Return to Sport
• Return to sport is both the ultimate goal of
rehab
• A source of doubt and worry about the
uncertainty of injured athlete’s abilities to
return to a level at or above where they
performed prior to the injury
Approaches
• It can be threat
– Low confidence
– Decreased adherence to
rehab
– Increase in pain
– Display avoidance
behaviors
– Increases anxiety
– Reduced motivation
• It can be challenge
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Positive attitude
High motivation
Excitement
Increased effort in rehab
Greater desire to return to
sport
– Overadherence to rehab
– Greater risk of reinjury due
to permature return
Stages of Return to Sport
Initial Return to Sport
Recovery confirmation
Return of Physical & Technical
Abilities
High Intensity Training
Return to Competition
Initial Stage
• Considered to be the most difficult
• Athlete quickly determines the effectiveness of the
rehabilitation
• Entire stage should include a series of tests of the
healed area
• Athlete’s expectation are:
– They will perform at the same level as prior to the injury
– Pain will not be present
• Discussion with the athlete are needed to examine their
expectations.
• A concern of AT is that athlete become “overzealous” in
their approach to train and compete.
Recovery Confirmation
• More psychological than physical
• Involves the athletes’ obtaining evidence from initial
stage that the injury is healed and ready to face the
demands of the sport participation
• This is considered the make or break period
– Athlete’s initial play will confirm their attitudes and approaches
• Success will lead to higher levels of self-confidence and motivation
– Injury does not swell, no pain, full range of motion,
– Self-confident and motivated
• Not being successful will lead to doubt if they will be able to return.
– Swelling occurs, unexpected pain, little range of motion, decrease
strength
– Highly anxious and depressed
Return of Physical & Technical
Skills
High intensity training marks the absolute
conclusion of athlete’s identification that they are
fully healed.
Re-establishment of their regimen of physical
conditioning and technical training
Major psychological concern is their level of
perceived preparedness:
- Provide a safe,
- progressive conditioning program developed
by the AT or physical trainer
Return to Competition
• First post-injury competition is key concern:
– Athlete is usually more anxious than at any other time
– Initial uncertainty
– Athlete may have a distorted perception of the
probability of the injury occurring again.
• Need to discuss with the athlete’s their attitude
and feeling about the upcoming competition
– Athlete should not be thinking negatively
– Athlete needs to redirect their focus to their skills,
game strategy, and goals.
Fear of Injury: A Major Concern
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Perception that recovery is incomplete,
returning to sport to soon,
impatient in returning to sport,
lack of acceptance of the risk of the sport,
low confidence,
highly anxious,
and preoccupied with being re-injured
Prevention of Fear of Reinjury
Continue involving in the sport during rehab
View rehab as a form of athlete performance
Becoming involved with a coping model
Performance imagery
Give the athlete time to progressively regain
their physical, psychological, and technical
skills.
Treatment of Fear of Injury
• Need to take a proactive approach to
alleviate the fear
– Athlete needs to face a similar situation as
when the injured occurred.
– Rational self-talk helps the athlete refocus
– Simulation practice
– Relaxation techniques
– Athlete establish pre-competition and
competition routines
Self-Determination Model & Return
to Sport
• Ryan & Deci (2000) focused on:
– Competence,
– Autonomy, and
– Relatedness in explaining the athlete’s return
to sport.
• From the self-determination perspective,
the success of an athlete’s return to sport
from injury is related to meeting these
psychological needs
Investigation of Competitive Athletes’ Return to
Sport Following Serious Injury
(Podlog & Eklund, 2004)
• 12 competitive amateur and semiprofessional athletes
• Average length of rehab was 7 months
• Each athlete was interviewed
- 1-2 months
- 3-4 months
- 6-8 months
Findings
Pre-competitive experiences of athletes from
their re-commencement of sport training
until the return of competition
Participant’s experiences following their
return to competition
Competency Issues
Athlete’s fear and concerns of returning to
sport
Loss of enjoyment because they could not
participate in the sport
Injury blocked their short & long term goals
Letting down others, teammates, and
coaches
Issues
Competence Issues
- Fear related to returning to sport
- Injury blocked their sport goals
- Overcoming their fear of reinjury
Competence
Autonomy
Relatedness Issues
- Feels of separation from team
- Support in re-entry into sport
- Having role models
Autonomy Issues
Relatedness
- Sense of personal control
- Pressure to return to sport
Implications
Regarding the assistance and
management of athletes returning
to sport following an injury:
Competence
Autonomy
Rehab environments meet these
three basic needs of the athlete
by:
1) Implementing goal-setting
2) Giving the athlete choices
when to return to sport
3) Provide role models
Relatedness
4) Rehab progress should be
safe and successful
The End