Guidelines for Returning an Athlete to Play

When can I return to play?

It’s a question often on the minds of injured athletes, whether they’re being evaluated on a sideline for something minor or suffered a season-ending injury.

The answer, of course, is that there is no one answer.
“Every athlete is going to be different in their return to play,” says Forté athletic trainer and outreach operations manager Jillian Hacker.

Below, Hacker and Dr. Michael Del Busto, a rehabilitation and sports medicine physician at Forté, offer several important factors to consider when returning an athlete to play.
Sports Requirements

The unique requirements of an athlete’s sport should be a major factor when deciding whether to return to play. In other words, says Del Busto, just because an athlete reaches a window when they could potentially return to competition doesn’t mean they should.

“I’ll ask, ‘Do you think you could go back out on the court or field and do your job at the highest level?’” says Del Busto. “Sometimes that shines some light that they need a few more weeks of physical therapy before they can be effective in their chosen sport or give their team the best chance to win.”

Functional Status
Functional status is also high on the priority list.
“You want to consider their pain level, range of motion, whether they’re swelling up after practice and if they’re back to full strength,” says Hacker.

Psychological Readiness
Another factor to consider is psychological readiness. Before returning to play, athletes should be evaluated as to whether they’re going to go out on the field or court with confidence.
“If they’re still trying to take the weight off their injured limb, that would be an example of a red flag for psychological readiness,” says Hacker. “Additionally, they may not be ready if they’re expressing that they’re feeling scared to go back out on the field or court.”

Cardiovascular Readiness
The same can be said of cardiovascular readiness. Athletes should be able to keep up with the level of play before returning to competition.

Predisposition to Reinjury
Finally, attention should be paid to an athlete’s predisposition to reinjury.
“If they look as though they’re going to go out there and reinjure their body part, then it’s not the right time to return to play,” says Hacker. “Alternately, if they look balanced, they may be ready to go.”

Return to Sport Progression
All factors considered, an athlete should complete a return to sport progression that gradually increases their physical activity. Different injuries have different timelines and phases for recovery, but most start with addressing issues such as pain and swelling and end with developing complete readiness for sport.
“We’re increasing their activity in a gradual manner,” says Hacker. “So, we may start with 30 minutes of practice, then go to 60 minutes and increase from there. Once they can do a full practice with full range of motion and minimal to no pain and swelling, then we’ll return them to competition.”
No matter the injury or sport, the end goal is to return an athlete to pre-injury level of performance or better.

“We want every athlete to feel completely confident before we send them back out there,” says Hacker.

These recommendations have been excerpted from Coaches Corner, a free monthly webinar series for coaches, athletic directors and athletic trainers. The series, developed and presented by Forté, in partnership with IHSAA, aims to arm coaching and support teams with helpful information to consider when working with their athletes. Subscribe online so you don’t miss an episode.