NFHS Return-to-Play Guidelines & Recovery 2 — Questions and Answers
Question 1: At which return-to-play step is the athlete first allowed to participate in non-contact training drills?
- Step 3
- Step 4 (Correct answer)
- Step 2
- Step 5
Correct answer: Step 4
Step 4 (Non-contact training drills) is when the athlete may participate in sport-specific exercise without contact.
Question 2: How long must an athlete be symptom-free at rest before beginning the NFHS graduated return-to-play protocol?
- 12 hours
- 48 hours
- 24 hours (Correct answer)
- 72 hours
Correct answer: 24 hours
An athlete must be symptom-free for at least 24 hours before initiating the graduated return-to-play protocol.
Question 3: A student-athlete completes Step 3 without symptoms but develops a headache during Step 4. What is the correct action?
- Rest 24 hours then retry Step 4
- Drop back to Step 2 and rest 24 hours
- Drop back to Step 3 and rest 24 hours (Correct answer)
- Withdraw from the protocol entirely
Correct answer: Drop back to Step 3 and rest 24 hours
If symptoms return at any step, the athlete drops back one step and rests for 24 hours before reattempting that step.
Question 4: Which professional must provide written medical clearance before an athlete may advance to full-contact practice under NFHS guidelines?
- School principal
- Athletic director
- Licensed healthcare professional (Correct answer)
- Team captain
Correct answer: Licensed healthcare professional
NFHS requires written clearance from a licensed healthcare professional before an athlete returns to full-contact practice.
Question 5: Step 2 of the return-to-play protocol focuses on which type of activity?
- Sport-specific exercise
- Full-contact practice
- Light aerobic exercise (Correct answer)
- Non-contact drills
Correct answer: Light aerobic exercise
Step 2 involves light aerobic exercise such as walking or swimming, with no resistance training.
Question 6: Why is rest during the early recovery phase considered the cornerstone of concussion management?
- It prevents the athlete from being re-injured
- It allows the brain to heal without increased metabolic demand (Correct answer)
- It keeps the athlete away from teammates
- It satisfies insurance requirements
Correct answer: It allows the brain to heal without increased metabolic demand
Physical and cognitive rest reduces metabolic demand on the injured brain, supporting neurological recovery.
Question 7: Which statement best describes the purpose of the return-to-play protocol's graduated steps?
- To document the injury for legal purposes
- To gradually increase activity while monitoring for symptom recurrence (Correct answer)
- To satisfy state law minimums for missed practices
- To determine if the athlete was faking symptoms
Correct answer: To gradually increase activity while monitoring for symptom recurrence
The graduated steps incrementally increase physical demand while ensuring symptoms do not return before full clearance.
NFHS Return-to-Play Guidelines & Recovery 2
At which return-to-play step is the athlete first allowed to participate in non-contact training drills?