In a recent article in the British Journal of Sports Medicine, 17 expert clinicians discussed key issues in, and presented recommendations for, return to sport decision-making. Here’s a link to the article. If you are a coach, athlete, or clinician, I recommend taking a look. The following is a summary.
What is return to sport (RTS)?
Return to sport is just as it sounds, returning an athlete to their sport after injury or illness. But successful RTS may be defined differently by those who are involved--coach, clinician, and athlete. Collaboration is important as RTS is a process of shared decision-making. Several contextual factors guide RTS. These include: type of injury, age of the athlete, sport played, physical requirements, level of participation, significance of upcoming competitions, and social and financial costs.
Return to sport is not a decision that occurs at the end of a rehab program, rather it is a process that parallels recovery. There are three elements of RTS:
Framework for RTS
A couple templates can be used to guide RTS. These include the StARRT framework and Biopsychosocial model. The StARRT framework is a 3 step process that includes the following:
Recall in a previous post that gradual and progressive overload is a key principle of training. This principle applies here too.
What is the Health Practitioner’s Role?
Using the above framework, clinicians can help determine readiness for RTS. In addition to treating and monitoring injury recovery, Chiropractors may use functional tests that challenge physical ability, including capacity to react and make decisions while fatigued. These functional tests are designed to replicate the sport experience. Psychosocial readiness should also be assessed. Talk to a practitioner you trust for more information.
Ardern et al. (2016). 2016 Consensus on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med., 50(14)
"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." ~ World Health Organization (WHO)
"Health is ... seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities " ~ The Ottawa Charter for Health Promotion
“The fundamental conditions and resources for health are: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity. Improvement in health requires a secure foundation in these basic prerequisites.” ~ The Ottawa Charter for Health Promotion
"Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment." ~The Ottawa Charter for Health Promotion
"Health education is any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes." ~WHO
Health education plays a large role in equity and empowerment (Green, 2008):