Return To Play Criteria: Semifinals

INTRODUCTION

As a sports physiotherapist I spend my weekends at sporting grounds assessing, diagnosing, treating, and probably most importantly preventing sports injuries. Similar to the majority of sports physios – I do this mostly out of love for the industry and sport (as sporting clubs are frequently strapped for cash). For my rugby league team it is getting to the business end of the season – semi final time. And the team has qualified in a strong position on the ladder, due in no small part to a brilliant medical team. Whilst this impacts many areas of my role as the team physiotherapist, I am most interested on it’s impact on return to play criteria.

IMPACT OF SEMI FINALS ON RTP

Through my experiences in the sports domain I have developed, discovered and implemented many forms of assessment for return to play criteria. Whilst some of them are evidence based, as is so often the case in the wonderful world of sports physiotherapy, the criteria are often experiential in basis.

They are developed with both performance and a durable return to sport in mind. Well, what if it is the last game of the season? This do or die situation can nullify the need for the player to be durable – and many are willing to “blow out” their injury to be a part of the game. It is the “let’s fix it in the off season” mentality. Making the right decision can be a challenge for the sports physiotherapist!

DEVELOPING YOUR RTP ALGORITHM

These are some of the components that have gone into my return to play “algorithm” during semifinals time:

• Will the athlete make a valuable contribution to the game – despite their injury?
• What is the importance of the player to the team?
• Is there a chance for the athlete to do irreparable damage?
• What are the team’s chances of progressing through to the grand final (will there be more games)?
• Does the athlete fully understand the risks of playing with the injury (this is obviously the job of the sports physiotherapist to educate the athlete)?

For those interested in evidence based practice or research regarding return to play criteria in sports physiotherapy (or physical therapy) may be interested in reading the following articles:

REFERENCES

Orchard J; Best TM; Verrall GM; Return to play following muscle strains. Clinical Journal of Sport Medicine, 2005 Nov; 15 (6): 436-4.

Clover J; Wall J; Return-to-play criteria following sports injury. Clinics in Sports Medicine, 2010 Jan; 29 (1): 169-75.

I’m sure that this is not an exhaustive list, do you have any articles or components to your return to play criteria you would add?