1. Chapter 16 Return to Play

2. Who Makes the Decision? Deciding whether an athlete may return to play sports following an injury can be difficult. Three categories of injury: First-degree injury considered minor Second-degree injury considered moderate Third-degree injury considered major 2

3. Who Makes the Decision? First- and second-degree injuries often do not require a physician’s care. Major injuries to either bone or soft tissues must be evaluated by a physician. Require written authorization from physician for return to play Any questions about return to play must be resolved by a physician. 3

4. Physician Permission to Return to Play Written permission from physician required for: Head injuries or concussions With or without loss of consciousness Spinal injuries Trauma to the internal organs 4

5. Physician Permission to Return to Play Written permission from physician required for: Any injury or illness in which the athlete was referred to a physician for further evaluation and treatment Any injury or illness that the person making the evaluation is unsure of 5

6. Physical and Psychological Considerations for Returning to Play An athletic trainer is the athlete’s advocate. Responsible for protecting the athlete from further injuries Must assess both the psychological and physical condition of the athlete who wishes to participate in the sport again 6

7. Physical Considerations An athletic trainer should refer an athlete to his or her physician if: Trainer feels uncomfortable about recognizing symptoms of an injury Athlete’s condition is not improving at an expected rate Only physicians can diagnose! 7

8. Physical Considerations An athletic trainer should refer an athlete to his/her physician if: Activities are causing unexpected pain Observe athlete closely as he/she may be trying to mask pain in order to play sports Athlete doesn’t seem to be coping well psychologically with disability produced by the injury 8

9. Goals of the Athletic Trainer Determine an athlete’s ability to return to play after an injury Ensure no additional injuries occur as a result of the athlete’s continued participation When in doubt, remove the athlete from participation. 9

10. Assessment Procedures Procedures for assessing an athlete’s suitability for participation: Write down a complete history of the incident in the injury log. Look at the injury and compare the injured side with the other side. 10

11. Assessment Procedures Procedures for assessing an athlete’s suitability for participation: Explain to the athlete what is being looked at. Ask about any abnormalities that might have been present before the injury. Palpate the injury to feel for deformities. 11

12. Assessment Procedures Procedures for assessing an athlete’s suitability for participation: Ask if the injured player can feel the area being palpated and if there is any numbness, unusual sensations, or feelings of weakness. Ask the injured player if both sides of the body feel the same. 12

13. Psychological Considerations Athletes may be restricted or removed from play, or have a permanent disability. Presents mental and physical challenges Coping mechanisms often emerge in response to the stress in the change of lifestyle. 13

14. Psychological Considerations For many athletes, their sport is the center of their lives. Restriction or loss of ability to participate in that sport is a significant loss. 14

15. Dealing with Disappointment and Loss Dr. Elisabeth Kübler-Ross Describes five psychological stages in dealing with death or great loss 15

16. Stages of Psychological Recovery Denial Anger Bargaining Depression Acceptance 16

17. Abnormal Behaviors Athletic trainers should note such problems; they are not expected to solve them. Notify the appropriate members of the sports medicine team and any other individuals as necessary of any potentially serious problems or issues an athlete is experiencing. 17