Return To Play
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When an injury occurs most athletes immediately begin to wonder when they will be able to return to play. With most injuries the time missed will be from a few minutes to one or two days, with severe injuries the time loss can be as high as the rest of the season. Many times the hardest thing to determine is exactly when the athlete can return to competition. The decision on when to return to competition is made only after several factors have been considered. These factors deal with the severity of the injury:
When these questions have been addressed and answered in a positive manner the athlete should be safe to return to competition. The first area to explore is whether the athlete is under a physician's care. If a physician has been consulted and he/she has not yet given the athlete a release to play, then the point is moot. From the time of the injury, the physician should have given the athlete a rehabilitation plan to follow. This plan is usually administered by the team's Athletic Trainer. A good rehabilitation plan will have return to play criterion established, so that as the rehab progresses, the athlete can see what goals have yet to be met for return to play. If a physician has not been consulted, then an Athletic Trainer should be the individual coordinating the rehabilitation and establishing return to play criterion. The general goals for return to play are:
To determine normal ROM, compare the injured limb to the uninjured limb. If both have the same freedom of movement, and the movements are essentially pain-free, the question is answered. If the injured body part is lacking motion, then the athlete may not be able to compete without causing further injury, or injuring another, compensating, body part. The saying "playing with pain" has some validity to it. When considering a return to play situation, some pain will be unavoidable. This type of pain is usually expressed as a dull ache, almost like a "tooth ache." If the pain is described as sharp or "knife-like," the activity should be modified or discontinued to avoid this sharp pain. Sharp pain is often an indicator that the area has not healed and further damage could be caused by "pushing through the pain." The swelling in the injured area should be minimized prior to return to play. This does not mean that the injured body part must look completely "normal," however, the swelling would be significantly lower that when the injury first occurred. If the athlete returns to play, it is very common for the injured area to swell after competition. This is a reaction to the new stresses of practice or play, and does not mean that the injury will worsen if it swells again. This type of swelling will usually decrease by the next morning. The athlete should poses near normal strength in the affected body part prior to return to play. The reasons for this are self-evident. If the athlete participates at 50% strength, he/she is more likely to sustain a recurrent injury, or injure another body part. Strength can be measured by weight lifting tests, manual resistance tests, or the ability to run or throw with proper mechanics. Proper mechanics while participating are very important for both prevention of further injury, but also to ensure that the athlete competes at his/her pre-injury level. For example, when returning throwers to competition, one must be sure that the throwing motion is proper. Sprinters must be able to jog, then run, then sprint with out a limp to be able to compete on the track. Probably the most important factor to consider is a return of quickness, agility, and coordination. These are the qualities that allow an athlete to be a positive contributor during competition rather than a hindrance. These qualities can be re-trained in the injured athlete by utilizing specific exercises to develop the lost coordination. For example, with lower extremity injuries, training balance is accomplished by utilizing one-leg balancing, one-leg calf raises, wobble boards, two-leg or one-leg hops and bounds, or beam walking. These types of exercises should be progressed from least to most difficult during the rehabilitation so that coordination is targeted during the entire recovery process. |
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©2000 - 2006 David Edell Information on this site is not a substitute for physician directed care. Please consult your personal physician for more detailed information concerning specific injuries or illnesses. Last Update for AthleticAdvisor.com: 06/04/2006 12:01:52 PM |
