Considerations for Return to Play from Injury

Beau Kinnaird, M.ED, AT, CSCS      

Southwest General Sports Medicine

The following is a guideline for an athlete to return to play from an athletic injury. This guideline does not take into consideration injuries assessed as a concussion or athletes limited or removed from activity by a physician. 

Injuries that are minor and acute in nature are part of athletics.  These injuries may limit activity for a few days, improve with rest and require activity modification. Examples of these types of injuries include contusions, sprains, pulled muscles and general athletic soreness.

As a parent or coach, there are a few things to take into consideration. First, when an athlete returns to play, can the athlete protect himself/herself from further injury? For instance, if the athlete has delayed reaction times, is unable to absorb contact, avoids contact with another athlete or object, or gets fatigued earlier than expected, he/she may be at risk for further injury.

Second, is the injured athlete responsible for the safety of another athlete?  A limited football lineman may not be able to protect a quarterback from injury. In this case, a coach may wind up with two injured athletes, instead of one.

Returning from injury is progressive, and the process may take several days to complete. After initial injury management of ice and rest, it is recommended that athletes start with gradual flexibility and strengthening, stationary bike and team flexibility exercises. If the athlete is pain free, he/she may progress to individual work such as jogging, change of direction, foul shooting and so forth.

The next phase may include individual activity that is functional to the athlete’s sport. If contact is involved, limit or control the contact by decreasing speed, repetitions, or size of activity. Start with individual line drills over full-team, full-speed practice. The last step would be full-speed activity. The athlete should be monitored at each step and evaluated for discomfort, swelling or joint-mobility limitations.

Coaches should control all aspects of the return-to-play process. If an athlete experiences discomfort, it may mean repeating or falling back one step to provide a positive return to play. It is recommended that athletes have a full day or two of practice without limitations before returning to competition.