Sustaining a sporting injury can be disheartening and inconvenient, no matter the severity. Depending on what sport or activity you participate in, your rehabilitation journey (including Surgical Rehabilitation) will look a little different to someone else’s. However, as physiotherapists, our goal is to get you back to your chosen sport or activity in the safest and most appropriate way. A common yet difficult question to answer following an injury is “when can I play again?”. With consideration of tissue healing times, this question is often answered with “it depends", as making the decision to return to play is often based on ‘ticking off’ certain criteria during rehabilitation, which is specific to that individual’s sport or activity.
Ardern et al. 2016, introduced the ‘Return to Sport (RTS) Continuum’ which heavily guides our rehabilitation. The key constructs of the RTS Continuum include;
Return to Participation -> Return to Play -> Return to Performance
This continuum is heavily based on an individual’s ability to meet the demands of their chosen sport/activity. These demands include:
Physiological
1) Cardiovascular/respiratory
Load/capacity
2) Musculoskeletal
Strength, power, endurance & speed
3) Neuromuscular
Balance, coordination, control, cutting, jump/landing, acceleration/deceleration
4) Psychological
Cognitive - Working memory, decision-making & mental fatigue
Emotional - Pressure, confidence, self-efficacy & coping
5) Technical
Skill - Competence & execution
6) Tactical
Communication - Verbal/non-verbal
Knowledge & experience
As physiotherapists, we are particularly specialised in determining one’s ability to meet the physiological demands of sport and will typically use specific tests in clinic or on the field. This is usually compared with data from the unaffected limb/side, baseline data (e.g., from preseason) or normative data (e.g., available information relating to the athlete’s demographic).
Rehabilitation before an athlete can return to participation will typically include preparing an individual for the above demands. For example, restoring normal and pain-free movement, increasing muscular strength/power/endurance, and restoring movement control and capacity to load. This is followed by an introduction to running and sports specific movements, which leads into reengaging with team drills and training. As physiotherapists, we strive to guide an athlete to return to participation as early as possible, and firmly believe that rehabilitation should be constructed to allow the athlete to do as much as possible, with respect to their injury. This best prepares an individual to return to play as soon as possible.
Book an appointment with one of our sports physio to discuss your return to play.
Written by Luke Chetcuti,
Sports Physiotherapist
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