“When can I play again?” This is one of the first questions you might ask if you get injured in sports. After sustaining an injury, most athletes are thinking of going back onto the field, court or rink too soon. However, the answer is rarely quick or simple because there are some things to consider when returning to sport.
Return-to-play decisions can be controversial and a source of conflict between an athlete and health care providers. Yet, this is fundamental to practice of sports medicine but vary greatly for the same medical condition and circumstance.
Return to Play
Return-to-play is the decision-making process of getting an injured or ill athlete to practice or competition. Ultimately, this leads to medical clearance of an athlete to fully participate in sport again. The goal of this decision-making is to return an injured or ill athlete to practice or competition without putting the player at undue risk for injury or illness.
The 3-Step Based Framework
The 3-Step Based Framework presented by Creighton et al (2010) provides team physicians and other sports medicine professionals with guidelines on making complex decisions about returning a player to sports.
The guidelines in the framework include the following:
- Evaluation of health status
- Evaluation of participation risk
- Decision modification
Evaluation of Health Status
This is the initial step when making decision. Evaluating health status means assessing the athlete’s recovery from different standpoints such as physical, functional, and psychological.
The health care provider evaluates how much the athlete has recovered and how close to “normal” the previously injured tissue is. This is important because the tissue that hasn’t healed is generally weaker or less functional compared to what it was before the injury and therefore more likely to be reinjured.
Not only medical factors like symptoms, range of motion, or x-rays should be assessed but also the athlete’s psychological state. Is he or she ready to play again? How confident is this athlete to get back into sports?
Evaluation of Participation Risk
This refers to the injury risk of an athlete when he or she gets injured again when returning to play too soon. Previous injury is associated with up to 4 times increase in the risk of reinjury.
One key factor to injury risk is the type of sport. There is a higher risk in contact sports such as basketball, yet in noncontact sports like running can also potentially lead to disabling overuse injuries. Other factors also include the position in the team, the level of competition, and the ability to protect the injury.
This is the third and most complex step. It requires attention to several and different situations and circumstances that may have bearing in the final decision in return-to-play. For example, decisions may be different if the injury occurs in the preseason before a playoff game. The desire of an athlete to compete may put pressure on the health care provider, and other people such as coaches, the athlete’s family, and even sponsors or the media may be sources of external pressure.
When the decision to return to sport is being made, the main priority should be the athlete’s welfare and safety. A Perth physiotherapist is skilled in decision-making and can help you return to your sport by recommending exercises for you to be physically and mentally prepared. Call us today at 9444 8729!