognitive testing if required, confirm Week 6 progression criteria were met. If contact sports do not apply to you, continue non-contact training at Week 6 intensity. STOP IMMEDIATELY and seek medical attention if any symptoms return during contact activities.
Focus
Controlled contact, full practice
Physical RPE
7–9 (Vigorous-Max)
Running
25–30 min continuous
New Elements
Contact drills, full practice
"You have proven your brain can handle progressive stress. Now we test it under game-like conditions — controlled, monitored, and reversible."
Morning Symptom Assessment
Confirm Week 6 criteria met and medical clearance obtained. Full-intensity training begins.
Jog: 5 min
Dynamic stretches
High knees: 30
Butt kicks: 30
A-skips: 15 each
Lateral shuffles: 20 yd × 2
BW squats: 15
Push-ups: 10
Jump squats: 8
Weight: Challenging but controlled
RPE: 7–8
Rest: 90 sec
Weight: Challenging
Rest: 90 sec
Weight: Moderate-heavy
Focus: Hip hinge pattern
Weight: Moderate-heavy
Rest: 60 sec
Box jump × 6
Medicine ball slam × 8
Explosive push-up × 6
Kettlebell swing × 10
Rest: 60 sec
Pallof press × 10 each
Dead bug × 12 each
Plank × 60 sec
Russian twist × 20
Rest: 30 sec
Moderate pace, RPE 5–6
Recovery after strength
Morning: Box Breathing (8 min)
6-6-6-6 pattern
Mental preparation for intense week
Evening: Body Scan (10 min)
Notice response to full-intensity training
Cool-down
Walk: 5 min
Full body stretch: 12 min
Foam rolling: 8 min
Morning Symptom Assessment
CRITICAL: Any symptoms from yesterday? If yes, DO NOT proceed with contact. Return to Week 6.
Jog: 5 min
Full dynamic routine
Agility drills: 5 min
Build-up sprints: 4 × 30 yd (75–90%)
Pace: Moderate-hard, RPE 6–7
HR: 75–80% max
T-drill: 4 reps (90–95%)
Pro agility: 4 reps (90–95%)
Reactive drills: 6 reps
Rest: 45 sec
Pre-Contact: Mental Preparation (5 min)
Visualize successful contact
Relaxed but alert state
Trust your preparation
Post-Contact: Self-Assessment
Sit quietly for 5 min
Notice any symptoms
Be honest with yourself
Evening: Extended Body Scan (12 min)
Detailed assessment post-contact
Cool-down
Easy walk: 5 min
Full stretch: 15 min
Extra recovery focus
Morning Symptom Assessment
CRITICAL 24-hour post-contact check. Any delayed symptoms? If yes, stop contact and consult medical provider.
Jog: 4 min
Dynamic stretches
Movement prep
Weight: Moderate-heavy
Rest: 60 sec
Weight: Moderate
Rest: 60 sec
Lateral lunge × 8 each
Face pulls × 15
Dead bug × 12 each
Plank × 45 sec
Rest: 30 sec
Sport-specific drills without contact
Full speed, game-like movements
Reaction and decision-making drills
Morning: Box Breathing (8 min)
Standard practice
Evening: Body Scan (10 min)
Continue monitoring post-contact
Cool-down
Walk: 3 min
Full body stretch: 12 min
Foam rolling: 5 min
Morning Symptom Assessment
48-hour post-contact check. How are you feeling? Any delayed symptoms?
Easy pace, RPE 3–4
Nature setting preferred
Mental recovery focus
Extended mobility session
Focus on recovery
Gentle, restorative poses
Dead bug: 8 each
Bird-dog: 8 each
Glute bridge: 12
Extended Morning Practice (15 min)
5 min box breathing
5 min loving-kindness
5 min visualization of successful return
Evening: Extended Body Scan (15 min)
Detailed recovery assessment
Evening Protocol
Epsom salt bath recommended
Quality sleep priority
Prepare mentally for Friday
Morning Symptom Assessment
Green light for full practice if: No symptoms since Tuesday contact, full recovery confirmed, feeling ready.
Team warm-up or individual: Jog 5 min
Full dynamic routine
Agility drills
Build-up sprints
Pre-Practice: Visualization (5 min)
See yourself performing well
Confident, controlled, capable
Post-Practice: Assessment + Body Scan
Honest self-assessment
Notice any symptoms
Extended body scan (15 min)
Cool-down
Team cool-down or individual: Easy movement 5 min
Full stretch 15 min
Recovery focus
Morning Symptom Assessment
24-hour post-full-practice check. This is critical. Any symptoms?
Easy walk or very light jog
RPE 2–3 max
Recovery focus
Full mobility routine
Focus on areas stressed during practice
Extended Morning Practice (15 min)
5 min box breathing
5 min gratitude reflection
5 min intentions for Week 8
Evening: Gratitude + Reflection
Journal Week 7 accomplishments
Reflect on contact integration
Body scan
Evening Protocol
Light social activity okay
Extended sleep: 9+ hours
Prepare for final week
Week 7 Complete: Final Assessment Before Clearance
◆ Comprehensive Assessment
Complete full symptom assessment
Compare: Day 49 vs Day 1 (should be minimal/no symptoms)
Clearance criteria for Week 8 (Return to Play):
• Completed full practice without symptom increase
• No symptoms 48+ hours post-contact
• All baseline cognitive tests passed (if applicable)
• Medical clearance confirmed
• Feeling confident and ready
If ANY criteria not met: Repeat Week 7 or consult medical provider
◆ Physical Activity
Light walking: 20–30 min
Gentle stretching: 15 min
Rest and prepare
◆ Week 7 Reflection Questions
How did contact feel?
Any symptoms during or after practice?
Do you feel ready for competition?
Any hesitation or concerns?
◆ Week 8 Preview: Return to Operations
• Full return to sport/activity
• Competition/game participation
• Unrestricted training
• Ongoing monitoring
• Maintenance protocols
◆ Week 7 Complete ◆
Contact integration successful. Final week: Return to Operations.
Week 8: Mission Complete — Return to Operations
Status
Full clearance, unrestricted
Activity Level
Competition-ready
Focus
Return + maintenance
Monitoring
Ongoing self-assessment
"The mission is complete, but the operator mindset remains. Stay vigilant, maintain your protocols, and trust your preparation."
◆ PROTOCOL COMPLETE ◆
You have successfully completed the 8-week Return to Operations protocol. Your brain has demonstrated the capacity to handle progressive physical and cognitive stress. You are cleared for full return to activity.
Morning Check-in
Continue daily self-assessment. You are cleared, but awareness remains important.
You are cleared for:
• Full-intensity strength training
• Unrestricted cardio
• All sport-specific activities
• Contact activities
• Competition preparation
Resume your normal training program or team practice schedule.
• Morning symptom awareness (quick mental check)
• Hydration: 80+ oz water
• Sleep: 7–9 hours minimum
• Continue omega-3 supplementation
• Mobility work: 10–15 min daily
Daily Practice (5–10 min minimum)
Continue box breathing or meditation practice
This is now a performance tool, not just recovery
Morning Check-in
How did yesterday full training feel? Any concerns?
Full training per your normal schedule. Team practice, individual training, sport-specific work — all unrestricted.
Pre-Training Visualization (5 min)
Visualize successful performance
Build mental preparation habits
Morning Check-in
Continue daily awareness. You know your body — trust it.
Full training per schedule. Consider this your normal training week with added awareness.
• Post-training: Full cool-down and stretch
• Evening: Mobility work 15 min
• Quality sleep priority
Morning Check-in
Mid-week recovery. Maintain the habits you have built.
Light activity: Easy cardio 20–30 min
Mobility: 20–25 min full routine
Or: Light practice/skill work
Recovery days remain important — do not abandon them.
Mindfulness Session (15 min)
5 min breathing
5 min body scan
5 min gratitude/reflection
Morning Check-in
Pre-competition preparation. You are ready.
If competition tomorrow:
• Light practice/walkthrough
• Mental preparation
• Physical preparation (activation, mobility)
If no competition:
• Full training as scheduled
Visualization Session (10 min)
Visualize successful competition
See yourself performing at your best
Build confidence through mental rehearsal
Evening Protocol
Quality sleep: 8+ hours
Hydration
Light, nutritious dinner
Early bedtime
Morning Check-in
You have earned this. Trust your preparation. Execute.
If competition:
• Pre-game routine as normal
• Full participation — you are cleared
• Post-game: Recovery protocols
If training:
• Full training session
• Sport-specific work
This is your official return. You have completed the protocol. Compete with confidence.
Pre-Competition (5 min)
Box breathing to center
Brief visualization
Present-moment focus
◆ MISSION COMPLETE ◆
◆ Final Assessment
Complete final symptom assessment
Compare Day 56 to Day 1
You should see:
• Symptom scores at or near zero
• Full return to all activities
• Confidence in your recovery
• Maintained fitness and strength
◆ Recovery Summary
8-Week Journey:
• Week 1–2: Rest & Stabilization → Light aerobic
• Week 3–4: Jogging intervals → Extended cardio
• Week 5–6: Resistance training → Sport-specific
• Week 7–8: Contact integration → Full return
You progressed through each phase with patience and discipline.
◆ Ongoing Maintenance
Continue these habits:
• Daily symptom awareness (brief mental check)
• Quality sleep: 7–9 hours
• Hydration: 80+ oz water
• Omega-3 supplementation
• Daily mobility work: 10–15 min
• Mindfulness practice: 5–10 min daily
• Regular recovery days
Watch for:
• Any return of symptoms after impact
• Unusual fatigue or headaches
• Cognitive difficulties
If symptoms return: Stop activity, rest, and consult medical provider
◆ Long-Term Considerations
• Previous concussion increases risk of future concussion
• Report any head impacts to medical staff
• Consider baseline cognitive testing annually
• Maintain neck strength (reduces concussion risk)
• Stay informed about concussion research and protocols
◆ RETURN TO OPERATIONS ◆
You have successfully completed the 8-week concussion recovery protocol. Your discipline, patience, and commitment have prepared you for this moment. You are cleared for full return to operations.
STAY VIGILANT. STAY STRONG. STAY OPERATIONAL.
10Mindfulness Protocol Library
The mindfulness practices used throughout RTO, consolidated for reference. Pick the one prescribed for the day, or substitute equivalents as needed.
Box Breathing
Inhale, hold, exhale, hold — equal counts. The foundational practice of the protocol. Used daily in some form.
- Beginner (Weeks 1–2): 4-4-4-4
- Progression (Weeks 3–4): 5-5-5-5
- Phase 3+ (Weeks 5+): 6-6-6-6
- Cycles: 12–15 per session
- Position: Seated upright, eyes closed or soft gaze
Body Scan
Sequential attention from head to toe, noticing sensations without judgment. Used as the standard evening practice.
- Lie flat, eyes closed. Take 3 deep breaths.
- Top of head → forehead → eyes → jaw (release tension) → neck → shoulders → arms → hands
- Chest → abdomen → hips → thighs → knees → calves → ankles → feet
- End with 3 breaths and rest.
5-4-3-2-1 Grounding
Sensory anchor for symptom-prone days. Used midday in Week 1.
- 5 things you can hear
- 4 sensations in your body
- 3 things you can smell
- 2 things you can feel with hands
- 1 thing you are grateful for
Progressive Muscle Relaxation (PMR)
Tense-release sequence by muscle group. Introduced Week 1 Day 5 and reused throughout.
- Lie down. Start with feet.
- Tense 5 seconds, release and notice relaxation 10 seconds.
- Progress: calves → thighs → glutes → abdomen → hands → arms → shoulders → face.
- Skip neck tensing — just relax it.
- End with body scan.
Mindful Walking
Used during prescribed walks, especially in Weeks 1–3.
- Slow, deliberate pace
- Focus on heel strike → weight transfer → toe push-off
- No headphones — be present with environment
- Notice breath rhythm and body sensations
Loving-Kindness Meditation
Used on active recovery days. Repeat silently:
"May I be healthy. May I be at peace. May I be free from suffering."
Then extend to loved ones, acquaintances, all beings.
Gratitude Journaling
Used weekly on Saturday/active recovery days. Write:
- 3 things you are grateful for today
- 1 thing your body did well
- (Week-end) 5 things grateful for this week, 3 things body did well, 1 intention for next week
Visualization (Phase 4)
Used pre-contact (Week 7) and pre-competition (Week 8).
- See yourself performing successfully
- Relaxed but alert state
- Trust your preparation
- Present-moment focus, not future-focused worry
11Nutrition Framework
The brain uses 20–40% of daily calories during recovery. The nutrition prescription is consolidated below.
Hydration
- Daily target: 80+ oz water
- Around exercise (Week 2+): Extra 16 oz
- During exercise (Week 3+): Water every 10–15 min
- Check: Urine should be pale yellow
Core Supplements
| Supplement | Dose | Purpose | Start |
|---|
| Omega-3 (DHA/EPA) | 2000–2500 mg | Anti-inflammatory, neural membrane support | Day 1 |
| Magnesium | 300–400 mg evening | Sleep, nervous system | Day 1 |
| Creatine | 5 g daily | Brain ATP production | Day 2 |
| Vitamin D | 2000 IU | Neural recovery, mood | Day 3 |
| B-Complex | 1 daily | Energy metabolism, nerve function | Day 4 |
| Melatonin (optional) | 0.5–1 mg if disrupted | Sleep regulation | As needed |
Anti-Inflammatory Foods (Daily Focus)
- Fatty fish (salmon, mackerel, sardines)
- Berries (blueberries, strawberries)
- Leafy greens (spinach, kale)
- Turmeric
- Walnuts and almonds
- Olive oil
- Cruciferous vegetables (broccoli, cauliflower)
What to Avoid
- Alcohol: Avoid throughout protocol; especially strict Weeks 1–2
- Caffeine: Avoid in acute phase (Week 1); reintroduce cautiously
- High sugar / processed foods
- Skipped meals: Small, frequent meals if nausea is an issue
Around Exercise (Week 2+)
- Pre-workout (30–60 min before): Light carbs (banana, oatmeal, toast)
- Post-workout (within 30 min): Protein + carbs (Greek yogurt + berries + walnuts is the canonical example)
- Daily protein target: 0.8–1 g per lb bodyweight
12Cognitive Load Protocol
Cognitive load is just as important as physical load in recovery. Screen time, work hours, and mental tasks progress alongside the physical prescription.
| Week | Screen Time | Reading | Work Hours | Dual-Task |
|---|
| Week 1 | 30-min blocks max, essential only | 15–30 min | 1–3 hr (Day 4+) | Walk + count back from 100 by 7s (Day 3) |
| Week 2 | Normal, 45-min breaks | 30–45 min | 4–6 hr full day | Walk + podcast, mental math |
| Week 3 | Normal | 30–45 min | Full day, regular breaks | Walk + alphabet backward, reaction apps |
| Weeks 4–6 | Normal | As tolerated | Full day | Sport-specific reaction drills |
| Weeks 7–8 | Normal | As tolerated | Full unrestricted | Practice + competition decision-making |
Cognitive Tasks by Phase
- Phase 1 (W1): Light reading only, journaling, light conversation. Avoid video games, intense TV, work emails, social media.
- Phase 2 (W2–3): Add memory exercises (read article, summarize 30–60 min later), simple math, sudoku/crossword. Introduce reaction time apps.
- Phase 3 (W4–6): Reaction training, dual-task during walking, full work schedule.
- Phase 4 (W7–8): Sport-specific cognitive load (play-calling, situational awareness), full unrestricted cognitive activity.
Environmental cues throughout (especially Weeks 1–2): Reduce bright lights, loud noises. Sunglasses outdoors. No screens 1 hour before bed. Dark, cool sleep environment.
13Progression Criteria
Each Sunday assessment uses these criteria to decide: advance, repeat, or step back.
| Phase |
Advance If |
Repeat If |
Step Back If |
| Phase 1 (W1) |
Symptom score reduced 50%+ OR all symptoms ≤ 3 OR no symptom increases during week |
Some improvement but not meeting advance criteria |
Symptoms unchanged/worse after 5 days — contact provider |
| Phase 2 (W2–3) |
Tolerated 15–20 min cardio (W2) / 3-min jog intervals (W3) without symptom increase |
Cardio tolerated but symptoms increased during agility/jogging |
2+ 48-Hour Rule triggers during the week |
| Phase 3 (W4–6) |
Tolerated 8–10 min continuous jog (W4) / resistance training (W5) / 20–25 min continuous run + high-intensity agility (W6) |
Completed most sessions but flared during peak intensity day |
Symptoms triggered by explosive movement; cannot tolerate strength sessions |
| Phase 4 (W7–8) |
Full practice / full training completed with no symptom increase, no symptoms 48+ hours post-contact, medical clearance confirmed |
Contact tolerated but practice triggered minor symptoms |
ANY symptoms during contact — stop, consult provider, return to Week 6 |
Repeating a week is not failure. It is the design. The protocol assumes many users will repeat at least one week. Forcing progression through symptoms is the failure mode. The 48-Hour Rule is non-negotiable.
14Bridge to Sentinel
RTO ends at full clearance. What comes next depends on what you want.
Returning to a Sport
If you came into RTO from a sport, return to your normal training schedule. Maintain the daily symptom awareness habit indefinitely. Any future head impact triggers an automatic step-back to Phase 3 protocols until cleared.
Starting Structured Strength Training: Sentinel
Sentinel is the DarkWolf foundational TBI-adapted strength template — 8-week cycle, 3–4 days per week, full-body, designed for athletes with TBI history. It is the natural next step for anyone who finished RTO and wants a structured strength program built with the same nervous-system-first philosophy.
The DarkWolf Program Family
- RTO (free): 8-week return-to-training after concussion. Where you are.
- Sentinel (free): Foundational strength — 8-week cycle, the on-ramp to all other programs.
- Phantom (in development): Aesthetic bodybuilding — hypertrophy-first, dumbbell-dominant, ICP-managed.
- Fenrir (in development): Powerlifting — controlled strength building with TBI-conscious loading.
The Neuro-RPE scale and 48-Hour Rule from RTO carry forward into every DarkWolf program. The protocols change. The autoregulation philosophy does not.
15Neuro-RPE Scale
The Neuro-RPE scale is the shared DarkWolf autoregulation system. It runs two ratings in parallel — muscular and neurological — and the higher score governs the session.
| Score |
Muscular |
Neurological |
Zone |
Action |
| 1–4 |
Light to moderate |
Clear. No symptoms. |
GREEN |
Continue as prescribed |
| 5–6 |
Moderate. 4+ RIR. |
Clear. Slight fatigue. |
GREEN |
Target zone for volume days |
| 7 |
Mod-hard. 3 RIR. |
Mild head pressure, warmth. |
YELLOW |
Extend rest to 4+ min. Do not increase load. |
| 8 |
Hard. 2 RIR. |
Head pressure, mild headache, slight dizziness. |
ORANGE |
Peak intensity only. Consider ending main work. |
| 9 |
Very hard. 1 RIR. |
Headache, dizziness, visual disturbance, fog. |
RED |
STOP. Reduce load 10–15% or end main work. |
| 10 |
Maximal. |
Sharp headache, nausea, disorientation. |
BLACK |
TERMINATE. Rest 48+ hrs. Consult provider. |
48-Hour Rule: If neurological symptoms last more than 48 hours after a session, your next session is automatically a deload or step-back — no matter where you are in the program.
16Medical Disclaimer
Read this carefully. This protocol is for adults recovering from a mild, medically diagnosed concussion who have been cleared by a healthcare provider to begin a structured return-to-training program. It is not a substitute for medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, continuing, or modifying any training program after a head injury. Stop immediately and seek medical attention if you experience repeated vomiting, seizures, loss of consciousness, worsening headache, slurred speech, unequal pupils, weakness or numbness on one side, fluid drainage from nose or ears, or inability to recognize people or surroundings. DarkWolf Mission Log and the author assume no liability for any injury, illness, or adverse outcome resulting from use of this protocol. Use at your own risk.
17References
- Leddy, J. J., Kozlowski, K., Donnelly, J. P., Pendergast, D. R., Epstein, L. H., & Willer, B. (2010). A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clinical Journal of Sport Medicine, 20(1), 21–27.
- Leddy, J. J., Haider, M. N., Ellis, M. J., et al. (2019). Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatrics, 173(4), 319–325.
- McCrory, P., Meeuwisse, W., Dvorak, J., et al. (2017). Consensus statement on concussion in sport — the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838–847.
- Schneider, K. J., Leddy, J. J., Guskiewicz, K. M., et al. (2017). Rest and treatment/rehabilitation following sport-related concussion: a systematic review. British Journal of Sports Medicine, 51(12), 930–934.
- Griesbach, G. S., Hovda, D. A., Molteni, R., Wu, A., & Gomez-Pinilla, F. (2004; replicated 2012). Voluntary exercise following traumatic brain injury: brain-derived neurotrophic factor upregulation and recovery of function. Neuroscience, 125(1), 129–139; (2012) Neuroscience, 219, 100–108.
- Patricios, J. S., Schneider, K. J., Dvorak, J., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport — Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695–711.