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Concussion Information

Return to Play (RTP) and Return to Learn (RTL)

With the start of the 2010-11 school term, the National Federation of State High School Associations (NFHS) implemented a new national playing rule regarding potential head injuries. The rule requires “any player who exhibits signs, symptoms, or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, of balance problems) shall be immediately removed from the game and shall not return to play until cleared by an appropriate health care professional.” In applying that rule in Illinois, it has been determined that only certified athletic trainers, advanced practice nurses (APN), physician’s assistants (PA) and physicians licensed to practice medicine in all its branches in Illinois can clear an athlete to return to play the day of a contest in which the athlete has been removed from the contest for a possible head injury.
In 2015, the Illinois General Assembly passed the Youth Sports Concussion Safety Act, and this legislation, among other items, required schools to develop Concussion Oversight Teams and create Return to Play (RTP) and Return to Learn (RTL) protocols that student-athletes must meet prior to their full return to athletic or classroom activity
Definition of a Concussion
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
        Behavior or Signs Observed:
Symptoms Reported by Player:
  • Loss of consciousness (seizure activity)*
  • Appears dazed or stunned
  • Appears confused
  • Forgets plays
  • Unsure of game, score, or opponent
  • Moves clumsily
  • Answers questions slowly
  • Shows behavior or personality changes*
  • Can't recall events prior to or after the injury
  • Headache (increases in intensity*)
  • Nausea (persistent vomiting*)
  • Balance problems or dizziness
  • Double or fuzzy vision*
  • Sensitivity to light or noise
  • Feeling foggy or groggy
  • Fatigue (difficulty awakening*)
  • Concentration or memory problems
  • Confusion
Any symptoms shown in red with an (*) are "Red Flags of Concussion." These symptoms should prompt emergency medical treatment.
Rock Island High School Return-to-Learn Protocol
Step: Intensity: Cognitive Activity:
  • Minimal Activity
  • No School
  • Rest
  • Half-Day of School with Accommodations
  • Allow accommodations for symptoms
  • 1/2 of school or to allow to rest in Clinic
  • All class work done at home in 30-minute intervals
  • Full Day of School with Accommodations
  • Allow accommodations for symptoms
  • Attend all classes - rest in Clinic if symptomatic
  • Begin class work, as symptoms allow
  • Students Return to Full Cognitive Activity
  • Full Day of School
  • Full Class Work
  • Return-to-Play Protocol with Athletic Trainer
  • Must complete RTP before PE/sports may resume
  • 5-Step Graded Exercise Protocol with increasing intensity
Criteria to Advance: Asymptomatic during full day of normal mental activity and Sway scores within normal limits 
Rock Island High School Return-to-Play Protocol
Physical Activity
  • RTL Must Be Completed (Complete Through Step 4)
  • Light Aerobic Activity
    • Non-impact exercise for 15-30 minutes
    • HR = 30-40% max exertion
  • Moderate Aerobic Activity
    • Circuit-based exercise 30-45 minutes
    • HR = 40-60% max exertion
  • Higher Intensity Sport-Specific Aerobic Activity
    • Circuit-based exercise 45-60 minutes
    • HR = 60-80% max exertion
  • Return to Full Contact Practice
  • Return to Game Play (Cleared by Medical Staff)
Criteria to Advance: Asymptomatic before, during, and after activity and at least 24 hours of time passed between phases