Returning to Work

  • After a concussion we recommend you follow a Graduated Return to Work Strategy that can be designed with you and your healthcare team and employer  

  • We don’t recommend prolonged absence from work beyond a few days.

  • You should begin working part time with reduced job demands then progress back to full schedule.

  • Consider creating a Graduated Return to Work Plan with your employer

 

 

Return to Work Strategy Example

  • A return to work plan should progress through several phases.
  • If your symptoms are tolerable at a given phase, then progress to the next step.
  • If symptoms worsen, don’t progress to the next phase until symptoms are tolerable
  • Remember: your plan should be individualized to you, these are only suggestions.

 

Phase 1: Off work and rest with very limited physical and cognitive activity for 1-3 days.  

  • Take time off work (usually a few days),
  • reduce cognitive exertion and stimulation, but maintain light activity
  • avoid driving and overstimulating community environments (eg. stores, crowds)
  • Let your employer know you've experienced a concussion and start return to work planning with your employer and team.

 

Phase 2: Light cognitive & physical activity

  • Start with 10 minutes of cognitive exertion or stimulation at home (eg. reading, computer, TV, conversation, planning/scheduling, cooking) followed by rest breaks.
  • Continue to gradually build up your time between rest breaks
  • Progress to roughly 60 minutes of sustained activity, before needing to take a rest break.

 

Phase 3: Modified sedentary work

  • At home or in the workplace perform menial sedentary work for up to 60 minutes at a time.  
  • Limit multitasking, stress, intense concentration or problem solving, or big decisions.
  • Limit strenuous physical exertion like lifting, carrying, and driving.  

 

Phase 4: Modified work

  • Continue modified duties for up to 2 hours at a time.  
  • Limit (but don't avoid) cognitive strain and continue to limit physical demands (do seated work, occasional standing, no loads greater than 10-20lbs).  
  • Continue taking extra breaks (at least every hour) and work reduced hours (up to about 50% of typical schedule).

 

Phase 5: Part time light duty work

  • Work full cognitive duties but continue to limit physical demands (do seated work, no prolonged standing, no loads greater than 20lbs,).  
  • Work up to 75% of your typical schedule

 

Phase 6: Full time light duty work

  • Return to full cognitive duties and hours (with light physical demands).
  • If you work in a physically demanding job (deal with lots of movement, lifting, weights >20lbs.) move onto Phase 7

 

For more physical jobs:

Phase 7: Full Time Medium Duty Work

  • Work a full time schedule but restrict weights lifted to 20-50lbs.
  • Avoid any activities that put you at risk for further injury.  
  • Be careful with balancing movements (eg. walking at heights or along ledges) and prolonged neck postures (like looking down all day).  
  • Take extra breaks.

 

Phase 8: Full Time Heavy Duty Work.

  • Work a full time schedule by restrict weights lifted to 50 – 100lbs.
  • Avoid any activities that put you at risk for further injury.  
  • Be careful with balancing movements (eg. walking at heights or along ledges) and prolonged neck postures (like looking down all day).  
  • Take extra breaks if needed.

 

Phase 9: Full Time Very Heavy Duty work.

  • Work a full time schedule and return to all physical demands.

 

 

Considerations for Driving and Equipment Operation:

If you have dizziness, concentration, memory or vision issues (or other issues that increase risk) do not return to driving and heavy equipment operation at work until being cleared by your medical team (for safety reasons).