Returning to Play After a Sports Injury

Caution must be used before putting an athlete back into the game. It's important to realize that sometimes a lot of pressure may exist to get the athlete back in the game. This pressure may come from parents who want to see their son/daughter play, from other athletes, from the coach, or even from the player themselves. But if a proper evaluation isn't performed the athlete may end up with even more severe injuries.

First, the injury must be assessed properly. This should be done by an expert such as a sports therapist. This may or may not require an x-ray to rule out a fracture. A proper treatment plan should be prepared by the therapist with regular follow-ups to ensure that the healing process is progressing as expected.

Assessing Readiness

Once the treatment plan is complete the athlete should be tested before returning to play. The athlete needs to have:

• 100% Range of Motion: This means that the athlete can move the body part through its full range as compared to the non-injured side without experiencing any pain or stiffness. This should be done first without any resistance and then repeated with resistance.
• 100% Strength: This is in comparison to the non-injured side. This can be tested with weights or with sport specific movements. Start off with just a little resistance and increase to similar level that are actually found in the sport.
• Free of Pain: Be totally free of pain during rest and during activity, and while testing for full range of motion and return of strength. If there is any pain then it is an indication that the injury is not fully healed and further rest and therapy is required. Be aware that many times athletes may not be totally honest when they feel pain. So watch for body language signs e.g. facial expressions, limping, protection of the injured area.
• Be Psychologically Ready: Psychological readiness may be a bit tricky to assess. This means the athlete is fully comfortable in going back to the game and has no apprehensions about further injuries. In assessing for this, which should only be done if the other 3 points have been met, start off by having the athlete perform sport specific movements and watch to see how comfortable they feel. Then have them participate in non-sport training e.g. weights, stretching, etc. If that goes well then they can participate in a regular practice and then in a game.

The Injury Cycle

Injuries follow a standard cycle as follows:

• Injury occurs.
• Tissue is damaged.
• Inflammation ensues.
• Loss of function.
• Restricted activity.
• Complete healing or a re-injury may occur, with the athlete now being worse off than before.
• Slowly returning to activity.