Return to Play

Return to Play

  • Indicators of readiness for return to play (pain free, degree of mobility)
  • Monitoring progress (pre-test and post-test)
  • Psychological readiness
  • Specific warm-up procedures
  • Return to play policies and procedures
  • Ethical considerations, eg pressure to participate, use of painkillers.

Indicators Of Readiness For Return To Play (Pain Free, Degree Of Mobility)

  • Graduated exercises and training sets contributes to the following parameters which are then assessed to confirm return to play:
    • Elasticity and flexibility of the injured area
    • Strength, being able to make movements without support
    • Pain free mobility, agile movements
    • Balanced movements

Monitoring Progress (Pre-test And Post-test)

  • Pre-tests are screening protocols that were carried out prior to injury.
  • Post-test are performed once the player returns to gameplay after rehabilitation from injury.
  • Helps in identifying what parameters have different results pre and post injury and can be used to modify exercise sets to fill up gaps.

Psychological Readiness

  • Mental readiness of the player for returning to gameplay.
  • Coaches should be positive on injury recurrence, although it isn’t anticipated. Often, the pressure and anxiety build upon the negative outlooks on injury can hold back the player from returning to the sport.
  • For mental reassurance, athletes can consult sport psychologists.

Specific Warm-up Procedures

  • Warm-up routines focused towards the injured area.
  • Low intensity exercise routines are followed, which gradually move towards higher intensity in a state where the athlete regains mobility.
  • Examples: PEP (prevent injury & enhance performance) program for ACL – stretching, strengthening, plyometrics and agility, jogging, knee dynamic exercises etc.

Return To Play Policies And Procedures

  • Professional athletes need to meet some set guidelines and procedures by the authority for returning to play.
  • The protocols often exceed a one-time medical clearance, which in case of amateur sports is the only form of clearance required along with the coach’s decision.
  • Based on the type of sport, protocols may involve strapping/bracing, fitness assessment and skills tests.
  • Policies differ from sport to sport as well as from region to region.

Ethical Considerations, Eg Pressure To Participate, Use Of Painkillers.

  • Pressure to participate
    • Common in commercially acclaimed players.
    • Pressure often comes from oneself, as well as peers (teammates, coaches).
    • The well-being of the athlete is the first priority, they should not be forced to return to play without proper recovery as it puts the athlete at risk of re-injury.
  • Use of Painkillers
    • Often injected or taken in oral dosage forms.
    • Masks pain, works in multiple ways depending on bioavailability.
    • Masking pain often increases rehabilitation period and can also have detrimental effects on the injured area.