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To determine what proportion of patients experience an exacerbation of their symptoms as a result of premature return to play (RTP) and return to learn (RTL) following a sport-related concussion (SRC).Retrospective longitudinal chart review.A sport medicine physician’s office in Ontario, Canada.266 cases related to 251 students with an SRC.A review of 266 electronic medical records (charts) of patients seen for SRC over a five-year period (2011–2016). Two blinded authors independently reviewed each chart and SCAT2 or SCAT3/Child SCAT3 symptom self report form. In situations where there was discrepancy between the two reviewers’ results, a third author reviewed the charts.remature RTP and RTL were defined as chart records documenting the recurrence or worsening of symptoms that accompanied the patients’ RTP or RTL.403 cases were identified as concussion patients assessed. 266 were included as these cases were related to 251 students involved in a sport activity. Premature return to sport and to school were observed in 67 (25.19%) and 107 (40.23%) of the cases, respectively.In our comparable study ending 5 years prior, premature return to sport and to school were observed in 43.5% and 44.7% of the cases, respectively. Despite changing our medical advice, based upon evolving expert recommendations on return to learn (RTL) after an SRC, premature RTL is still quite common. Efforts are needed to find the best method of implementing a coordinated plan for the post-concussion athlete who is returning to school.None.