Sweden Introduces Hjärntrappan 2.0 for Concussion Recovery in Sports

Leading Swedish researchers have launched 'Hjärntrappan 2.0', a new protocol for managing concussions in sports that replaces the outdated practice of total rest. This updated approach emphasizes gradual re-engagement in activity rather than complete inactivity after a concussion, with six distinct stages designed to facilitate a more effective recovery process.

The protocol begins with 24-48 hours of **relative rest**, focusing on calm activities that do not exacerbate symptoms, followed by **light exercise** such as cycling and strength training, where heart rates can reach up to 70% of maximum. Subsequent stages include **sport-specific training** that avoids head impacts, then a move to **non-contact training**, and finally **full training**. A complete **return to competition** is permitted once the athlete is symptom-free.

Kajsa Johansson, assistant professor at Linköping University, noted that excessive initial rest could prolong recovery and emphasized the importance of these updated guidelines, which have garnered international endorsement, including a consensus report from the Concussion In Sport Group in 2023.

Former pro hockey player Sanny Lindström, who experienced multiple concussions, expressed support for Hjärntrappan 2.0, reflecting that it could have altered his recovery had it been in place during his career. Lindström stressed the necessity of consulting specialized medical professionals rather than relying on general treatments, highlighting the pressing need for professional support in concussion management as the adoption of the new protocol remains uneven across different levels of sports participation.