Returning to Sports Post Injury

James Fowler Physical TherapySports TherapyLeave a Comment

Around the globe there are a number of great doctors, physical therapists and trainers who have taken on the task of guiding an athlete back to the field.  It’s a difficult task that requires a specific problem list, willingness to follow through and an intuitive nature to train the athlete in the moment.  Working with elite athletes comes with the challenge of collaborating with a team of MD’s, trainers and coaches. It’s important to assimilate the information and data to make clear decisions on the training progression. Whether it’s an elite athlete or recreational athlete there are fundamental stepping-stones and specific questions to be addressed through the phases of the recovery process.

Naturally there may be questions marks and uncertainty regarding the athlete’s level of preparation to return to sports.  I’m assuming most people have heard of Derrick Rose or Robert Griffin III, just a few of the notable athletes who were arguably not physically prepared to return to competition.  By developing a clear problem list of deficits the therapist can lessen the uncertainty and doubts. Start by asking very specific questions about the athlete’s ability to return at 100%. The questions reveal the athletes level of preparation and the therapist’s thoroughness through rehabilitation process.  Wishful thinking and hoping for the best is not a methodology that one should use while assessing the readiness of an athlete returning to competition.

I use a series of question to guide my decision making when determining if my athlete is ready to advance to the next level of rehabilitation or ready to return to competition. These questions will outline the “The Return to Sports Blog”, giving it both structure and a forum for discussion.

Questions to determine the Athlete’s readiness to return to competition:

  1. Did the therapist understand every aspect of the athlete’s athletic spectrum and did he/she cover it during rehabilitation process.
  2. Did the athlete achieve complete symmetry with the contralateral side and at 100% strength?
  3. If a bio-mechanical flaw lead to the injury, was enough work done to correct/improve the underlying cause of the injury, and or was it even discovered?
  4. Is the athlete mentally prepared to give up the injury and return to playing with no doubts? Is the athlete over eager to return or nervous to return?

What is the athlete’s athletic spectrum and was it covered during the rehabilitation process?

  • Do I understand the sport that my athlete is playing? What are the physical requirements of the position they play?
    1. Is the game stop and start or is free flow?
    2. Does the athlete initiate movement from a low squat position or more upright?
    3. What are typical diagonal movements in the sport; lateral, anterior lateral, posterior lateral?
    4. What are the changes in direction; forward and back, hard cut left, hard cut right, back slides with pivot right or left, quick pivot right on a spot and quick pivot left on a spot?
    5. Does the sport play vertically?  If so, how much and in what orientation.
    6. What is the athlete’s dominant side and how much do they favor it?
  • What was the athlete’s performance level prior to injury?
    1. Ask for video of the athlete prior to the injury to analyze the level of acceleration and deceleration, explosiveness from dead start, ability to change direction, and overall athletic ability.
    2. Set realistic rehabilitation goals for the athlete.
    3. Set a date for athlete to return to competition.
  • How committed is the athlete to return to their sport?

As 2015 progresses we’ll continue our discussion in the “Return to Sports” blog and talk about our approach, raise questions, and share some of our athlete’s timelines with pictures and videos. Let us know your thoughts in the comment section below

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