Injured Athletes and Return to Play

When the team physician or sports medicine staff gives the green light, most athletes are anxious to return to full practice and competition right away. The vast majority of athletes have no problem re-entering their area of play.

One of the goals of sports medicine is to try to get an athlete back into their sport as soon as possible. Returning too soon can put the athlete at greater risks for reinjury and possibly an even longer down time.

A recovery plan will involve a series of logical steps from the time of injury until a player can return to the field or court. During the acute phases of the injury, the RICE formula (Rest, Ice, Compression and Elevation) should be applied, and the athlete should limit their activities. Type of injury and severity of damage will determine if things such as surgery, bracing or casting are necessary. During this acute stage, it is most important to maintain overall conditioning while the injury heals – this can include exercises such as an injured runner running in water or using a stationary bike.

The next phase of recovery involves regaining full motion and strength of the injured limb or joint. For this stage, your physician or trainer will outline an exact regimen. As the athlete returns to normal strength, functional drills can then begin. After this, higher levels of sport-specific movement patterns can start.

Another topic to consider is the mental aspect of returning to play. Though physically capable, mental preparation is a large – often overlooked – aspect of returning to play. Not being mentally ready could result in:

  • Decreased confidence, leading to a decline in performance
  • Re-injury or further injury
  • Stress and anxiety due to lack of confidence
  • Fear of injury or fear of returning to play

There are many ways in which trainers can help in an athlete’s rehabilitation, not only in the physical sense, but mentally as well. Athletic trainers can become a vital part of an athlete’s social support, and offer encouragement to keep his or her “head in the game” even if their body is not. Trainers can incorporate mental training skills into a rehab program in several ways. Here are a few examples:

  • Incorporate imagery
  • Sport specific skill
  • Incorporate goal setting

Only when you are practicing hard without substantial difficulty, and the healing has reached a point in which the likelihood of subsequent injury or harm is low, are you ready to return to play. Each stage requires close observation, and should not be sped up more than they have to. All too often athletes believe they are ready when really they are only 70 to 75% recovered – this invites reinjury. While it is the trainer’s goal to return their player to activity as soon as possible, the athlete’s health and safety must be placed above other concerns.

Reference: American Academy of Orthopaedic Surgeons, “Return to Play,” August 2007.

Reference: Association for Applied Sport Psychology, Weiss, Windee M., “Mentally Preparing Athletes to Return to Play Following Injury”.