Return to Sport: Why there is Much to Consider
In our practice at Movement Solutions Physiotherapy (MSP), we treat athletes of all demographics. One of our particular focuses when treating injured athletes then, is helping them return to sport.
Questions to Ask Before Returning to Sport
This practice includes a lot of nuance:
- When is it safe to return?
- What tools do we use to assess or predict a safe return?
- How do we avoid re-injury/practice injury prevention once returned?
- When will an athlete feel ready to return?
- Will there be fears of returning or other stresses that affect their performance?
The questions go on and on. Our scientific literature in the world of rehab has been making efforts to shed light here and help us predict when and how we can initiate a return to sport for each injured athlete. One thing I’ve often noted about our literature is that we suggest timelines and physical markers for return to sport yet don’t always comment on what makes an athlete himself, or herself, feel ready to return. For example, it is commonly suggested that an athlete can return to sport safely at 9-12 months after ACL reconstructive surgery on their knee if they can achieve certain physical tasks (sprints, jumps, cutting movements) (1). Yet, in contrast to this, we have other literature that suggests these tests don’t accurately predict if someone will return to sport after this surgery because they may still just be afraid of re-injuring their knee! (2)
Key Markers for a Successful Return to Sport
The point I am hoping to make here, is that it is important to consider the athlete’s feelings/opinions as we assist in their recovery/return to sport as well. This is something we at MSP are continuing to learn as we reflect on our own practice. I recently reviewed a journal article that followed high-level (National, International) athletes as they recovered from injuries and went through the return to sport process (3). The markers they identified as key for them to have a successful return to sport included:
- An absence of injury-related concerns upon return
- A feeling of self-satisfaction with their return and rehab process
- Having realistic goals for schedules/timeline/performance
- Avoiding pressure from others (i.e. therapist/coach/parent) to return too early (3)
The insights of these athletes help remind us of all the factors that weigh on an athlete as they transition back to their sport. Yes this is just one article, but I think it is important to note the athletes commented more on their experience and feelings as influential in their return more than their particular physical performance measures (i.e. cut, jump, sprint). It then is imperative that as physiotherapists we consider not just the client’s pain and physical function as they recover, but also their feelings/goals/fears etc. As noted prior, this is something at MSP we are continuing to implement in our practice as we work to be client-centred and this reflection should serve as a welcome reminder.
1. Anterior Cruciate Ligament (ACL) Rehabilitation. Physiopedia. http://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Rehabilitation. Accessed February 24, 2017.
2. Thomeé R, Kaplan Y, Kvist J et al. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2011; 19: 1798.
3. Eklund RC and Podlog L. High-level athletes’ perceptions of success in returning to sport following injury. Psychology of Sport and Exercise. 2009; 10: 535-44.