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Return to Sports Continuum

Updated: Jan 14



A previous injury is the greatest risk factor for sustaining an injury in the future. This is especially true for athletes or recreational players since their bodies must be ready to sustain the high-intensity demands of their respective sport.


Rehabilitation and recovery are the first steps toward managing an injury, but the process or continuum doesn’t end there. Return to sport or performance is the other end of the spectrum where the player is tested for any residual deficits and trained in a graded progressive manner to be able to return to his or her sport.









So where does return to sport fall in the treatment program?


Return to sport (RTS) is part of a continuum once the rehabilitation phase after an injury is over. The continuum comprises-


  • Return to Participation- The athlete is physically active, but not yet ‘ready’ medically, physically and/or psychologically for RTS.


  • Return to Sport- The athlete has returned to his/her sport but is not performing at their desired performance level.


  • Return to Performance- The athlete has gradually returned to their defined sport and is performing at or above the preinjury level.





What does Return to Sports include?


  • Return to sport in simple terms can be explained as Training as Treatment.

  • Besides preventing deconditioning and reduction of pain, one must know the injured tissues are mechanosensitive. This means that tissues adapt in response to the loads they are subjected to. Thus, including a gradual resistance training program is a non-negotiable part of an athlete’s journey in returning to sport.

  • At the same time, restoring motor control strategies and fundamental movement patterns and patterns specific to the sport is extremely important. This is done with movement training beginning with fundamental movement patterns and progressing to complex athletic skills such as running and jumping and finally sports skills like throwing and kicking under conditions of increasing complexity.

  • Additionally, we must consider the psychological and social impact of the injury on the player and make sure the player is psychologically ready to return along with being functionally fit.






What factors determine the right time to return to sport for a player?



Realistically speaking, there’s not one single magical day post in which the player is deemed fit to return to sport. When a player will return to sport, depends on several factors which are assessed periodically.


These factors are-

  • Adequate strength, Range of motion and stability

  • Quality of movement patterns

  • Fear of reinjury and psychological readiness

  • Open skills specific to the sport


These factors are tested with a test battery, but monitoring continues periodically even after the player has returned so as have an ongoing risk factor analysis and prevent re-injury.


Thus, return to sport testing and management are part of advanced rehabilitation following an injury and should be offered to all individuals wanting to get back to their desired sport.



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