How many of us have missed out on a sports opportunity because of an injury?
How many of us have had less fun playing the sport we love while playing in pain? How do we know when to return to sport so that this doesn’t happen? This blog post reviews points to consider before returning to sport after an injury.
1. Pain doesn’t tell the full story
We may think that we’re ready to return to sport once our pain is gone, however, this can be misleading when looking to return to sport without reinjury. What matters most for returning to your sport is to compare things side-to-side like strength, agility, range of motion, and balance, based on what you’re returning to! (1-4). A physiotherapist will pick sport-specific measurements to make sure we’re not just focusing on pain relief.
Example: Catherine has a 6-week-old right ankle sprain. Since then, she has played some pickup and shot around with friends. She is excited to return to full competition tomorrow night as she’s been totally pain free for a week. However, her physiotherapist checks her single leg triple hopping and jumping, she only moves 50% compared to left – this means she is not ready to return and would have a high likelihood of reinjury.
2. Post-injury recovery time should be active!
“Waiting it out” or strict “R and R” for injury recovery is not always a successful strategy. With most injuries, our bodies need a short period of rest to heal but staying active during both short/long term recovery is best. An example for an active recovery follows the acronym P.E.A.C.E and L.O.V.E (5).
Acute (1-3 days)
Protect (Avoid painful activities >4/10 intensity)
Elevate affected area
Avoid NSAIDs (conflicting evidence)
Compress to reduce swelling using tape or bandages.
Education: seek information from a physiotherapist.
Longer (> 3 days)
Load: Strengthen and move with <4/10 discomfort
Optimistic: expect recovery and stay positive!
Vascularization: Complete full-body cardio exercise to improve healing
Exercise to promote active recovery
3. Consider Personal Reinjury Risk Factors when Returning to Sport
Being confident and mentally ready to return to sport is essential (6), however, it’s also important to discuss your personal risk of reinjury with your physiotherapist. It’s essential to consider the injury to sport-specific demands, history of injuries, and current abilities with your physiotherapist.
Example: After an Anterior Cruciate Ligament reconstruction, research shows that teenaged females returning to a cutting/pivoting sport with a family history of ACL injuries, who have less than 9 months of sport-specific rehab are at highest risk of reinjury (7). These show factors are both controllable and out of our control, but it’s important to know if you were to fit into this category!
In summary, if you have been practicing with your team, followed PEACE + LOVE, spoke with your physiotherapist about different reinjury factors, and feel mentally confident.. You’re in a great position to have a successful return to sport! Play on and have fun!
If you’re beginning the return to sport process, check your local FCAMPT Physiotherapist registry to find excellent clinical help!
- Doherty C, Bleakley C, Hertel J, Caulfield B. Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability: A Prospective Cohort Analysis. Am J Sports Med. 2016; doi: 10.1177/0363546516628870
- Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: The Delaware-Oslo ACL cohort study. Br J Sports Med. 2016;50(13):804–8.
- Kyritsis P, Bahr R, Landreau P, Miladi R, Witvrouw E. Likelihood of ACL graft rupture: Not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. Br J Sports Med. 2016;
- Mai HT, Chun DS, Schneider AD, Erickson BJ, Freshman RD, Kester B, et al. Performance-Based Outcomes after Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ between Sports. Am J Sports Med. 2017;
- Dubois B, Esculier J-F. soft-tissue injuries simply need peace and love. Br J Sports Med January 2020; 54 (2).
- Nwachukwu BU, Voleti PB, Berkanish P, Chang B, Cohn MR, Williams RJ, et al. Return to Play and Patient Satisfaction After ACL Reconstruction: Study with Minimum 2-Year Follow-up. J Bone Joint Surg Am. 2017.
- Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of Secondary Injury in Younger Athletes after Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2016;44(7):1861–76.
About Colin Wiseman
Colin Wiseman treats clients on the East Coast of Canada in Dartmouth, Nova Scotia. Colin is FCAMPT certified by completing the MClSc Advanced Healthcare – Manipulative Therapy program at Western University, 2019, where completed research with the Fowler Kennedy Sports Medicine Clinic involving ACL-R Return to Sport guidelines. Colin has a specific interest in the rehabilitation/prevention of running injuries, in addition to post-operative lower extremity return to sport management. Outside the clinic, he can be found enjoying the outdoors or chasing his 1.5 year old Noah! Find out more about Colin on his Website, Instagram & Facebook.