Pre-Season, Mid-Season, or Post-Season: When Is the Best Time to Baseline Test?

The standard timing for baseline testing is pre-season — ideally during the pre-participation physical examination window before practices begin. This is the approach recommended by the NATA, the SCAT6 protocol, and most clinical concussion management guidelines. But the question of optimal timing is more nuanced than “before the season starts.”

Pre-season baselines

Pre-season baselines capture cognitive function during a period of relative physical and academic calm (depending on when the season starts). For fall sports, pre-season testing typically occurs in July or August — before school is in session, when academic stress is low and sleep schedules may be more relaxed. This may or may not represent the athlete’s typical cognitive state during competition, when they’re balancing sports, school, social life, and often sleep deprivation.

Mid-season testing

Mid-season testing has been proposed by some researchers as a way to capture how an athlete’s cognitive function changes during a season of cumulative physical and cognitive stress. If subconcussive impacts accumulate during a football season, mid-season testing might detect changes that a pre-season baseline wouldn’t capture. However, mid-season testing is logistically challenging and adds cost — and the clinical utility of mid-season data for individual concussion management (as opposed to research on cumulative effects) remains debated.

End-of-season testing

Post-season or end-of-season testing has been advocated by researchers studying subconcussive exposure. Comparing end-of-season cognitive performance to pre-season baselines can reveal whether a full season of contact sport participation has produced measurable cognitive changes — even in athletes who were never diagnosed with a concussion. Research using head impact sensors and serial cognitive testing, published in the Journal of Neurotrauma and Neurosurgery, has explored this approach in football and hockey populations.

Our recommendation

Pre-season baseline testing is the practical standard and the clinically essential timing for concussion management purposes. Mid-season and end-of-season testing are valuable for research, for monitoring athletes with extensive concussion histories, and for sports with heavy subconcussive exposure (football, hockey, heading-intensive soccer). At Headquarters, we typically recommend pre-season testing with annual renewal, and we offer mid- and post-season assessments for programs that want longitudinal monitoring.

Frequently asked questions