Category

Injury

Concussion – Return-to-Cycling

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Concussion Return‑to‑Cycling

Version 1.2 | As at: 19 Sep 2025
Protocol
Injury

Concussions are brain injuries that require careful, staged recovery to prevent long‑term damage. This protocol ensures a safe, structured return to cycling, reducing the risk of relapse or secondary injury.

🚨 Red‑Flag Symptoms — Stop & Seek Medical Help: Severe or worsening headache • Repeated vomiting • Confusion • Slurred speech • Loss of consciousness • Se izure • Weakness or numbness in limbs • Vision changes. If any occur at any stage, contact a medical professional immediately.
Progression rule: You must be symptom‑free at rest before moving forward. If any symptoms return during or after an activity, stop immediately, rest 24 hours, and resume from the previous symptom‑free stage.

Monitoring & Feedback Loop

Goal: Keep your coach fully informed to guide safe progression

  • Log daily symptom status in your TrainingPeaks metrics.
  • Add post‑exercise comments describing symptoms, perceived exertion, and recovery quality.
  • Update resting HR and HRV daily.
  • Ensure your coach reviews this data before you progress to the next stage.

Stage 1 — Light Cognitive Activity

Goal: Gentle brain stimulation without symptoms

  • Short periods of reading or screen use.
  • Light conversation and basic tasks.
  • No intense concentration or problem‑solving.
  • Continue daily symptom, HR, and HRV logging.

Minimum time in stage: 24 hrs symptom‑free before progressing.

🗒 Coach notes: Check cognitive load tolerance, confirm no symptom flare‑ups, keep physical activity at zero.

Red‑flag check: If any red‑flag symptoms appear, stop immediately and seek medical review.

Stage 2 — Light Physical Activity

Goal: Increase heart rate slightly without head impact

  • Gentle cycling on a stationary trainer or flat terrain.
  • Maximum 15–20 minutes.
  • No resistance, sprinting, or group riding.
  • Target Intensity: Zone 0 — no training load, just light activity.
  • Continue daily symptom, HR, and HRV logging.

Minimum time in stage: 24 hrs symptom‑free before progressing.

🗒 Coach notes: Verify activity stayed in Zone 0, check HR/Power relationship for disproportionate HR response, confirm no symptoms during/after.

Red‑flag check: If any red‑flag symptoms appear, stop immediately and seek medical review.

Stage 3 — Moderate Cycling

Goal: Introduce moderate intensity without contact or risk

  • Outdoor riding on familiar, low‑risk routes.
  • Up to 30 minutes at a steady pace.
  • No bunch riding, technical descents, or high‑intensity intervals.
  • Target Intensity: Zone 1–2 — easy endurance pace.
  • Continue daily symptom, HR, and HRV logging.

Minimum time in stage: 24 hrs symptom‑free before progressing.

🗒 Coach notes: Review HR/Power relationship for signs of decoupling, confirm no symptom recurrence, ensure athlete stayed within Zone 1–2.

Red‑flag check: If any red‑flag symptoms appear, stop immediately and seek medical review.

Stage 4 — Sport‑Specific Drills

Goal: Add cycling‑specific skills and coordination

  • Include cornering, gear changes, and light climbs.
  • Short efforts at moderate intensity.
  • No racing or competitive drills.
  • Target Intensity: Zone 2–3 — moderate, skill‑focused.
  • Continue daily symptom, HR, and HRV logging.

Minimum time in stage: 24 hrs symptom‑free before progressing.

🗒 Coach notes: Monitor skill execution quality, review HR/Power relationship for signs of decoupling, ensure intensity stayed in Zone 2–3, confirm no post‑session symptoms.

Red‑flag check: If any red‑flag symptoms appear, stop immediately and seek medical review.

Stage 5 — Controlled Intensity

Goal: Return to near‑normal training load under supervision

  • Structured intervals at 80–90% of pre‑injury intensity.
  • Group riding allowed if low‑risk and controlled.
  • Coach or medical clearance before progressing.
  • Target Intensity: Zone 3–4 — controlled high intensity.
  • Continue daily symptom, HR, and HRV logging.

Minimum time in stage: 24 hrs symptom‑free before progressing.

🗒 Coach notes: Review structured interval data, check HR/Power relationship for stability, confirm no symptom return, ensure group riding remains low‑risk and controlled.

Red‑flag check: If any red‑flag symptoms appear, stop immediately and seek medical review.

Stage 6 — Full Simulation

Goal: Resume full training and race‑specific efforts

  • Normal training volume and intensity.
  • Include sprints, climbs, and tactical drills.
  • Final clearance from a medical professional before competition.
  • Target Intensity: Zone 4–5 — full race simulation.
  • Continue daily symptom, HR, and HRV logging.

Minimum time in stage: Only progress to competition after full medical clearance.

🗒 Coach notes: Confirm medical clearance, review race‑simulation data, check HR/Power relationship for normal patterns, ensure athlete is fully symptom‑free before competition.

Red‑flag check: If any red‑flag symptoms appear, stop immediately and seek medical review.