Injury prevention is an important part of keeping your body healthy and happy, but even the most prepared athletes can never eliminate the risk of injury. When facing a spell on the sidelines, it is critical to take the proper steps to get back to 100% and avoid lasting complications. In this new Sports Medicine guide on the topic, I cover the initial reactions you may experience in the recovery process, a 3-part, decision-based model to follow during recovery, and information on maintaining your fitness from the first week through the sixth month.Whether you are currently injured or not, “Returning to Play” is a process that is essential to every athlete at some point, and knowing how to do so properly will make the process as smooth and effective as possible!Returning from Injury is a Process!“My doctor told me I am cleared to play!”Who was involved in the decision to clear?What information was used to decide?How long have they been out?Healed injury/surgical repair, or physical ability and condition to play a sport?Consider which phase “cleared to play” is referring to:Return to Participation: Passing, dribblingReturn to Sport: Playing 20 minutes of a gameReturn to Performance: Playing at 100% ability“Return to Sport” refers to a process. If an athlete has not been seen by a Physical Therapist, the Athletic Trainer will be the one to dictate guidelines to progress the athlete back to game play.3-Part, Decision-based Model for Returning to Play(1) Medical factors/health statusExample: kneeDoes the knee feel stable?Is the quad muscle strong enough?Is this a recurring injury?(2) Participation risk, including Sport Risk ModifiersExample: AnkleProtecting an ankle sprain with a brace for a certain period of timeFear of re-injury(3) Decision modifiers not limited to the injured athleteRegular season vs. playoffs, pressure from parents/players/selfIn Clinic vs On the Field Factors:In Clinic: MD, PT, ATCStrength, range of motion, swelling, functional testsFunction tests do a better job of ruling out a player from competition than determining readiness (if a soccer player cannot cut, they certainly cannot practice or play in a game). If they can, it doesn’t clarify whether or not they are prepared for training and competition.Psychological state: difficult to measure. Typically done with questionnaires OR using the partnership with DU CPEX department of sports psychologists (contact Julie for more information on this).On Field: ATC, sports performance trainer, parentLimping or favoring one side, lacking power kicking on one sideHesitation and avoiding contactMessage from parents or medical team vs. what you see at practiceOptions for limited practice or game minutes, position assignmentCoaches play a crucial role in progressing the athlete through training and helping to decide when it is time to return to gameplay!Last but certainly not least, fitness related to Readiness to Play.The workload in an individual event (tryouts, practice, game) causes fatigue.The overall amount of training and preparation work done before an event causes an increase in sport-specific fitness and physical readiness.There is a strong predictive relationship between the fatigue: fitness ratio and injury likelihood, AKA…A player who has not completed adequate training is more likely to be injured in a game.After an injury, players should be working on overall fitness in conjunction with rehab i.e. a Sports Performance Specialist. UCHealth has a wonderful partnership with Elite Speed, so be sure to reach out to them after an injury to make sure the athlete is preparing for return to play in a wholesome approach.Trust the coach to assess number of practices and amount of work done at practices before allowing to play in a game.Overuse injuries cannot heal with rest alone. They require gradual recondition of the body part and the athlete.Consider factors that interrupt training: vacation, illness, etc…Examples of expected Return to Sport Times based on injury:Acute hamstring injuries: 11 days-4 monthsAnkle Sprains: 3-6 weeksGroin injury: <4 weeksKnee cartilage repairs: 7-18 months wide range due to variation in proceduresACL reconstruction: 9-12 months or moreMeniscus repair: 6-9 months or moreHip Labral Repair: 4-6 monthsMCL Sprain: 4-6 weeksTakeaways(1) Being “Cleared” does not mean the athlete jumps back into practice at 100%. This means “Return to Play” in a progressive manner.(2) Trust the medical professionals and the coach that they have the athlete’s best interest in mind and want to get them back on the pitch just as much as the athlete and parent.(3) Progression to gameplay is going to take time but trust the process so that the athlete comes back stronger and better than before the injury occurred.
